Neuromyelitis optica a poruchy jejího širšího spektra – Nytrová Petra (2024)

Clinical presentation, therapy, and differential diagnosis utilizing insights from radiology, neuro-ophthalmology, and laboratory diagnostics. Neuromyelitis optica and disorders of its broader spectrum (NMOSD) are among the autoimmune diseases of the central nervous system. They typically manifest as inflammation of the optic nerves and spinal cord, and less frequently of the brainstem. In most patients, antibodies against aquaporin-4 (AQP4-IgG) are found in serum, which are specific to this disease and play a crucial role in the pathogenesis of the disease in more than about 75% of patients. Common key clinical characteristics include optic neuritis, myelitis, and area postrema syndrome. Despite significant improvements in the diagnostic process due to the availability of AQP4 antibody testing, delays in diagnosis still occur in AQP4-IgG seronegative patients, patients with partial spinal syndromes, older patients, etc. Among the most frequently established misdiagnoses are multiple sclerosis, spinal tumors, ischemic lesions of the optic nerves, neuroinfections, and others. It is also important to distinguish AQP4-IgG positive patients from patients with positivity for antibodies against myelin oligodendrocyte glycoprotein. These antibodies also...