Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Neurofisiopatologia, Dipartimento di neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Mult Scler. 2024 Nov;30(13):1689-1692. doi: 10.1177/13524585241261535. Epub 2024 Jul 30.
A 52-year-old man experienced two seizures in January and June 2021. In October, the neurological examination did not reveal sensory/motor deficits. Brain magnetic resonance imaging (MRI) showed hyperintense lesions with contrast enhancement (CE) involving white matter bilaterally, brainstem, and cerebellum. Spine MRI showed hyperintense C2-C3 and C4-C6 lesions with CE. Anti-aquaporin-4 (AQP4) antibodies were detected, confirming the diagnosis of neuromyelitis optica spectrum disorder (NMOSD). The patient experienced a status epilepticus compatible with treated with antiseizure medications. He was also treated with methylprednisolone, plasma exchange, and rituximab. Status epilepticus can be a rare manifestation of NMOSD, heightening the broad spectrum of AQP4 autoimmunity.
一位 52 岁男性于 2021 年 1 月和 6 月经历了两次癫痫发作。10 月,神经系统检查未发现感觉/运动缺陷。脑部磁共振成像(MRI)显示双侧脑白质、脑干和小脑存在高信号病变伴对比增强(CE)。脊柱 MRI 显示 C2-C3 和 C4-C6 存在高信号病变伴 CE。抗水通道蛋白 4(AQP4)抗体被检测出来,确诊为视神经脊髓炎谱系疾病(NMOSD)。患者发生了符合治疗的癫痫持续状态。他还接受了甲基强的松龙、血浆置换和利妥昔单抗治疗。癫痫持续状态可能是 NMOSD 的一种罕见表现,凸显了 AQP4 自身免疫的广泛谱。