Very Late-Onset Neuromyelitis Optica Spectrum Disorder
Presenting with Falls and Monoparesis: A Case Report
Pannathat Soontrapa MD1, Varalak Srinonprasert MD1, Wattanachai Chotinaiwattarakul MD2,
Patumporn Suraarunsumrit MD1
Affiliation :
1 Division of Geriatrics, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
2 Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Here, we report a case of very late-onset neuromyelitis optica spectrum disorder [NMOSD] in an 83-year-old female who
presented with monoparesis at right leg and subsequent falling that resulted in right femoral neck fracture. The patient was
initially diagnosed as having lumbar spondylosis with radiculomyelopathy. As the disease progressed, she developed quadriparesis
that resulted from extensive transverse cervical myelitis with positive anti-aquaporin-4 antibody. This (cid:976)inding helped to guide us
to a diagnosis of NMOSD. Accordingly, any patient, regardless of age, that presents with extensive transverse myelitis should be
considered as NMOSD.
Keywords : Neuromyelitis optica, Late-onset, Elderly
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