Clinical variability in neuromyelitis optica: three case reports

Three cases of neuromyelitis optica (NMO) admitted in our hospital with a heterogeneous clinical characteristics are presented. Case 1: a middle-aged woman with five acute transverse myelitis episodes and a high latency of the P100 in the visual evoked potentials. The MRI and the NMO antibodies were both negatives. Case 2: a young lady with a two months duration episode of optic neuritis in one eye first, and both myelitis and optic neuritis on the other eye burst secondly, with a very good evolution and positive NMO antibodies. Case 3: a 72 years-old woman with three episodes of acute transverse myelitis. After three years she had two more acute myelitis bursts and finally one optic neuritis, with no lesions in the brain MRI and negative NMO antibodies. The concept of the NMO has changed from its original description. Today it is conceived as a clinical spectrum by a well definite diagnostic criteria, but very heterogeneous as for the clinical characteristics, the outbreak age, or the response to the treatment, since it remains reflected in this three cases.