Intractable vomiting as the initial presentation of neuromyelitis optica

Metha Apiwattanakul; Bogdan F. Popescu; Marcelo Matiello; Brian G. Weinshenker; Claudia F. Lucchinetti; Vanda A. Lennon; Andrew McKeon; Adam F. Carpenter; Gary M. Miller; Sean J. Pittock

doi:10.1002/ana.22121

Intractable vomiting as the initial presentation of neuromyelitis optica

Metha Apiwattanakul, Bogdan F. Popescu, Marcelo Matiello, Brian G. Weinshenker, Claudia F. Lucchinetti, Vanda A. Lennon, Andrew McKeon, Adam F. Carpenter, Gary M. Miller, Sean J. Pittock

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130 Scopus citations

Abstract

We report 12 aquaporin-4 antibody-positive patients (12% of seropositive Mayo Clinic patients identified since 2005) whose initial presenting symptom of neuromyelitis optica was intractable vomiting. The initial evaluation in 75% was gastroenterologic. Vomiting lasted a median of 4 weeks (range, 2 days-80 weeks). Optic neuritis or transverse myelitis developed after vomiting onset in 11 patients (median interval, 11 weeks; range, 1-156). At last evaluation (median, 48 months after vomiting onset), 7 patients fulfilled neuromyelitis optica diagnostic criteria. Our clinical, pathologic and neuroimaging observations suggest the aquaporin-4-rich area postrema may be a first point of attack in neuromyelitis optica. Ann Neurol 2010;68:757-761

Original language	English (US)
Pages (from-to)	757-761
Number of pages	5
Journal	Annals of neurology
Volume	68
Issue number	5
DOIs	https://doi.org/10.1002/ana.22121
State	Published - Nov 2010

ASJC Scopus subject areas

Neurology
Clinical Neurology

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title = "Intractable vomiting as the initial presentation of neuromyelitis optica",

abstract = "We report 12 aquaporin-4 antibody-positive patients (12% of seropositive Mayo Clinic patients identified since 2005) whose initial presenting symptom of neuromyelitis optica was intractable vomiting. The initial evaluation in 75% was gastroenterologic. Vomiting lasted a median of 4 weeks (range, 2 days-80 weeks). Optic neuritis or transverse myelitis developed after vomiting onset in 11 patients (median interval, 11 weeks; range, 1-156). At last evaluation (median, 48 months after vomiting onset), 7 patients fulfilled neuromyelitis optica diagnostic criteria. Our clinical, pathologic and neuroimaging observations suggest the aquaporin-4-rich area postrema may be a first point of attack in neuromyelitis optica. Ann Neurol 2010;68:757-761",

author = "Metha Apiwattanakul and Popescu, {Bogdan F.} and Marcelo Matiello and Weinshenker, {Brian G.} and Lucchinetti, {Claudia F.} and Lennon, {Vanda A.} and Andrew McKeon and Carpenter, {Adam F.} and Miller, {Gary M.} and Pittock, {Sean J.}",

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AU - Apiwattanakul, Metha

AU - Popescu, Bogdan F.

AU - Matiello, Marcelo

AU - Weinshenker, Brian G.

AU - Lucchinetti, Claudia F.

AU - Lennon, Vanda A.

AU - McKeon, Andrew

AU - Carpenter, Adam F.

AU - Miller, Gary M.

AU - Pittock, Sean J.

PY - 2010/11

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AB - We report 12 aquaporin-4 antibody-positive patients (12% of seropositive Mayo Clinic patients identified since 2005) whose initial presenting symptom of neuromyelitis optica was intractable vomiting. The initial evaluation in 75% was gastroenterologic. Vomiting lasted a median of 4 weeks (range, 2 days-80 weeks). Optic neuritis or transverse myelitis developed after vomiting onset in 11 patients (median interval, 11 weeks; range, 1-156). At last evaluation (median, 48 months after vomiting onset), 7 patients fulfilled neuromyelitis optica diagnostic criteria. Our clinical, pathologic and neuroimaging observations suggest the aquaporin-4-rich area postrema may be a first point of attack in neuromyelitis optica. Ann Neurol 2010;68:757-761

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Intractable vomiting as the initial presentation of neuromyelitis optica

Abstract

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