Frequency of non optico-spinal manifestation in neuromyelitis optica spectrum disorder at tertiary care hospital in Pakistan

Abstract

Objective: To determine the frequency of non-optico-spinal manifestations in neuromyelitis optica spectrum disorder patients in a tertiary care setting.

Method: The observational study was conducted from February 1 to November 30, 2025, at the Department of Neurology, Dr Ruth K.M. Pfau Civil Hospital, Karachi, and comprised patients aged at least 18 years with confirmed neuromyelitis optica spectrum disorder diagnosis based on the 2015 International Panel for Neuromyelitis Optica Diagnosis criteria. Data included demographics, clinical features, anti-aquaporin-4 antibody status and magnetic resonance imaging findings. Data was analysed using SPSS 25.

Results: Of the 65 patients with mean age 31.17±10.33 years, 47(72.3%) were female, and 32(49.2%) had at least one optico-spinal manifestation. Non-optico-spinal symptoms appeared only alongside core symptoms, with area postrema syndrome being the most common feature 13(20%). Brainstem lesions were observed in 9(13.8%) patients and cerebral lesions in 5(7.7%), with corresponding magnetic resonance imaging abnormalities observed in these patients. The mean disability score was 3.88±2.98, indicating moderate disability.

Conclusion: Comprehensive clinical and radiological evaluation in neuromyelitis optica spectrum disorder patients was found to be of critical importance.

Key Words: Demyelinating disorders, Neuromyelitis optica spectrum disorders, Optic neuritis, Transverse myelitis, Acute brainstem syndrome.