Journal Article

Neuromyelitis Optica Presenting as Non-Communicating Hydrocephalus: A Case Report

Rao, Prajwal, Rohatgi, Shalesh, Naphade, Pravin, Kotharu, Sravya, Nirhale, Satish, Gupta, Sahil

2023

Overview

Neuromyelitis Optica (NMO) is a demyelinating disease predominantly involving optic nerves, spinal cord and peri-ventricular regions which are rich in Aquaporin-4 receptors. Aquaporin-4 (AQP4) antibodies are implicated in the pathogenesis of NMO. Association of hydrocephalus (communicating and non communicating) with NMO is very rare. We report a case of 32 years old female patient who presented with 2 months history of progressive headache, visual obscurations and gait imbalance. Clinical examination revealed bilateral papilloedema with preserved visual acuity. She had truncal and gait ataxia. Rest of the examination of nervous system was normal. MRI brain showed non- communicating hydrocephalus and T2 and FLAIR hyperintensities in periventricular and periaqueductal regions. AQP4 antibodies were positive in serum and negative in cerebrospinal fluid(CSF). Ventriculo - peritoneal shunt was placed and she was treated with steroids and azathioprine. Her headache and visual symptoms improved. However, after 8 months she presented with acute optic neuritis of right eye which was treated with intravenous methylprednisolone and plasmapharaesis.

• Publisher: Wolters Kluwer - Medknow,Medknow Publications and Media Pvt. Ltd,Medknow Publications & Media Pvt. Ltd
• Subject: Aquaporins / Case Report / Case studies / Diagnosis / Hydrocephalus / Neuromyelitis optica