Neuromielite Óptica (Doença de Devic): Relato de Caso e Revisão dos Critérios Diagnósticos

• Autor(a) principal: Neri, Vanderson Carvalho
• Data de Publicação: 2010
• Outros Autores: Dias Mendonça, Tatiane Vieira, Alvarenga, Regina Maria Papais
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Científica da Faculdade de Medicina de Campos
• Texto Completo: https://www.fmc.br/ojs/index.php/RCFMC/article/view/123
• topic: Neuromielite óptica; diagnóstico; diagnóstico diferencial; Neuromyelitis óptica; diagnosis; diferential diagnosis.

Introduction: Neuromyelitis Optica (NMO) is an inflammatory, demyelinating autoimmune and necrotizing disorder of Central Nervous System (CNS) clinically characterized by the involvement of the optic nerve and spinal cord. Objective: To report a case of NMO and discuss the diagnostic criteria for this disorder. Methods: Review of medical record and literature review. Case Report: An diabetic patient, Afro-Brazilian, in 1996, at age 10, fell from height, progressing to paraplegia and areflexia, presenting after 24 hours with flaccid quadriplegia and respiratory failure requiring ventilator assistance. In 1998 showed bilateral visual loss, with spontaneous remission. The following month showed a similar episode, and performed Magnetic Resonance Imaging (MRI) of brain, which was normal  except for optic nerve injury. In 1999, new episode of sudden paraplegia. New outbreaks of bilateral optic neuritis occurred in subsequent months. Received after the outbreaks pulse therapy with methylprednisolone (EV), achieving partial improvement. Imaging examinations showed inflammatory lesions in bilateral optic nerve and cervical spinal cord. The patient recovered motor deficits, but remained with impairment of visual acuity. Conclusion: The new criteria of NMO according Wingerchuk 2006 are based on MRI data indicate normal skull and extensive spinal cord injuries. The evolution of this case resembles those described in the literature of severe bilateral visual dysfunction and multiple events restricted to the spinal cord and optic nerve.