The log-rank test was used to compare the survival analysis between anti-AQP4 (+) and anti-AQP4 (-) ABS patients. method. The primary study endpoint was the time to NMO conversion, as indicated by the Wingerchuks criteria [18]. The log-rank test was used to compare the survival analysis between anti-AQP4 (+) and anti-AQP4 (-) ABS patients. All valueacute brainstem syndrome, neuromyelitis SB 242084 hydrochloride optica, neuromyelitis optica spectrum disorder, multiple Sclerosis, optic neuritis, cerebrospinal fluid, Kurtzke Expanded Disability SB 242084 hydrochloride Status Scale, a, EDSS scores at the first attack; b, EDSS scores of the last visit of follow-up Brainstem symptoms The brainstem symptoms of 31 ABS patients were listed in Table?2. Five anti-AQP4 (+) patients (35.71?%) experienced recurrent brainstem symptoms before the attacks of ON or myelitis, while only one anti-AQP4 (-) patients (5.88?%, valueacute brainstem syndrome MRI examinations Brain and spinal cord MRI examinations were conducted for all patients. On the sagittal section of brain MRI, the lesions were more frequently occurred in the medulla of anti-AQP4 (+) patients than those in anti-AQP4 (-) SB 242084 hydrochloride patients (78.75?% vs 35.29?%, valueacute brainstem syndrome Open in a separate window Fig. 3 Axial T2-weighted FLAIR MRI shows periependymal lesions are involved in the dorsal midbrain (a, b and f, g; value
Brain MRIsLesions in other brain regions?Juxtacortical0/14 (0)2/17 (11.76?%)2/31 (6.45?%)0.488?Subcortical1/14 (7.14?%)5/17 (29.41?%)6/31 (19.35?%)0.185?Infratentorial14/14 (100?%)17/17 (100?%)31/31 (100?%)Spinal cord MRI?Segments5 (3C7)2 (0C4)3.5 (0C8)0.001?Cervical10/14 (71.43?%)13/17 (76.47?%)23/31 (74.19?%)0.750?Thoracic7/14 (50?%)5/17 (29.41?%)12/31 (38.71?%)0.242?Cervical and thoracic3/14 (21.43?%)1/17 (5.88?%)4/31 (12.90?%)0.199?LETM9/14 (64.29?%)3/17 (17.65?%)12/31 (38.71?%)0.012Meet Barkhof criteria0/14 (0?%)5/17 (29.41?%)5/31 (16.13?%)0.185 Open in a separate window CSF examinations CSF specimens were obtained from all patients at the acute stage (Table?1). The protein concentrations in CSF of anti-AQP4 (+) patients (0.30??0.10?mg/dl) were similar with those of anti-AQP4 (-) patients (0.25??0.12?mg/dl). Rabbit polyclonal to GNRHR Anti-AQP4 (+) patients had a slightly higher number of white blood cells (WBCs) in CSF (11.29??4.27) than anti-AQP4 (-) patients (8.47??2.07). However, the values of IgG index in anti-AQP4 (+) patients were significantly higher than those of anti-AQP4 (-) patients (0.68??0.07 vs 0.42??0.13, p?p?=?0.031) (Table?1). Although the EDSS scores at the first attack were similar between two groups, anti-AQP4 (+) patients presented a significantly higher EDSS scores than anti-AQP4 (-) patients at the last visit of follow-up [5(3C7) VS 2.5(1.5C4.5), p?p?=?0.012) (Fig.?4). Open in a separate window Fig. 4 A survival analysis comparison of the risk of developing to NMO between anti-AQP4 (+) (n?=?14) and anti-AQP4 (-) (n?=?17) patients with ABS (p?=?0.012) Discussion NMO frequently begins with an acute or subacute episode of ON or myelitis. However, brainstem symptoms in NMO were not rare [8, 10C12, 17]. According to the previous studies, brainstem symptoms have recently been described in NMO as well as in NMOSD [10, 12, 13, 17, 21]. In 17.05C30.61?% NMO patients, brainstem symptoms act as the only real manifestation [14 also, 17]. Brainstem symptoms with anti-AQP4 antibodies continues to be recommended in the most recent diagnostic requirements for NMOSD [1] also. Several brainstem symptoms such as for example area postrema scientific brainstem symptoms (including intractable hiccups, nausea and throwing up), diplopia, and bulbar dysfunctions related to lesions in the dorsal area from the medullar as well as the pons encircling the 4th ventricle may be the initial manifestation of symptoms [9, 10, 12, 14]. Our outcomes demonstrated that region postrema scientific brainstem symptoms in anti-AQP4 (+) Stomach muscles.