scholarly journals Influence of Pregnancy on Neuromyelitis Optica From an Ophthalmological Point of View: a Case Report and Literature Review

2021 ◽  
Author(s):  
Fatih Aslan ◽  
Meral Tuğba-Çimşir ◽  
Ece Özdemir-Öktem
Keyword(s):  
Neuromyelitis Optica ◽  
Postpartum Period ◽  
Demyelinating Disease ◽  
Transverse Myelitis ◽  
Point Of View ◽  
Pregnancy And Postpartum ◽  
History Of ◽  
The Central Nervous System ◽  
Changes In Pregnancy ◽  
Sd Oct

Abstract Neuromyelitis Optica (NMO, Devic’s disease) is a rare demyelinating disease of the central nervous system leading to optic neuritis and transverse myelitis. The clinical course of the disease and ocular changes in pregnancy is still not well known. Here, we present the subclinical ophthalmological changes which are evaluated by spectral domain optical coherence tomography (SD-OCT) during the 39 weeks gestation and postpartum period in a pregnant woman with a diagnosis of NMO. Additionally, we present the obstetric and neurologic course of our patient and review the literature. A 30-year-old female with a history of NMO had been ophthalmologically examined and performed SD-OCT every trimester periodically to observe the effects of pregnancy on the disease course. No ophthalmological changes were observed during the pregnancy and postpartum period. Cesarean delivery was preferred due to obstetric indication. The patient was discharged on the second day of postpartum period.

Risk factors for multiple sclerosis, neuromyelitis optica and transverse myelitis

2014 ◽  
Vol 21 (6) ◽  
pp. 703-709 ◽  
Author(s):  
KC Simon ◽  
H Schmidt ◽  
S Loud ◽  
A Ascherio
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Neuromyelitis Optica ◽  
Case Control Study ◽  
Demyelinating Disease ◽  
Transverse Myelitis ◽  
Smoking History ◽  
Gender Study ◽  
History Of ◽  
Control Study

Background: Little is known about risk factors for neuromyelitis optica (NMO) or transverse myelitis (TM). Objective: The objective of this paper is to evaluate whether established multiple sclerosis (MS) risk factors, including smoking history, a history of infectious mononucleosis (IM), anti-EBNA1 Ab titers and HLA-DR15 are associated with NMO or TM. Methods: We conducted a case-control study among participants in the Accelerated Cure Project for Multiple Sclerosis (ACP) Repository, which includes patients with MS, NMO and TM. Controls include related and unrelated individuals without evidence of demyelinating disease. Analyses included 1237 cases of MS, 98 cases of NMO, 133 cases of TM and 488 healthy controls. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were used to assess the association between smoking, HLA-DR15, anti-EBNA1 Ab titers and a history of IM adjusting for gender, study site and ethnicity. Results: Overall, the association between smoking, IM, HLA-DR15 and anti-EBNA1 Ab titers and odds of MS were as expected and no significant interactions were observed. However, there was little evidence of association between these MS risk factors and odds of NMO or TM. Conclusions: Established MS risk factors do not appear to be associated with susceptibility to TM or NMO and, among MS patients, these risk factors appear to act independently.

First Presentation of an Acquired Demyelinating Syndrome

2017 ◽  
Vol 16 (03) ◽  
pp. 164-170
Author(s):  
Rachel Gottlieb-Smith ◽  
Amy Waldman
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Neuromyelitis Optica ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
The Central Nervous System

AbstractAcquired demyelinating syndromes (ADS) present with acute or subacute monofocal or polyfocal neurologic deficits localizing to the central nervous system. The clinical features of distinct ADS have been carefully characterized including optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis. These disorders may all be monophasic disorders. Alternatively, optic neuritis, partial transverse myelitis, and acute disseminated encephalomyelitis may be first presentations of a relapsing or polyphasic neuroinflammatory disorder, such as multiple sclerosis or neuromyelitis optica. The clinical features of these disorders and the differential diagnosis are discussed in this article.

