BRAIN and NERVE Shinkei Kenkyu no Shinpo Volume 70, Issue 10 (October 2018)

A Case of Neuromyelitis Optica Spectrum Disease with Hypoglycorrhachia Hiroko Kitanosono 1 , Hiroshi Iwanaga 2 , Hanako Annoura 3 , Tomoaki Shima 2 , Naomi Fukushima 2 , Akira Tsujino 1 1Department of Neurology and Strokology, Nagasaki University Hospital 2Department of Neurology, National Hospital Organization, Nagasaki Medical Center 3National Hospital Organization, Nagasaki Medical Center Keyword: 視神経脊髄炎 , 髄液糖低下 , neuromyelitis optica spectrum disease , hypoglycorrhachia pp.1115-1118
Published Date 2018/10/1
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A 75-year-old Japanese woman developed myelitis 3years prior to her admission. She was diagnosed with HTLV-1-related myelitis and had taken prednisolone. Her myelitis relapsed several times, and serum aquaporin-4 was positive in an ELISA. She developed a sudden headache, consciousness disturbance, dysarthria, and left limb paralysis, and was admitted to our hospital. The CSF analysis revealed pleocytosis dominated by morphonuclear cells and hypoglycorrhachia. Magnetic resonance imaging revealed abnormalities in the corpus callosum, bilateral thalamus, and corticospinal tracts. We initially suspected a relapse of neuromyelitis optica spectrum disorder (NMOSD) and infection. We treated the patient with methylprednisolone pulse and antibacterial and antiviral treatment, which were not effective. Plasmapheresis was performed five times, and she gradually improved. Immunosuppressive treatment was added. It is rare for NMOSD to cause hypoglycorrhachia. This case suggests that infection may trigger an autoimmune response in NMOSD.

(Received February 13, 2018; Accepted July 12, 2018; Published October 1, 2018)

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BRAIN and NERVE-神経研究の進歩
70巻10号 (2018年10月)
電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院