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Findings

Abnormally enhancing and slightly thickened right optic nerve which extends to the chiasm

Extensive area of T2 hyperintensity and minimal enhancement in the cervical spinal cord (cord is mildly expanded)

Differential diagnosis

ADEM (Acute disseminated encephalomyelitis)

SLE

Sarcoidosis

Behcet’s disease

Devic’s syndrome

Devic’s disease (Neuromyelitis Optica)

Uncommon disease that affects the optic nerves and spinal cord

Optic neuritis and severe transverse myelitis

Usually present with first with optic neuritis in one or both eyes followed by transverse myelitis days to years later.

Two types:

One episode with no recurrence

Repeated episodes of optic neuritis and transverse myelitis separated by months to years

MRI of the brain is usually normal in Devic’s disease

Spinal cord inflammation is usually extensive in Devic’s disease and more patchy in MS

Spinal fluid in Devic’s patients usually do not have elevated antibodies

Relapses are usually more frequent and severe in Devic’s disease

Complications

Blindness

Sudden brief spasms of the arms and legs

Severe damage to the upper spinal cord

Inability to breath

Fatal