Abstract
Background: Neuromyelitis optica (NMO) is an immune-mediated inflammatory disorder of the central nervous system characterized by demyelination and axonal injury, predominantly affecting the optic nerves and spinal cord. In 2015, neuromyelitis optica and its related spectrum disorders were unified under the term neuromyelitis optica spectrum disorder (NMOSD). The International Consensus Diagnostic Criteria were subsequently established, incorporating clinical manifestations, magnetic resonance imaging (MRI) findings, and lesions involving the brain, spinal cord, and optic nerves in patients with either positive or negative aquaporin-4 immunoglobulin G (AQP4-IgG) status. Subjects and Methods: A cross-sectional descriptive study was conducted on 42 patients diagnosed with NMOSD who were hospitalized at the Neurology Center, Bach Mai Hospital. Objective: To describe the clinical and paraclinical characteristics of patients with neuromyelitis optica spectrum disorder. Results: Most patients were younger than 50 years (76.2%, p < 0.05), with a mean age at disease onset of 36.3 ± 12.1 years. Females accounted for 81.0% of cases, yielding a female-to-male ratio of approximately 4:1. Disease relapse occurred in 90.5% of patients. Associated conditions included hyperthyroidism, positive antinuclear antibodies (ANA), and allergic predisposition. The major clinical syndromes included acute myelitis (85.7%), acute optic neuritis (69.0%), area postrema syndrome (19.0%), brainstem/cerebellar syndrome (21.4%), and diencephalic syndrome (11.9%). Serological testing revealed AQP4-IgG positivity in 86.4% of patients (p = 0.000). MRI abnormalities were observed in the brain (42.9%), spinal cord (85.7%), and optic nerves (23.8%). Additional lesion locations included the periventricular brainstem/cerebellar region (26.2%), dorsal medulla (19.0%), hypothalamus/periependymal region surrounding the third ventricle (16.7%), periventricular white matter adjacent to the lateral ventricles (14.3%), and deep cerebral white matter (7.1%). Conclusion: NMOSD predominantly affects young adults and women, is characterized by multifocal central nervous system involvement and a high relapse rate, and frequently results in severe motor disability and visual impairment. Early diagnosis and prompt initiation of appropriate therapy are essential to improve long-term outcomes.
