Neuromyelitis Optica as an Initial Presentation of Systemic Lupus Erythematosus in a Young Male.

Aquaporin-4 antibodies are hallmark of neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD) that are distinct disease entities. We report a 24-year male with NMO, who presented with Brown-Sequard syndrome. Clinical and laboratory parameters confirmed the diagnosis of systemic lupus erythematosus (SLE). Involvement of sympathetic trunk causing Horner's syndrome and a wide time lapse of 13 years from the occurrence of optic neuritis to myelitis with no relapses in between is a rarity to be seen in NMO associated with SLE.