The Research And Analysis Of Clinical Characteristics Of Neuromyelitis Optica Spectrum Disorders

Objectives Through investigating the features of Neuromyelitis Optica Spectrum Disorders(NMOSD),to better understand the disease,avoid misdiagnosis,timely intervene in the natural course,and reduce disability.Methods 71 NMOSD patients were enrolled,and the clinical,laboratory,and MRI features were assessed.The differences in the time spent for diagnosis and the incidence of pain in the acute stage were compared by grouping the core symptoms.We also compared the incidence of pain in the acute phase of the first episode and the current remission period.AQP4 antibody status was grouped to compare the differences in clinical,laboratory and imaging data.SPSS 23.0 software was used to analyze the above data,and P-values of <0.05 were considered statistically significant.Results 1.The onset age ranged from 13 to 74 years,with an average of 45.87±14.92 years.There were 65 females and 6 males,including 56 AQP4 antibody positive and 15 AQP4 antibody negative patients.The most common onset season is summer and winter.47.9% of the patients had no inducement before onset.26 cases first present with myelitis,26 with optic neuritis(ON),13 cases with ON and myelitis,2 cases with area postrema syndrome(APS),and 4 cases with APS and myelitis.Except the department of ophthalmology(42.3%)and neurology(38.0%),the number of patients in other departments accounted for 19.7%.15 cases coexist with other autoimmune diseases.2.43.5% had residual motor symptoms,63.7% had visual symptoms,and some patients had other sequelaes.Sixty-seven patients took immunosuppressants.3.The time spent for diagnosis in patients onset with myelitis or ON combined with myelitis were both shorter than that in patients onset with ON(P=0.014,P=0.045).The frequency of pain in the acute stage in the patients onset with myelitis was higher than that in the patients onset with ON(P=0.025). 4.45 patients tested tumor marker.14 cases were abnormal,one with breast cancer,and the remained wasn’t diagnosed with tumors during follow-up.Thyroid function was tested in 52 patients,of which 9 patients had decreased FT3.A total of 65 patients tested non-organ specific autoimmune antibody,with a rate of 75.4% antinuclear antibodies(ANA),35.4% anti-Ro-52 antibody,and 26.2% anti-SSA antibody.13 cases were negative,7 in AQP4 antibody positive group and 6 in AQP4 antibody negative(P=0.042).36 patients completed the lumbar puncture,13 patients had elevated cerebrospinal fluid(CSF)white blood cell(WBC)counts,and 20 patients had elevated CSF protein.The AQP4 antibody-positive group and the antibody-negative group had no statistical difference in CSF pressure,WBC counts and protein level.5.65 cases had brain MRI data.44 cases was abnormal.There was no difference between the AQP4 antibody positive group and the AQP4 antibody negative group in the lesion location.50 cases onset with myelitis had spinal MRI data.Most of the lesions was in the cervical and thoracic parts,and 80.0% were continuous.The lesion length ranged from 2 to 19 vertebral segments with a median of 7.No difference was found between the AQP4 antibody positive and negative group.Conclusions 1.NMOSD is prone to young and middle-aged women.The average onset age is 45.87±14.92 years.However,children and the elderly may also suffer from NMOSD.2.Some patients have inducements before onset.The relapse rate may increase during pregnancy and the postpartum period.3.NMOSD patients can coexist with autoimmune diseases.ANAs are often detectable in NMOSD patients without clinical evidence of a autoimmune disease,especially in AQP4 positive cases.4.The time of diagnosis is shorter in patients with myelitis or myelitis combined with ON than patients with simple ON.5.A large proportion of NMOSD patients are accompanied by pain.Patients with onset of myelitis are more likely to accompany pain than patients with onset of ON.6.Patients may have intracranial lesions,and there is no difference in the location of the lesions between the AQP4 antibody positive group and negative group.7.The length of spinal cord lesions is mostly continuous and more than 3 vertebral segments on MRI.In order to avoid missed diagnosis,we should also pay more attention to the short segment myelitis patients.There was no difference in the location or lesion length between the AQP4 antibody positive group and negative group.8.It is necessary to make full use of the 5G era to increase the propaganda of NMOSD,and to raise the awareness of it.