Cortical blindness: An unusual manifestation of neuromyelitis optica spectrum disorder

Dear Editor, The clinical armamentarium of neuromyelitis optica spectrum disorders (NMOSD) has gradually evolved over the years, encompassing variable involvement of the brain and spinal cord. Episodes of optic neuritis and transverse myelitis are the most common presentations that often pose a diagnostic challenge in differentiating it from multiple sclerosis (MS).[1] The usual cause of vision loss in a patient with NMOSD is optic neuritis, which is more severe and often bilateral as compared to multiple sclerosis.[2] Cortical blindness in NMOSD without optic neuritis is very rare.[3,4]

[1]  S. Ismail,et al.  Extensive Cerebral Cortical Involvement in Aquaporin 4 Antibody Positive Neuromyelitis Optica Spectrum Disorder , 2021, Journal of Neurosciences in Rural Practice.

[2]  Lei Wu,et al.  Cerebral cortex impairment in neuromyelitis optica spectrum disorder: A case report and literature review. , 2019, Multiple sclerosis and related disorders.

[3]  E. Flanagan.  Neuromyelitis Optica Spectrum Disorder and Other Non-Multiple Sclerosis Central Nervous System Inflammatory Diseases. , 2019, Continuum.

[4]  I. Izbudak,et al.  Cortical blindness and not optic neuritis as a cause of vision loss in a Sjögren's syndrome (SS) patient with the neuromyelitis optica spectrum disorder (NMOSD) , 2017, Medicine.

[5]  B. Weinshenker,et al.  Neuromyelitis Spectrum Disorders , 2017, Mayo Clinic proceedings.

[6]  V. Fung,et al.  Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis , 2016, Multiple sclerosis.

[7]  F. Paul,et al.  Neuromyelitis optica: Evaluation of 871 attacks and 1,153 treatment courses , 2016, Annals of neurology.

[8]  Joong-Yang Cho,et al.  Cerebral Cortex Involvement in Neuromyelitis Optica Spectrum Disorder , 2016, Journal of clinical neurology.

[9]  A. Traboulsee,et al.  International consensus diagnostic criteria for neuromyelitis optica spectrum disorders , 2015, Neurology.

[10]  F. Paul,et al.  MRI characteristics of neuromyelitis optica spectrum disorder , 2015, Neurology.

[11]  Ichiro Nakashima,et al.  A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis , 2004, The Lancet.

[12]  B. Weinshenker,et al.  A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease , 1999, Annals of neurology.

[13]  B. Weinshenker,et al.  Short myelitis lesions in aquaporin-4-IgG-positive neuromyelitis optica spectrum disorders. , 2015, JAMA neurology.