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NMOSD — SCE Neurology MCQ

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HardMultiple sclerosisNMOSDSCE Neurology

Severe bilateral optic neuritis is followed by a longitudinally extensive cervical myelitis. Serum aquaporin-4 IgG is positive on a cell-based assay. Which diagnosis is established?

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Correct answer: A — Aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder

The best answer is “Aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder”. AQP4-IgG positivity plus core optic-nerve and spinal-cord syndromes establishes NMOSD after reasonable exclusion of alternatives. “Relapsing-remitting multiple sclerosis” can be reasonable in another presentation, but it does not account for the defining feature here. “MOG-antibody-associated disease” can be reasonable in another presentation, but it does not account for the defining feature here. “Acute disseminated encephalomyelitis” can be reasonable in another presentation, but it does not account for the defining feature here. “Subacute combined degeneration” can be reasonable in another presentation, but it does not account for the defining feature here.

Reference: International consensus diagnostic criteria for NMOSD: https://pubmed.ncbi.nlm.nih.gov/26092914/