Dement Neurocogn Disord.  2016 Mar;15(1):20-23. 10.12779/dnd.2016.15.1.20.

Improvement of Frontal Lobe Dysfunctions in Neuromyelitis Optica after Treatment: A Case Report

• Joo J
• Lee SK
• Hwang IH
• Kwon KI
• Ahn BJ
• Yang Y

• KMID: 2442867
• DOI: http://doi.org/10.12779/dnd.2016.15.1.20

Abstract

BACKGROUND
Neuromyelitis optica (NMO) is characterized by optic neuritis and longitudinally extensive transverse myelitis. Generally, the brain had been considered healthy in NMO patients, though recent studies have demonstrated that T2-weighted abnormalities may be observed in various brain regions. Logically, NMO brain lesions are localized at sites of high aquaporin-4 expression.
CASE REPORT
A 68-year-old right-handed man with dysuria, weakness in the bilateral upper and lower limbs, and decreased sensation of the lower extremities, was diagnosed with neuromyelitis optica. The patient was gradually speaking less, was showing reduced interest in hobbies, and had undergone changes in character and behavior. An examination was performed using the Seoul Neuropsychological Screening Battery (SNSB), which revealed that the profile of frontal lobe dysfunctions was prominent as compared with other cognitive domains. The patient was treated with prednisolone and azathioprine for about 1 year without recurrence, and showed prognostic improvement according to further SNSB testing.
CONCLUSIONS
Further studies are considered necessary in order to find the most effective medication regimen for improving cognitive functions in those accurately diagnosed with NMO, and to develop systematic treatment using even more diversified immune-related agents.

Keyword

neuromyelitis optica; frontal function; treatment

MeSH Terms

Aged
Azathioprine
Brain
Dysuria
Frontal Lobe*
Hobbies
Humans
Logic
Lower Extremity
Mass Screening
Myelitis, Transverse
Neuromyelitis Optica*
Optic Neuritis
Prednisolone
Recurrence
Sensation
Seoul
Azathioprine
Prednisolone

Figure

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  Fig. 1 Sagittal T2-weighted image of spine shows diffuse enlargement of cervical and thoracic spinal cord and continuous high signal intensity in the central gray matter from C1 level. Axial fluid-attenuated inversion recovery image of brain shows high signal intensity lesions in the cerebral periventricular and deep white matter.

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