Case report: Devic's disease

Patient K., 45 years old, male, applied to Tomografiya Medical Centre with complaints about progressive deterioration of vision.

First complaints occurred 1.5 years ago. The man repeatedly applied to an ophthalmologist and was examined at the department of ophthalmology of one of the clinical hospitals in Minsk. No eye disorders were detected.

The presence of abnormal masses was not detected on an MR image of the brain obtained using a 1.5 Tesla MR imaging system. For the record, the examination was preformed twice: Non-enhanced and contrast enhanced MRI.

When the patient applied to Tomografiya Medical Centre, he was referred for MRI of the brain and demyelination protocol using a 3 Tesla MRI system.

The results were evaluated at a multidisciplinary team meeting by the head of the MRI unit, an MRI technologist and a neurologist of the highest category. Upon close examination of thin slices of the brain image, a demyelination process was suspected in the area of optic chiasm.

After the second consultation of our neurologist, the patient was diagnosed as follows: Neuromyelitis optica (Devic's disease). The man was referred to a hospital for a course of special treatment.

P.S. Neuromyelitis optica, or Devic's disease, is a severe demyelinating disorder that was until recently considered a variant of multiple sclerosis, but now it is identified as a separate disease.

The disease most often occurs in adult patients. On average, the first symptoms occur at the age of 40 years or later. Women are more often affected.  Manifestations of neuromyelitis optica include bilateral neuritis (myelitis) of the optic nerve, blindness and paraplegia (palsy of the upper or lower extremities). As a rule, these symptoms occur at the same time, but often one manifestation precedes another. In addition, there are cases associated with unilateral lesion of the optic nerve.