Neuromyelitis optica or Devic's disease: a childhood case and a review of the literature

Neuromyelitis optical (NMO) or Devic's disease is an uncommon clinical synd rome associating unilateral or bilateral optic neuritis and transverse myel itis within about 8 weeks. Usually reported in adults, childhood cases cons titute a distinctive clinical entity with good visual and neurological prog nosis without long-term recurrence or sequelae. The pathogenesis is explain ed by autoimmune demyelinization triggered by a viral disease. Some authors suggest an infectious cause. The CT scan is usually negative while MRI sho ws nonspecific small foci in the white matter. Unlike multiple sclerosis, t he main differential diagnosis, in NMO the cerebrospinal fluid may show ple ocytosis with elevated protein level without an oligoclonal band. We report a case of neuromyelitis optica occurring in a 4-year-old child following a flu-like syndrome. Clinical outcome was favorable with a short course of h igh-dose corticosteroids.