Clinical Characteristics And Early Disease Msidiagnosis Reasons Analysis Of Neuromyelitis Optica Spectrum Disorder

Objective Discuss our optic myelitis spectrum disease in patients with clinical characteristics and misdiagnosis reasons, improve the understanding of the disease.Methods Application 2015 NMOSD diagnostic criteria of the first affiliated hospital of guangxi medical university in July 2012 to December 2015 were optic myelitis, to diagnose patients with multiple sclerosis, ultimately 100 patients were clinical diagnosis of NMOSD, among which 72 were the original diagnosis of NMO,28 cases the original diagnosis of MS.The clinical and imaging data were retrospectively analyzed, and analyzes the original diagnosis of NMO group for the first time the reason of misdiagnosis and the diagnosis of MS updates for NMOSD.Follow-up is updated NMOSD diagnosed and original clinical NMO group with and without differences between the recurrence rate of 1 year for the first time.Results1. In this study,89 cases of female, male 11, female:male is about 8.09:1; Aged between 12-76, the average age (38.23±13.83), the peaks of 20 to 49 years old.2.33% of patients before the onset of explicit incentive, of which more than the most common respiratory infections, accounting for about 84.9%.13% of patients with autoimmune diseases (see more in dry syndrome).The antibody positive patients accounted for 31%, including the ANA positive, accounting for 19%.3. Most common starting symptoms:vision loss, accounted for 65%, spinal symptoms (46%), brain symptoms accounted for 24%.4. Recurrence of symptoms:100 cases of patients, the most common symptoms of spinal cord, accounting for 64.5%.Followed by the optic nerve symptoms (30.6%) and brain symptoms (9.8%).5. Head MRI abnormality rate was 73%., deep white matter/subcortical area accounted for 53.8%, medulla oblongata (30.8%), brain bridge (16.9%), next to the lateral ventricle (15.4%), midbrain (13.8%), next to the third ventricle (7.7%), cerebellum (6.2%), cerebral hemisphere (4.6%).Spinal cord MRI lesions in neck, chest pulp, involving three or more than three vertebral segment, the involvement of vertebral body more than 5 patients (73.7%).Sagittal position, the lesions were diffuse damage in 49 cases (51.5%), diffuse and line sample damage 22 cases (23.2%), line sample damage 24 cases (25.3%).Shaft on a visible lesions involving the spinal cord grey matter is given priority to, also involving white matter, morphological diversity, a dot, snake eyes, butterfly (H), also can have eccentric sample damage.6. Atypical early symptoms of NMO, easy misdiagnosis.Misdiagnosis in four patients in this study.Among them 2 cases misdiagnosed as acute gastroenteritis,1 case was misdiagnosed as orthostatic hypotension,1 case was misdiagnosed as bile reflux disease.7. Update diagnosed NMOSD group compared with the original diagnosis of NMO group, the recurrence rate of the disease 1 year for the first time differences, with statistical significance (P< 0.05).Conclusion1. NMOSD occurs in young and middle-aged women, diverse clinical symptoms.2. NMOSD can appear brain lesions,the most common in subcortical/deep white matter in the area. And easy involvement of the third ventricle, the midbrain aqueduct, part of the fourth ventricle ependymal weeks. Long segmental spinal cord lesions, line kind of NMOSD has certain diagnostic value.3. NMOSD of the main causes of early misdiagnosis for MS:understanding of NMOSD brain lesion characteristics is inadequate.