Brain MRI Lesions in Neuromyelitis Optica Spectrum Disorders

A 22-year-old woman presented with vomiting, vertigo, and difficulty in walking. Brain MRI scans showed large T2 weighted lesions in the corpus callosum and periventricular white matter. Initial MRI of the cervical spine was unremarkable, but re-evaluation four months later revealed a longitudinally extensive lesion in the cervical cord and positive serum NMO IgG antibody. Brain MRI abnormalities are not uncommon in NMO Spectrum Disorders (NMOSD) and may precede the occurrence of optic neuritis or transverse myelitis. It is important to recognize brain MRI abnormalities that may assist in investigating NMOSD, leading to timely diagnosis and therapeutic intervention.