Neuromyelitis Optica Spectrum Disorder Associated with Cervical Spondylosis.

A 44‐year‐old woman was admitted to our hospital with a 10‐day history of ache of double upper limbs and numbness on the trunk below the chest and bilateral thighs. Ten days before, she had an onset of ache of double upper limbs without apparent inducement. At the same time, she developed trembling on hands when writing and numbness between the chest and bilateral knees, which were unable to be alleviated. At admission, she presented with hypoesthesia of superficial sensibility from bilateral costal margins to knees, positive bilateral Hoffman sign, and Babinski sign. Magnetic resonance imaging (MRI) [Figure 1a] of cervical vertebrae showed: (1) Cervical intervertebral disc herniation (C3–C7); (2) Intramedullary lesions with edema (C2–T2); (3) Cervical spondylolisthesis (C3–C5). She was admitted to our hospital with a presumptive diagnosis of cervical spondylosis and intramedullary lesions with edema (C2–T2). After admission, she was given dehydration, anti‐inflammatory, nerve nutrition, and symptomatic treatment immediately. Subsequent lumbar puncture showed results of cerebrospinal fluid routine were normal with normal protein, glucose, and chloride levels. Serum aquaporin‐4 (AQP‐4) antibody was tested by enzyme‐linked immunosorbent assay and showed positive. Also, visual evoked potential, brainstem auditory evoked potential, and somatosensory evoked potential were normal. All told that she was diagnosed as NMOSD as well as cervical spondylosis. Then, she received methylprednisolone (500 mg) impact therapy and sequential reduction of hormone therapy. Fifteen days later, MRI [Figure 1b] showed cervical and thoracic spinal cord lesions were significantly reduced. Her symptoms of upper limbs pain, numbness of chest, and abdomen had improved markedly and was discharged.