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Objective: To present a mother-daughter pair with neuromyelitis optica (NMO) spectrum disorder and discuss what is known about familial NMO.

Background Familial NMO is described but is very rare. The underlying genetics of NMO are unknown.

Design/Methods: Single case report and literature review.

Results: A 77-year-old Caucasian woman with a history of hypertension and hyperlipidemia presented with 5 days of progressive paraparesis and leg numbness, inability to urinate, and severe mid-thoracic back pain. Spine MRI showed a longitudinally extensive transverse myelitis (LETM), centrally located and partially enhancing, with contiguous T2 hyperintensity extending from C2 to the conus medullaris. Brain MRI showed nonspecific white matter hyperintensities consistent with age and medical comorbidities. Spinal fluid showed a protein of 66 mg/dL and white blood cell count of 92 cells/uL (83 …