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Open Access Case report

New onset neuromyelitis optica in a young Nigerian woman with possible antiphospholipid syndrome: a case report

Morenikeji A Komolafe1*, Edward O Komolafe2, Taofiki A Sunmonu1, SO Olateju2, CM Asaleye3, Olufemi A Adesina1 and SA Badmus2

Author Affiliations

1 Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

2 Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

3 Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

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Journal of Medical Case Reports 2008, 2:348  doi:10.1186/1752-1947-2-348

Published: 17 November 2008

Abstract

Introduction

Devic's neuromyelitis optica is an inflammatory demyelinating disease that targets the optic nerves and spinal cord. It has a worldwide distribution and distinctive features that distinguish it from multiple sclerosis. There has been no previous report of neuromyelitis optica from our practice environment, and we are not aware of any case associated with antiphospholipid syndrome in an African person.

Case presentation

We report the case of a 28-year-old Nigerian woman who presented with neck pain, paroxysmal tonic spasms, a positive Lhermitte's sign and spastic quadriplegia. She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome. Her initial magnetic resonance imaging showed a central linear hyperintense focus in the intramedullary portion of C2 to C4. Repeat magnetic resonance imaging after treatment revealed resolution of the signal intensity noticed earlier.

Conclusion

Neuromyelitis optica should be considered in the differential diagnoses of acute myelopathy in Africans. We also highlight the unusual association with antiphospholipid syndrome. Physicians should screen such patients for autoimmune disorders.