Very Late-Onset Neuromyelitis Optica Spectrum Disorder Presenting with Falls and Monoparesis: A Case Report
Pannathat Soontrapa MD1, Varalak Srinonprasert MD1, Wattanachai Chotinaiwattarakul MD2, Patumporn Suraarunsumrit MD1
Affiliation : 1 Division of Geriatrics, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Here, we report a case of very late-onset neuromyelitis optica spectrum disorder [NMOSD] in an 83-year-old female who presented with monoparesis at right leg and subsequent falling that resulted in right femoral neck fracture. The patient was initially diagnosed as having lumbar spondylosis with radiculomyelopathy. As the disease progressed, she developed quadriparesis that resulted from extensive transverse cervical myelitis with positive anti-aquaporin-4 antibody. This (cid:976)inding helped to guide us to a diagnosis of NMOSD. Accordingly, any patient, regardless of age, that presents with extensive transverse myelitis should be considered as NMOSD.
Keywords : Neuromyelitis optica, Late-onset, Elderly
