The clinical profile of NMOSD in Australia and New Zealand

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Bukhari, Wajih
Clarke, Laura
O'Gorman, Cullen
Khalilidehkordi, Elham
Arnett, Simon
Prain, Kerri M
Woodhall, Mark
Silvestrini, Roger
Bundell, Christine S
Ramanathan, Sudarshini
Abernethy, David
Bhuta, Sandeep
Blum, Stefan
Boggild, Mike
Boundy, Karyn
Brew, Bruce J
Brownlee, Wallace
Butzkueven, Helmut
Carroll, William M
Chen, Celia
Coulthard, Alan
Dale, Russell C
Das, Chandi
Dear, Keith
Fabis-Pedrini, Marzena J
Fulcher, David
Gillis, David
Hawke, Simon
Heard, Robert
Henderson, Andrew PD
Heshmat, Saman
Hodgkinson, Suzanne
Jimenez-Sanchez, Sofia
Kilpatrick, Trevor J
King, John
Kneebone, Chris
Kornberg, Andrew J
Lechner-Scott, Jeannette
Lin, Ming-Wei
Lynch, Christopher
Macdonnell, Richard AL
Mason, Deborah F
McCombe, Pamela A
Pereira, Jennifer
Pollard, John D
Reddel, Stephen W
Shaw, Cameron
Spies, Judith
Stankovich, James
Sutton, Ian
Vucic, Steve
Walsh, Michael
Wong, Richard C
Yiu, Eppie M
Barnett, Michael H
Kermode, Allan G
Marriott, Mark P
Parratt, John
Slee, Mark
Taylor, Bruce V
Willoughby, Ernest
Wilson, Robert J
Brilot, Fabienne
Vincent, Angela
Waters, Patrick
Broadley, Simon A
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2020
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Abstract

Neuromyelitis optica spectrum disorders (NMOSD) are an inflammation of the central nervous system associated with autoantibodies to aquaporin-4. We have undertaken a clinic-based survey of NMOSD in the Australia and New Zealand populations with the aim of characterising the clinical features and establishing the value of recently revised diagnostic criteria. Cases of possible NMOSD and age and sex-matched controls with multiple sclerosis (MS) were referred from centres across Australia and New Zealand. Cases were classified as NMOSD if they met the 2015 IPND criteria and remained as suspected NMOSD if they did not. Clinical and paraclinical data were compared across the three groups. NMOSD was confirmed in 75 cases and 89 had suspected NMOSD. There were 101 controls with MS. Age at onset, relapse rates and EDSS scores were significantly higher in NMOSD than in MS. Lesions and symptoms referable to the optic nerve were more common in NMOSD whereas brainstem, cerebellar and cerebral lesions were more common in MS. Longitudinally extensive spinal cord lesions were seen in 48/71 (68%) of cases with NMOSD. Elevations of CSF, white cell count and protein were more common in NMOSD. We have confirmed a clinical pattern of NMOSD that has been seen in several geographical regions. We have demonstrated the clinical utility of the current diagnostic criteria. Distinct patterns of disease are evident in NMOSD and MS, but there remains a large number of patients with NMOSD-like features who do not meet the current diagnostic criteria for NMOSD and remain a diagnostic challenge.

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Journal of Neurology

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267

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5

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Bukhari, W; Clarke, L; O'Gorman, C; Khalilidehkordi, E; Arnett, S; Prain, KM; Woodhall, M; Silvestrini, R; Bundell, CS; Ramanathan, S; Bhuta, S; Heshmat, S; Jimenez-Sanchez, S; Broadley, SA et al, The clinical profile of NMOSD in Australia and New Zealand, Journal of Neurology, 2020, 267 (5), pp. 1431-1443

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