Pregnancy in Patients With AQP4-Ab, MOG-Ab, or Double-Negative Neuromyelitis Optica Disorder

Neurology ◽  
2021 ◽  
Vol 96 (15) ◽  
pp. e2006-e2015
Author(s):  
Nicolas Collongues ◽  
Cecilia Alves Do Rego ◽  
Bertrand Bourre ◽  
Damien Biotti ◽  
Romain Marignier ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Previous History ◽  
International Study ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Double Negative ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Pregnancy And Postpartum ◽  
History Of ◽  
Mog Antibodies ◽  
The Mean

ObjectiveTo analyze the effects of pregnancy on neuromyelitis optica spectrum disorder (NMOSD) according to patients' serostatus and immunosuppressive therapy (IST).MethodsWe performed a retrospective multicenter international study on patients with NMOSD. Patients were tested for aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies (Ab). Informative pregnancies were reported when NMOSD onset occurred before or during pregnancy or up to 12 months postpartum. The mean annualized relapse rate (ARR) was calculated for the 12 months before conception, for each trimester of pregnancy, and postpartum. Events such as miscarriage, abortion, and preeclampsia were reported. IST was considered if taken in the 3 months before or during pregnancy.ResultsWe included 89 pregnancies (46 with AQP4-Ab, 30 with MOG-Ab, and 13 without either Ab) in 58 patients with NMOSD. Compared to the prepregnancy period, the ARR was lower during pregnancy in each serostatus group and higher during the postpartum period in patients with AQP4-Ab (p < 0.01). Forty-eight percent (n = 31) of pregnancies occurred during IST and these patients presented fewer relapses during pregnancy and the 12 months postpartum than untreated patients (26% vs 53%, p = 0.04). Miscarriages occurred in 10 (11%) pregnancies, and were mainly in patients with AQP4-Ab (with or without IST) and a previous history of miscarriage. Preeclampsia was reported in 2 (2%) patients who were AQP4-Ab-positive.ConclusionWe found a rebound in the ARR during the first postpartum trimester that was higher than the prepregnancy period only in AQP4-Ab-positive patients. Taking IST just before or during pregnancy reduces the risk of relapses in these conditions.

THE FAMILY HISTORY OF SPINA BIFIDA CYSTICA

PEDIATRICS ◽  
1965 ◽  
Vol 35 (4) ◽  
pp. 589-595
Author(s):  
John Lorber
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Spina Bifida ◽  
Index Case ◽  
Progressive Increase ◽  
Point Of View ◽  
The Family ◽  
History Of ◽  
The Central Nervous System ◽  
Spina Bifida Cystica

1. The family histories of 722 infants who were born with spina bifida cystica were studied. 2. The index cases were referred for surgical treatment and were not selected in any way from the genetic point of view. 3. Intensive inquiries were made to obtain a complete family pedigree, including a prospective follow-up of siblings born after the index case. 4. Of 1,256 siblings 85 or 6.8% had gross malformation of the central nervous system: spina bifida cystica in 54, anencephaly in 22, and uncomplicated hydrocephalus in 9. 5. Of 306 children born after the index case 25 (8%) or 1 in 12 were affected. 6. There was a progressive increase in multiple cases in the family with increasing family size. In sibships of five or more, multiple cases occurred in 24.1%. 7. In 118 families cases of gross malformation of the central nervous system were known to have occurred among members of the family other than siblings. Cases occurred in three generations. 8. It is possible that spina bifida cystica might be a recessively inherited condition.

scholarly journals Immune system markers of neuroinflammation in patients with clinical diagnose of neuromyelitis optica

2008 ◽  
Vol 66 (3b) ◽  
pp. 678-684 ◽  
Author(s):  
Soniza Vieira Alves-Leon ◽  
Maria Lucia Vellutini Pimentel ◽  
Gabrielle Sant'Anna ◽  
Fabíola Rachid Malfetano ◽  
Cláudio Duque Estrada ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
B Lymphocyte ◽  
Demyelinating Disease ◽  
Interferon Γ ◽  
Interleukin 4 ◽  
Control Group ◽  
Regulatory Cells ◽  
Immunological Parameters ◽  
Healthy Control ◽  
The Central Nervous System

Neuromyelitis optica (NMO) is an inflammatory, demyelinating disease of the central nervous system characterized by the association of a serious myelitis and unilateral or bilateral optic neuritis. The present study aimed to analyze the immunological parameters of NMO patients with diagnosis established based on Wingerchuck et al. (1999) criteria. Production of IgG and IgA antibodies to antigens of MBP, PLP 95-116, MOG 92-106, and the cytokines interleukin-4 (IL-4) and interferon-γ (INF-γ) were assessed by Elisa assay. The cohort was formed by 28 NMO patients and a matched healthy control group. NMO patients had significant high levels of IgG to MOG (p<0.0001), PLP (p=0.0002) and MBP (p<0.0001), and solely IgA to MBP (p<0.0001). INF-γ (p=0.61) levels were similar to healthy controls. Increased production of IL-4 (p=0.0084) indicates an important role for this cytokine in the activation of Th2 regulatory cells and of the IgA producers B lymphocyte indicating activation of humoral immunity.

