ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA BỆNH NHÂN RỐI LOẠN PHỔ VIÊM TỦY THỊ THẦN KINH

Abstract

Objectives: To describe the clinical and paraclinical characteristics of neuromyelitis optica spectrum disorders (NMOSD). Methods: A prospective, descriptive study was conducted on 43 patients treated at the Neurology Department of 108 Military Central Hospital diagnosed with NMOSD according to the 2015 IPND criteria. Results: The disease predominantly affected females (93.4%), with a female-to-male ratio of approximately 20:1. The average onset age was 44.2 ± 13.9 years. The disease showed immune overlap phenomena. Most active episodes presented with a single clinical syndrome. During active disease episodes, acute myelitis and optic neuritis were the most common clinical syndromes,, accounting for 80.5% and 28.3%, respectively; area postrema syndrome 8.8% and acute brainstem syndrome 10.1%. The relapse rate was high, with 65.8% in the first year and 89.6% in the first five years. 90% of patients were positive for anti-AQP4 antibodies, all of whom were female. CSF analysis showed increased CSF protein in 67.9% and increased white blood cells in 37%. MRI findings indicated long-segment myelitis and optic neuritis. Conclusion: The disease is common in females under 50, has a high relapse rate, and most patients are positive for anti-AQP4 antibodies. Clinical findings often include longitudinal extensive tranverse myelitis and optic neuritis, with additional brainstem involvement.