engleski

Recurrent optic neuromyelitis with endocrinopathies – case report

Background: Recurrent optic neuromyelitis (RONM) with endocrinopathies is a rare syndrome, primarily described in French Antilles and Brazil. Although it closely resembles multiple sclerosis and Devic's syndrome, it should be regarded as a separate entity because of it s associations with endocrinopathies, stereotypy of recurrences, and the absence of MRI lesions in the cerebral white matter. Case report: In December, 2002, a 44 year-old, female patient with history of hypothyroidism and diabetes mellitus, developed right retrobulbar neuritis with good recovery. In January, 2004, extensive work-up was performed because of acute transverse myelitis with paraplegia, thoracic sensory level and urinary and faecal incontinence. After the treatment with corticosteroids, insignificant improvement of deficit occurred. Nine months later she developed retrobulbar neuritis of the left eye, again with good recovery. In December, 2004, she developed partial myelitis with left hemiparesis and ipsilateral sensory changes in the segmental distribution of the trigeminal nerve and contralateral temperature and pain loss on the body. After treatment with corticosteroids, plasmaferesis and immunoglobulins neurological status was stationary. Results of the neurophysiological tests, CSF studies and magnetic resonance images are discussed. Conclusion: The clinical picture with rapid evolution to paraplegia, endocrine disturbances and CSF and MRI findings lead us to the diagnosis of RONM with endocrinopathies. Throughout the course of the disease, only the optic nerves and the spinal cord were affected, without any evidence of lesions in other parts of the central or peripheral nervous system.

Recurrent optic neuromyelitis; Endocrinopathy; Magnetic resonance imaging

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