Optic-spinal multiple sclerosis (OSMS) is characterized by the selective and severe involvement of the optic nerves and spinal cord. Typical OSMS is similar to neuromyelitis optica (NMO) in many respects. NMO has distinct laboratory findings from those in classical MS, which are important to understand the unique pathogenesis of NMO. In the cerebrospinal fluid (CSF) examination, oligoclonal IgG bands are negative, and IgG1% is not elevated in NMO. Both Th1- and Th2-associated chemokines are altered in the CSF of NMO as well as classical MS. Neurofilament heavy chain levels in the CSF are elevated in NMO, but not in classical MS, suggesting severer axonal damage in NMO. Unique neuropathological findings in NMO include tissue necrosis, gray matter involvement, and perivascular deposition of immunoglobulins and complements. NMO-IgG is a disease-specific autoantibody for NMO. Complete blindness and longitudinally extensive (> 3 vertebral segments) myelitis are commonly seen in NMO-IgG-positive cases. Some NMO-IgG-positive patients develop such brain lesions as hypothalamic, periaqueductal, and bilateral extensive ones, and they appear to be different from typical lesions of classical MS. A recent multi-center study in Japanese OSMS has revealed that OSMS is classified into two subtypes, 1) NMO and 2) MS with optic-spinal presentation.
|出版ステータス||Published - 2006 11|
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