Recurrent Central Nervous System Demyelination with Longitudinally Extensive Transverse Myelitis in a Young Female: A Case of Neuromyelitis Optica Spectrum Disorder

Abstract

Neuromyelitis optica spectrum disorder (NMOSD) is an immune-mediated demyelinating disease of the central nervous system that commonly presents with recurrent neurological deficits and longitudinally extensive transverse myelitis (LETM).¹ ² We report a 33-year-old female with recurrent episodes of left-sided limb weakness. Magnetic resonance imaging revealed a small demyelinating lesion in the brain and a longitudinally extensive cervical spinal cord lesion extending from C3 to C7 with contrast enhancement, a characteristic finding in NMOSD.¹ Cerebrospinal fluid analysis showed lymphocytic pleocytosis and strong positivity for anti–aquaporin-4 antibodies, with negative oligoclonal bands, supporting the diagnosis.² ³The patient showed significant clinical improvement following high-dose intravenous methylprednisolone. Early recognition of NMOSD is crucial to prevent relapses and long-term neurological disability.³ ⁴