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Mimiwati Zahari
Nor Fadhilah Mohamad


Title: To report a case of paediatric Neuromyelitis 0ptica (NMO)

Objective: To report a case of paediatric Neuromyelitis 0ptica (NMO)

Method: Case report

A 14-year-old girl presented with right eye blurring of vision for 4 days associated with acute bilateral lower limb weakness and urinary incontinence. At presentation, visual acuity on the right eye was counting fingers and left eye vision was 6/9 with positive relative afferent pupillary defect. Light brightness and red saturation were reduced to 50% as compared to left eye with right central visual field defect. The anterior segments and funduscopy of both eyes were normal.
On systemic examination, there were upper motor neuron signs and segmental sensory loss from T1-L2. Powers for both upper and lower limbs were reduced with hyperreflexia. Blood investigation for Aquaporin 4 Ab was positive. Magnetic Resonance Imaging spine showed longitudinal extensive transverse myelitis.
She was given intravenous methylprednisolone 1gram daily for 5 days followed with tapering dose of oral prednisolone. She completed 5 cycles of plasmapheresis. Subsequently, she has near complete recovery with normal lower limb power. Her right eye vision has improved significantly to 6/9. She completed 3 cycles of Rituximab infusion.
Conclusion: This case report highlights the importance in early diagnosis of paediatric neuromyelitis optica and prompt treatment will ensure better prognosis of disease
Conflict of interest: The authors declare no conflict of interest.
Keyword: Paediatric, Neuromyelitis optica, Immunomodulatory, plasmapheresis


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