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The article characterizes late onset of neuromyelitis optica (LONMO) and late onset of neuromyelitis optica spectrum disease (LONMOSD) and examines their predictive factors of disability and death. Both LONMO and LONMOSD are defined by an optic neuritis/longitudinally extensive transverse myelitis with aquaporin-4 antibodies (AQP4-Ab).

Longitudinally extensive transverse myelitis is characteristic but not pathognomonic for neuromyelitis optica spectrum disorders (NMOSDs) and may mimic local tumors. In this retrospective study based on a cohort of 175 NMOSD patients we identified seven patients who initially presented with a longitudinally extensive spinal cord lesion and underwent spinal cord biopsy due to magnetic resonance imaging (MRI)-suspected malignancies. Remarkably, routine neuropathology was inconclusive and did not guide the diagnostic process to anti-aquaporin-4 (AQP4)-seropositive NMOSD. Serious postoperative complications occurred in 5/7 patients and persisted during follow-up in 2/7 patients (29%). Considering these sequelae, AQP4-antibody testing should be mandatory in patients with inconclusive longitudinally extensive spinal cord lesions prior to biopsy. [ABSTRACT FROM PUBLISHER]

The article focuses on a study evaluate the time of occurrence, the frequency and the characteristics of brainstem symptoms in an unbiased cohort of neuromyelitis optica (NMO) patients. Study observed brainstem signs in 81 patients which includes vomiting, hiccups and hearing loss. Study found high frequency of brainstem symptoms in NMO with a majority of vomiting and hiccups.