NEUROMYELITIS OPTIC, A NECROTIZING DISEASE OF THE CENTRAL-NERVOUS-SYSTEM - REPORT OF 2 CASES

Optic neuromyelitis is characterized by simultaneous or successive nec rotizing lesions involving the optic nerves and the spinal cord. We re port two females with the disease, aged 30 and 34 years old. In the la tter, a neuropathological study was done. Both patients had clinical, neuroradiological and pathological features that differed from those o f primary demyelinating syndromes such as multiple sclerosis. These pa tients illustrate the selectivity of optic nerve and spinal cord lesio ns. The latter involve mainly pyramidal and Goll tracts while, within the necrotizing lesions of the optic chiasma, the fibers of the unaffe cted optic nerve are spared. This pattern suggests a selective injury to some population of axons. Blood vessels were not affected in the ne crotizing areas and the lesions did not follow a vascular territory, t herefore a vascular mechanism causing the disease is unlikely. The cli nical and neuropathological features of neuromyelitis optic suggest a selective involvement of some axons.