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Acute Cervical Segmental Denervation in Neuromyelitis Optica Spectrum Disorder

Mingbunjerdsuk, Prompan MD; Katirji, Bashar MD

Journal of Clinical Neuromuscular Disease: December 2014 - Volume 16 - Issue 2 - p 90–97
doi: 10.1097/CND.0000000000000060
Case Review

Objectives: Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of central nervous system. We report a case of NMO spectrum disorder that developed acute cervical segmental denervation during an episode of transverse myelitis.

Methods: Case report and a literature review.

Results: A 69-year-old woman presented with right leg weakness, which improved in 2 weeks of intravenous methylprednisolone. Six weeks later, she returned with recurrent transverse myelitis followed by left hand weakness and atrophy. Electromyography showed active denervation on left C8/T1-innervated muscles. Magnetic resonance imaging of thoracic spine showed patchy T2-signal enhancement from T10 to lower cervical spine. NMO antibody was positive. Review of literature revealed 5 cases of cervical transverse myelitis that developed denervation on electromyography.

Conclusions: Segmental denervation may occur in NMO and variants resulting from severe myelitis extending to involve gray and white matter leads to anterior horn cell loss.

Neurological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH.

Reprints: Prompan Mingbunjerdsuk, MD, Department of Neurology, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106 (e-mail:

The authors report no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins