Tan Yeow Leng, Koh Minghe Moses
Department of Rehabilitation Medicine, Singapore General Hospital, Singapore.
Department of General Medicine, Sengkang General Hospital, Singapore.
Surg Neurol Int. 2021 Aug 9;12:396. doi: 10.25259/SNI_677_2021. eCollection 2021.
The occurrence of cervical neuromyelitis optica (NMO) in a patient with a thoracic ependymoma is uncommon. Here, we present a patient with a spinal ependymoma who developed the new onset of NMO 2 months later.
A 66-year-old male presented with right lower limb weakness. The magnetic resonance (MR) revealed an intramedullary spinal cord tumor at the T2-T4 level. It was surgically excised and proved pathologically to be an ependymoma. 2 months later, the patient presented with an acute partial quadriparesis and a high signal intensity cord lesion at the C2-C3 level attributed to seropositive NMO (i.e. additional diagnostic studies confirmed this diagnosis).
Patients with intramedullary thoracic ependymomas may also develop NMO resulting in recurrent/ new neurological deficits. Critical studies utilized to diagnose NMO include brain and spine MRs showing unique intramedullary brain/cord lesions, aquaporin-4 positive serology, and classical abnormal visual studies. If the diagnosis of NMO is established, multiple additional medical therapies are warranted.
胸段室管膜瘤患者发生颈髓视神经脊髓炎（NMO）并不常见。在此，我们报告一名脊髓室管膜瘤患者，其在2个月后新发NMO。
一名66岁男性因右下肢无力就诊。磁共振成像（MR）显示T2 - T4水平髓内脊髓肿瘤。手术切除后病理证实为室管膜瘤。2个月后，患者出现急性部分四肢轻瘫，C2 - C3水平脊髓病变呈高信号，归因于血清学阳性的NMO（即其他诊断性检查确诊了该诊断）。
胸段髓内室管膜瘤患者也可能发生NMO，导致复发/新的神经功能缺损。用于诊断NMO的关键检查包括脑部和脊柱MR显示独特的脑内/脊髓髓内病变、水通道蛋白-4血清学阳性以及典型的异常视觉检查。如果确诊为NMO，则需要多种额外的药物治疗。
