상향안진과 난치성 구토로 발현한 시신경척수염범주질환

• Published in: Research in vestibular science pp. 50 - 53
• Main Authors: 김현수, 김재명, 남태승, 이승한
• Format: Journal Article
• Language: Korean
• Published: 대한평형의학회 01.06.2019
• Subjects: 신경과학
• ISSN: 2092-8882; 2093-5501
• DOI: 10.21790/rvs.2019.18.2.50

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory demy-elinating autoimmune disease of central nervous system characterized by relapsing attacks that target the optic nerves and spinal cord, as well as aquaporin-4 (AQP4) enriched periventricular brain regions. The area postrema (AP), located in the dorsal medulla, is the chemosensitive vomiting center and has high AQP-4 expression. The AP syndrome with unexplained hiccups, nausea, and vomiting is one of the core clinical characteristics in the NMOSD and maybe the first presenting symptom. We experienced a 25-year-old woman presented with intractable vomiting, dizziness and oscillopsia. Upbeat nystagmus detected on the bedside examination led to comprehensive neurological workups including magnetic resonance imaging, and she was diagnosed as the AP syndrome. Ten months later, she experienced a recurrence as a longitudinally extensive transverse myelitis and the diagnosis was finally compatible with NMOSD without AQP4-IgG. NMOSD, especially the AP syndrome, should be considered in any dizzy patient with intractable vomiting, and detailed neuro-otologic and neuro-ophthalmologic examinations are warranted for the correct diagnosis. KCI Citation Count: 0