Edorium Journal of

Neurology

 
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Case Report
 
Neuromyelitis optica spectrum disorder presenting as Brown-Sequard syndrome
Abhinav Agrawal1, Dennis Lourdusamy1, Abhishek Agarwal2, Neil R. Holland3
1Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA.
2Department of Internal Medicine, Cooper University Hospital, Camden, New Jersey, USA.
3Section of Neurology, Monmouth Medical Center, Long Branch, New Jersey, USA.

Article ID: 100002N06AA2015
doi:10.5348/N06-2015-2-CR-1

Address correspondence to:
Abhinav Agrawal
MD, Department of Internal Medicine, Monmouth Medical Center
Long Branch, New Jersey-07740
USA
Phone: abhinav72@gmail.com

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How to cite this article
Agrawal A, Lourdusamy D, Agarwal A, Holland NR. Neuromyelitis optica spectrum disorder presenting as Brown-Sequard syndrome. Edorium J Neurol 2015;2:1–4.


Abstract
Introduction: Brown - Sequard syndrome (BSS) presents with features of ipsilateral motor function loss and contralateral loss of pain and temperature. It is most commonly caused from trauma/stab injuries and is also known to be be caused by multiple sclerosis. Here, we are presenting a rare case of neuromyelitis optica spectrum disorder (NMOSD) presenting as Brown - Sequard syndrome.
Case Report: A 70-year-old female presented the emergency room with a 2–3 day history of abrupt onset weakness in her left leg. Magnetic resonance imaging (MRI) scan of the spine showed T2 hyperintense signal seen within the upper thoracic cord centered at T2–T5 level with mild expansion of the cord. A diagnosis of neuromyelitis optica (NMO) spectrum disorder was made based on positive AQP4 antibody titres.
Conclusion: This case underscores the clinical diversity of NMO spectrum disorder, and suggests that we should probably be checking NMO antibody status in more patients with unexplained myelopathy.

Keywords: AQP4 antibody, Brown - Sequard syndrome, Devic disease, Multiple sclerosis, Spinal cord, Traumatic injury, Neuromyelitis optica


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Author Contributions
Abhinav Agrawal – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Dennis Lourdusamy – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Abhishek Agarwal – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Neil R. Holland – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Abhinav Agrawal et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Abhinav Agrawal attended Government Medical College in Kolhapur, India and is currently a Resident in the Department of Internal Medicine at Monmouth Medical Center in the United States. He intends to purse a fellowship career in Pulmonary and Critical Care Medicine. His research interests include pulmonary hypertension, pancreatic involvement in critically ill patients and septic shock among others.



Dennisdhilak Lourdusamy attended Stanley Medical College in Chennai, India and currently a Resident in the Department of Internal Medicine at Monmouth Medical Center in the United States.



Abhishek Agarwal attended Government Medical College in Kolhapur, India and is currently a Resident in the Department of Internal Medicine at Cooper University Hospital in the United States. He intends to pursue a fellowship career in Pulmonary and Critical Care Medicine and his research interests include septic shock and interventional pulmonology amongst others.



Neil Holland attended UCL Medical School in London, UK, and trained in neurology at the Johns Hopkins University and Hospital in Baltimore. He was formerly Neurology Section Chief and Site Clerkship Director at Monmouth Medical Center in Long Branch NJ. He is currently Director of Neurology for Geisginger's North East Pennsylvania region, and in addition to his administrative responsibilities he practices and teaches neurology and neuromuscular medicine in Wilkes-Barre and Scranton.




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