Cognitive Changes in Pregnancy

2018 ◽  
Author(s):  
Miriam T. Weber
Keyword(s):  
Cognitive Function ◽  
Postpartum Period ◽  
Care Pathway ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Cognitive Changes ◽  
Memory Complaints ◽  
Pregnancy And Postpartum ◽  
Changes In Pregnancy ◽  
In Pregnancy

Subjective memory complaints are commonly reported in pregnancy and the postpartum period. Given the frequency of such complaints, there is great interest in understanding the effects of pregnancy and the postpartum period on objectively measured cognitive function in healthy women, as well as the potential clinical significance of subjective memory complaints (SMC) in this population. In this chapter, we review the literature examining objective cognitive function in pregnant and postpartum women. We focus on studies that employed neuropsychological tests of memory and other domains of cognitive function, discuss the literature on contributions to cognitive changes in pregnancy and postpartum, and outline a care pathway for practitioners encountering pregnant women with cognitive concerns.

Neuromyelitis Optica

2017 ◽  
Author(s):  
Teri L. Schreiner ◽  
Jeffrey L. Bennett
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Optic Neuritis ◽  
Neuromyelitis Optica ◽  
Water Channel ◽  
Transverse Myelitis ◽  
Inflammatory Disorder ◽  
The Central Nervous System

Neuromyelitis optica (NMO), or Devic’s disease is an inflammatory disorder of the central nervous system that preferentially affects the optic nerves and spinal cord. Initially considered a variant of multiple sclerosis (MS), NMO is now clearly recognized to have distinct clinical, radiographic, and pathologic characteristics. Historically, the diagnosis of NMO required bilateral optic neuritis and transverse myelitis; however, the identification of a specific biomarker, NMO-IgG, an autoantibody against the aquaporin-4 (AQP4) water channel, has broadened NMO spectrum disease to include patients with diverse clinical and radiographic presentations. This chapter addresses the diagnosis, pathophysiology, and management of the disease.

scholarly journals The Epidemiology Study in Multiple Sclerosis - Relevance to Natural History

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Jeffrey Sloka
Keyword(s):  
Multiple Sclerosis ◽  
Natural History ◽  
Search Strategy ◽  
Demyelinating Disease ◽  
Epidemiological Studies ◽  
Reference Points ◽  
Specific Reference ◽  
Future Directions ◽  
History Of ◽  
The Central Nervous System

Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system white matter that has been extensively studied using the epidemiological approach, and yet an etiology for the disease remains elusive. This paper presents a review of past publications that have made suggestions toward the design of epidemiological studies in MS. A formal search strategy is described, and a short summary of these papers is provided. A natural history of MS based on previous studies is proposed as a framework for describing future directions in the neuroepidemiology of the disease, and categorization based on the clinical forms of MS is described. Within the context of a proposed natural history, suggestions are made on the use of sub-regionalization in cluster studies across different domains, as well as on the use of specific reference points in a patient's lifetime in the analysis of clusters.

scholarly journals Case Report: Postvaccination Anti–Myelin Oligodendrocyte Glycoprotein Neuromyelitis Optica Spectrum Disorder

2020 ◽  
Vol 22 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Neha Kumar ◽  
Kelsey Graven ◽  
Nancy I. Joseph ◽  
John Johnson ◽  
Scott Fulton ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Transverse Myelitis ◽  
First Trimester ◽  
Acute Disseminated Encephalomyelitis ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Spectrum Disorder ◽  
Aquaporin 4 ◽  
Future Research ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
The Central Nervous System

Abstract Stimulation of the immune response after vaccination can occasionally result in adverse effects, including demyelination of the central nervous system. The most common presentation of postvaccination demyelination is acute disseminated encephalomyelitis, but cases of optic neuritis, transverse myelitis, and multiple sclerosis relapses have been reported. More recently, an increasing number of postvaccination neuromyelitis optica spectrum disorder (NMOSD) cases have surfaced in the literature, especially in patients with aquaporin-4 antibodies. In this article, we report an unusual case of myelin oligodendrocyte glycoprotein antibody–related NMOSD after the receipt of multiple vaccines in a first-trimester pregnant woman from Africa. We review the reported cases of postvaccination demyelination in the past decade, with a focus on the relationship between NMOSD and vaccination in patients with aquaporin-4 or myelin oligodendrocyte glycoprotein antibodies. Finally, we discuss the clinical relevance of the present case and similar reported cases as it relates to patient care in the neuroimmunology clinic and identify potential areas for future research.

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