TY - JOUR
T1 - Brainstem manifestations in neuromyelitis optica
T2 - A multicenter study of 258 patients
AU - Kremer, Laurent
AU - Mealy, M.
AU - Jacob, A.
AU - Nakashima, I.
AU - Cabre, P.
AU - Bigi, S.
AU - Paul, F.
AU - Jarius, S.
AU - Aktas, O.
AU - Elsone, L.
AU - Mutch, K.
AU - Levy, M.
AU - Takai, Y.
AU - Collongues, N.
AU - Banwell, B.
AU - Fujihara, K.
AU - De Seze, J.
N1 - Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2014/6
Y1 - 2014/6
N2 - Background: Neuromyelitis optica (NMO) is a severe autoimmune disease of the central nervous system characterized by spinal cord and optic nerve involvement. Brainstem manifestations have recently been described. Objective: To evaluate the time of occurrence, the frequency and the characteristics of brainstem symptoms in a cohort of patients with NMO according to the ethnic background and the serologic status for anti-aquaporin-4 antibodies (AQP4-abs). Methods: We performed a multicenter study of 258 patients with NMO according to the 2006 Wingerchuk criteria and we evaluated prospectively the frequency, the date of onset and the duration of various brainstem signs in this population. Results: Brainstem signs were observed in 81 patients (31.4%). The most frequently observed signs were vomiting (33.1%), hiccups (22.3%), oculomotor dysfunction (19.8%), pruritus (12.4%), followed by hearing loss (2.5%), facial palsy (2.5%), vertigo or vestibular ataxia (1.7%), trigeminal neuralgia (2.5%) and other cranial nerve signs (3.3%). They were inaugural in 44 patients (54.3%). The prevalence was higher in the non-Caucasian population (36.6%) than in the Caucasian population (26%) (p<0.05) and was higher in AQP4-ab-seropositive patients (32.7%) than in seronegative patients (26%) (not significant). Conclusions: This study confirms the high frequency of brainstem symptoms in NMO with a majority of vomiting and hiccups. The prevalence of these manifestations was higher in the non Caucasian population.
AB - Background: Neuromyelitis optica (NMO) is a severe autoimmune disease of the central nervous system characterized by spinal cord and optic nerve involvement. Brainstem manifestations have recently been described. Objective: To evaluate the time of occurrence, the frequency and the characteristics of brainstem symptoms in a cohort of patients with NMO according to the ethnic background and the serologic status for anti-aquaporin-4 antibodies (AQP4-abs). Methods: We performed a multicenter study of 258 patients with NMO according to the 2006 Wingerchuk criteria and we evaluated prospectively the frequency, the date of onset and the duration of various brainstem signs in this population. Results: Brainstem signs were observed in 81 patients (31.4%). The most frequently observed signs were vomiting (33.1%), hiccups (22.3%), oculomotor dysfunction (19.8%), pruritus (12.4%), followed by hearing loss (2.5%), facial palsy (2.5%), vertigo or vestibular ataxia (1.7%), trigeminal neuralgia (2.5%) and other cranial nerve signs (3.3%). They were inaugural in 44 patients (54.3%). The prevalence was higher in the non-Caucasian population (36.6%) than in the Caucasian population (26%) (p<0.05) and was higher in AQP4-ab-seropositive patients (32.7%) than in seronegative patients (26%) (not significant). Conclusions: This study confirms the high frequency of brainstem symptoms in NMO with a majority of vomiting and hiccups. The prevalence of these manifestations was higher in the non Caucasian population.
KW - Anti-aquaporin 4 antibodies
KW - Brainstem
KW - Demyelinating diseases
KW - Epidemiology
KW - Ethnicity
KW - Neuromyelitis optica
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U2 - 10.1177/1352458513507822
DO - 10.1177/1352458513507822
M3 - Article
C2 - 24099751
AN - SCOPUS:84902187911
SN - 1352-4585
VL - 20
SP - 843
EP - 847
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 7
ER -