Skip to main content

Advertisement

Log in

Revised diagnostic criteria for neuromyelitis optica (NMO)

Application in a series of suspected patients

  • ORIGINAL COMMUNICATION
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

We analyzed neuromyelitis optica (NMO) IgG in the serum or CSF samples from 46 patients with suspected NMO (28) and limited forms of NMO (18). One hundred and fifteen samples from multiple sclerosis (MS) patients were included as controls. The final clinical diagnosis after follow-up was 16 NMO, 12 MS, 11 transverse myelitis (TM) and seven recurrent optic neuritis (RON). NMO-IgG was detected in 62.5% of NMO, 50% of the recurrent longitudinally extensive TM, 14.3% of the RON but in none of the MS patients. The authors then compared the newly revised diagnostic criteria for NMO with the criteria published in 1999, in the 28 patients with suspected NMO. The revised criteria had higher specificity, and positive and negative predictive value (83.3% vs. 25%; 87.5% vs. 62.5; 83.3% vs. 75%), but slightly lower sensitivity (87.5% vs. 93.7%). Our study confirms NMO-IgG as a highly specific marker of NMO, and the usefulness of the revised diagnostic criteria in predicting a diagnosis of NMO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lucchinetti CF, Mandler RN, McGavern D, Bruck W, Gleich G, Ransohoff RM, Trebst C, Weinshenker B, Wingerchuck D, Parisi JE, Lassmann H (2002) A role for humoral mechanisms in the pathogenesis of Devic’s neuromyelitis optica. Brain 125:1450–1461

    Article  PubMed  Google Scholar 

  2. Mandler RN, Davis LE, Jeffery DR, Kornfeld M (1993) Devic’s neuromyelitis optica: a clinicopathological study of 8 patients. Ann Neurol 34:162–168

    Article  CAS  PubMed  Google Scholar 

  3. O’Riordan JL, Gallagher HL, Thompson AJ, Howard RS, Kingsley DP, Thompson EJ, McDonald WI, Miller DH (1996) Clinical, CSF, and MRI findings in Devic’s neuromyelitis optica. J Neurol Neurosurg Psychiatry 60:382–387

    Article  PubMed  Google Scholar 

  4. Wingerchuck DM, Hogancamp WF, O’Brien PC, Weinshenker BG (1999) The clinical course of neuromyelitis optica (Devic’s syndrome). Neurology 53:1107–1114

    Google Scholar 

  5. Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR (2005) IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 202:473–477

    Article  CAS  PubMed  Google Scholar 

  6. Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, Nakashima I, Weinshenker BG (2004) A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 364:2106–2112

    Article  CAS  PubMed  Google Scholar 

  7. Weinshenker BG, Wingerchuk DM, Vukusic S, Linbo L, Pittock SJ, Lucchinetti CF, Lennon VA (2006) Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis. Ann Neurol 59:566–569

    Article  CAS  PubMed  Google Scholar 

  8. Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG (2006) Revised diagnostic criteria for neuromyelitis optica. Neurology 66:1485–1489

    Article  CAS  PubMed  Google Scholar 

  9. Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GS, Johnson KP, Sibley WA, Silberger DM, Tourtellote WW (1983) New diagnostic criteria for multiple sclerosis; guidelines for research protocols. Ann Neurol 13:227–231

    Article  CAS  PubMed  Google Scholar 

  10. Saiz A, Arpa J, Sagasta A, Casamitjana R, Zarranz JJ, Tolosa E, Graus F (1997) Autoantibodies to glutamic acid decarboxylase in three patients with cerebellar ataxia, late-onset insulindependent diabetes mellitus, and polyendocrine autoimmunity. Neurology 49:1026–1030

    CAS  PubMed  Google Scholar 

  11. Graus F, Vincent A, Pozo-Rosich P, Sabater L, Saiz A, Lang B, Dalmau J (2005) Anti-glial nuclear antibody: marker of lung cancer-related paraneoplastic neurological syndromes. J Neuroimmunol 165:s166–171

    Article  Google Scholar 

  12. Zuliani L, López de Munain A, Ruiz Martínez J, Olascoaga J, Graus F, Saiz A (2006) Anticuerpos IgG-NMO en la neuromielitis óptica: a propósito de 2 casos. Neurología 6:314–317

    Google Scholar 

  13. Ghezzi A, Bergamaschi R, Martinelli V, Trojano M, Tola MR, Merelli E, Mancardi L, Gallo P, Filippi M, Zaffaroni M, Comi G, the Italian Devic’s study group (IDESG) (2004) Clinical characteristics, course and prognosis of relapsing Devic’s neuromyelitis optica. J Neurol 251:47–52

    Article  PubMed  Google Scholar 

  14. Blanche P, Diaz E, Gombert B, Sicard D (2000) Devic’s neuromyelitis optica and HIV-1 infection. J Neurol Neurosurg Psychiatry 68:795–796

    Article  CAS  PubMed  Google Scholar 

  15. Durán E, Gálvez J, Patriagnani G, Izquierdo G (2004) Multiple sclerosis-like illnes in a HIV-1 patient. J Neurol 251:1142–1144

    Article  PubMed  Google Scholar 

  16. Lalive PH, Menge T, Barman I, Cree BA, Genain CP (2006) Identification of new serum autoantibodies in neuromyleitis optica using protein microarrays. Neurology 67:176–177

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to Albert Saiz.

Additional information

Other members of the Spanish–Italian NMO study group are listed below: Spain: Hospital de Basurto, Bilbao (A. Antiguedad); Hospital Clínico San Carlos, Madrid (R. Arroyo; M. Bartolomé; V. de Las Heras); Hospital de Donostia, San Sebastián (A. López de Munain; J. Olascoaga); Hospital Josep Trueta, Girona (L. Ramió); Hospital Germans Trias i Pujol, Badalona (C. Ramo); Hospital La Fe, Valencia (I. Boscá, B. Casanova); Hospital “Rio Carrión” Palencia (AL. Guerrero); Hospital de Valme, Sevilla (RF. Bolaños); Hospital de Viladecans, Viladecans (A. Martínez-Yélamos); Hospital Virgen del Rocío, Sevilla (JL. Casado-Chocán; A. Uclés-Sánchez). Italy: Department of Neuroscience, University of Padua (V. Argentiero); Department of Neurology, Hospital of Treviso (M. Vianello).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saiz, A., Zuliani, L., Blanco, Y. et al. Revised diagnostic criteria for neuromyelitis optica (NMO). J Neurol 254, 1233–1237 (2007). https://doi.org/10.1007/s00415-007-0509-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-007-0509-8

Key words

Navigation