To provide an update on imaging features of neuromyelitis optica (NMO) and multiple sclerosis (MS) on magnetic resonance imaging.
Differentiating these conditions in a tabulated format to serve as a quick radiological review for residents.
NMO and MS are autoimmune inflammatory demyelinating diseases of the CNS with similar clinical manifestations.
However with advent of new diagnostic criteria for NMO and MS,
our understanding of these diseases and their characteristics has improved.[1,2]
NMO autoantibody(AQP4-Ab) detection is specific for diagnosis of NMO,
but radiological diagnosis by MRI still holds importance in antibody negative patients.[1,2]
Differentiation of these two diseases is also crucial as some treatments for MS are totally ineffective in NMO and can even exacerbate it.[3,4]
Findings and procedure details
NMO was first described by Dr.
Allbutt in 1870s and subsequently by Dr.
Eugène Devic in 1894 as a monophasic disease characterized by both severe bilateral optic neuritis and transverse myelitis(TM).[1,5] Later studies showed that NMO is often relapsing rather than a monophasic disorder and authors then considered NMO to be a variant of multiple sclerosis. However with further advances in the past decade initiated by the discovery of the disease-specific autoantibody,
NMO–immunoglobulin G (NMO-IgG),
and subsequent identification of the main target...
Though clinical differentiation between NMO and MS is challenging,
early identification of their characteristic imaging features can aid in its accurate diagnosis and timely management.
Third year resident,
Patil Hospital and Research centre,
1) Bruna Garbugio Dutra,Antônio José da Rocha et al.,
Neuromyelitis Optica Spectrum Disorders: Spectrum of MR Imaging Findings and Their Differential Diagnosis,
Radiographics 2018; 38:169–193.
2) Kim HJ,
MRI characteristics of neuromyelitis optica spectrum disorder: an international update.Neurology.
3) Lalan S,
Differentiation of neuromyelitis optica from multiple sclerosis on spinal magnetic resonance imaging.Int J MS Care.
4) Tatekewa H.,