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Spinal cord lesions in patients with neuromyelitis optica: a retrospective long-term MRI follow-up study

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Abstract

Neuromyelitis optica (NMO) is characterised by a particular pattern of the optic nerves and the spinal cord. Long-term MRI follow-up studies of spinal NMO lesions are rare, or limited by short observation periods. In nine patients with definite NMO or recurrent longitudinally extensive transverse myelitis (LETM) with NMO-IgG serum antibodies, repeated MRI examinations of the spine were carried out over a period of up to 11 years and evaluated regarding the changes over time in this retrospective study. In eight patients spinal cord lesions were located centrally, involving the grey and white matter. In the first examination after clinical onset changes resembled a stroke of the anterior spinal artery in two patients. Symmetrical signal alterations within the grey matter were observed. In one patient this pattern was transient, but it remained in the other. During the chronic stage, either a variable degree of spinal cord atrophy and high signal alterations, or almost complete remission of the lesions, was observed. Spinal MRI of patients with NMO myelitis can resemble a stroke. MRI of acute NMO stages did not allow a prediction of the clinical outcome. To a variable degree, NMO left behind typical defects which correlated with the clinical outcome.

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Abbreviations

MRI:

magnetic resonance imaging

MS:

multiple sclerosis

NMO:

neuromyelitis optica

LETM:

longitudinally extensive transverse myelitis

References

  1. Wingerchuk DM, Lennon VA, Lucchinetti CF et al (2007) The spectrum of neuromyelitisoptica. Lancet Neurol 6:805–815

    Article  PubMed  CAS  Google Scholar 

  2. Devic E (1894) Myélite subaiguë compliquée de névrite optique. Bull Méd (Lyon) 8:1093–1094

    Google Scholar 

  3. Wingerchuk DM, Pittock SJ, Lucchinetti CF et al (2007) A secondary progressive clinical course is uncommon in neuromyelitis optica. Neurology 68:603–605

    Article  PubMed  CAS  Google Scholar 

  4. Lennon VA, Wingerchuk DM, Kryzer TJ et al (2004) A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 364:2106–2112

    Article  PubMed  CAS  Google Scholar 

  5. Lucchinetti CF, Mandler RN, McGavern D et al (2002) A role for humoral mechanisms in the pathogenesis of Devic’s neuromyelitis optica. Brain 125:1450–1461

    Article  PubMed  Google Scholar 

  6. Pittock SJ, Lennon VA, Krecke K et al (2006) Brain abnormalities in neuromyelitis optica. Arch Neurol 63:390–396

    Article  PubMed  Google Scholar 

  7. Wingerchuk DM, Lennon VA, Pittock SJ et al (2006) Revised diagnostic criteria for neuromyelitis optica. Neurology 66:1485–1489

    Article  PubMed  CAS  Google Scholar 

  8. Jarius S, Aboul-Enein F, Waters P et al (2008) Antibody to aquaporin-4 in the long term course of neuromyelitis optica. Brain 131(Pt 11):3072–3080. doi:10.1093/brain/awn240

    Article  PubMed  CAS  Google Scholar 

  9. Stepper F, Lövblad KO (2001) Anterior spinal artery stroke demonstrated by echo-planar DWI. Eur Radiol 11:2607–2610

    Article  PubMed  CAS  Google Scholar 

  10. Hundsberger T, Thömke F, Hopf HC et al (1998) Symmetrical infarction of the cervical spinal cord due to spontaneous bilateral vertebral artery dissection. Stroke 29:1742

    PubMed  CAS  Google Scholar 

  11. Aboul-Enein F, Rauschka H, Kornek B et al (2003) Preferential loss of myelin-associated glycoprotein reflects hypoxia-like white matter damage in stroke and inflammatory brain diseases. J Neuropathol Exp Neurol 62:25–33

    PubMed  CAS  Google Scholar 

  12. Aboul-Enein F, Lassmann H (2005) Mitochondrial damage and histotoxic hypoxia: a pathway of tissue injury in inflammatory brain disease? Acta Neuropathol 109:49–55

    Article  PubMed  CAS  Google Scholar 

  13. Auer RN, Dunn JF, Sutherland GR (2008) Hypoxic and related conditions. Greenfield’s neuropathology, 8th edn. Oxford University Press, Oxford, pp 63–119

    Google Scholar 

  14. Ferrer I, Kaste M, Kalimo H (2008) Vascular diseases. Greenfield’s neuropathology, 8th edn. Oxford University Press, Oxford, pp 121–220

    Google Scholar 

  15. Zhang J, Huan Y, Qian Y et al (2005) Multishot diffusion-weighted imaging features in spinal cord infarction. J Spinal Disord Tech 18:277–282

    PubMed  Google Scholar 

  16. Kastrup O, Wanke I, Maschke M (2005) Neuroimaging of infections. NeuroRx 2:324–332

    Article  PubMed  Google Scholar 

  17. Faig J, Busse O, Salbeck R (1998) Vertebral body infarction as a confirmatory sign of spinal cord ischemic stroke: report of three cases and review of the literature. Stroke 29:239–243

    PubMed  CAS  Google Scholar 

  18. Suzuki T, Kawaguchi S, Takebayashi T et al (2003) Vertebral body ischemia in the posterior spinal artery syndrome: case report and review of the literature. Spine 28:260–264

    Article  Google Scholar 

  19. Wiendl H, Strayle-Batra M, Schulz JB (2002) Very bright dorsal columns: spinal magnetic resonance imaging in funicular myelosis. Arch Neurol 59:147–148

    Article  PubMed  CAS  Google Scholar 

  20. Wingerchuk DM, Weinshenker BG (2003) Neuromyelitis optica: clinical predictors of a relapsing course and survival. Neurology 60:848–853

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, SMZ-Ost Donauspital, 1220, Langobardenstrasse 122, Vienna, Austria

    Wolfgang Krampla & Walter Hruby

  2. Department of Neurology, SMZ-Ost Donauspital, 1220, Langobardenstrasse 122, Vienna, Austria

    Fahmy Aboul-Enein, Julia Jecel & Wolfgang Kristoferitsch

  3. Department of Neurology, Hospital of Barmherzige Brueder, 1020, Gr. Mohrengasse 9, Vienna, Austria

    Wilfried Lang

  4. Department of Neurology, Krankenanstalt Rudolfstiftung, 1030, Juchgasse 25, Vienna, Austria

    Elisabeth Fertl

Authors
  1. Wolfgang Krampla
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  2. Fahmy Aboul-Enein
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  3. Julia Jecel
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  4. Wilfried Lang
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  5. Elisabeth Fertl
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  6. Walter Hruby
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  7. Wolfgang Kristoferitsch
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Correspondence to Wolfgang Krampla.

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Krampla, W., Aboul-Enein, F., Jecel, J. et al. Spinal cord lesions in patients with neuromyelitis optica: a retrospective long-term MRI follow-up study. Eur Radiol 19, 2535–2543 (2009). https://doi.org/10.1007/s00330-009-1425-3

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  • DOI: https://doi.org/10.1007/s00330-009-1425-3

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