Irresistible hiccups for 15 years culminates in a diagnosis of neuromyelitis optics in Puerto Rican

Neuromyelitis optica is also called Neuromyelitis optics spectrum disorder or Devic’s disease.

Magnetic resonance imaging of axial T2-weighted sequences of the cervical spinal cord. Photo: Case reported to the National Library of Medicine in the United States.

A Puerto Rican woman has been suffering from irreparable hiccups for about 15 years, unaware that it was just a central nervous system disorder known as optic neuromyelitis (NMOSD), which causes a medical signal among health professionals, before this type of diagnosis, which may go unnoticed.

The reported case states that a 46-year-old woman had hiccups when she was 31 (2004). During the trial, she was admitted to a hospital in New York, where her diagnosis has not yet been found, despite the fact that she lost much of her vision in her left eye, according to the report.

After almost 15 years of the first symptom and two severe relapses, he was officially diagnosed with NMOSD in March 2019 when he arrived in Puerto Rico in search of a neurologist, Dr. Angel Cinea, who commissioned an MRI scan of the brain and neck. of the uterus, together with an aquaporin antibody test (AQP4).

In addition, the case report states that she was treated with 500 mg intravenous methylprednisolone for three days to reduce symptoms. After evaluating the tests performed, the patient was officially diagnosed with NMOSD.

Treatment began with rituximab, a monoclonal antibody, in April 2019. However, the lack of response led to a change in therapy with eculizumab, another monoclonal antibody, in August 2019.

In 2020, the patient was again subjected to magnetic resonance imaging of the cervix and brain, which shows a noticeable reduction

in swelling and hyperintensity within the cervical spinal cord without lesions, compared to the first MRI of 2019. In addition, the patient did not experience new relapses.

However, this significant reduction is not observed in all patients with NMOSD, but greater awareness of the disease is needed, especially in Puerto Rico, say the authors of the case, which in turn illustrates the effectiveness of eculizumab therapy and the importance of differentiating clinical, histopathological and neuroimaging characteristics that distinguish inflammatory autoimmune demyelinating disorders such as NMOSD and multiple sclerosis (MS).

IN optic neuromyelitis is a disorder of the central nervous system, which mainly affects the nerves of the eye (optic neuritis) and the spinal cord (myelitis). IN optic neuromyelitis Also called spectrum disorder optic neuromyelitis or Devich’s disease.

Access the case here.