Two Cases of Very-Late-Onset Neuromyelitis Optica Spectrum Disorder (NMOSD) in Patients over the Age of 80

• Published in: Case reports in neurology Vol. 12; no. 1; pp. 13 - 17
• Main Authors: Fujiwara, Shunya, Manabe, Yasuhiro, Morihara, Ryuta, Yunoki, Taijun, Kono, Syoichiro, Narai, Hisashi, Abe, Koji
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2020; Karger Publishers
• Subjects: Age; anti-aquaporin-4 antibody; Antibodies; Case reports; Hospitalization; Hospitals; Inflammatory diseases; Magnetic resonance imaging; Medical diagnosis; Nervous system; Neurology; neuromyelitis optica; Older people; Single Case – General Neurology; Spinal cord; transverse myelopathy; very late onset; Japan; Anti-aquaporin-4 antibody; Neuromyelitis optica; Transverse myelopathy; Very late onset
• ISSN: 1662-680X; 1662-680X
• DOI: 10.1159/000505231

We report two cases of very-late-onset neuromyelitis optica spectrum disorder (NMOSD) in patients over the age of 80 with transverse myelopathy as the initial manifestation. In both cases, the patients presented with paraplegia and sensory, bladder, and rectal disturbances. Thoracic magnetic resonance imaging showed longitudinal high-intensity signals on a T2-weighted image. The patients received high-dose methylprednisolone. Their serum was positive for anti-AQP4 antibody (cell-based assay) during the clinical course. They were diagnosed with NMOSD and treated with immunoadsorption, plasmapheresis, and followed up with daily prednisolone. Very-late-onset NMOSD in patients over the age of 80 has only rarely been reported. The present cases suggest that NMOSD should be considered for elderly patients presenting with transverse myelitis. Early diagnosis and treatment are important.