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Brain MRI abnormalities were found for 89% of the patients, and the most prominent feature was \u201ccloud\u2010like enhancement,\u201d multiple patchy enhancing lesions with blurred margin, found in 90% of the patients with positive contrast enhancement. In NMO, brain MRI abnormalities are frequent, and cloud\u2010like enhancement appears to be an MRI finding specific to NMO, possibly caused by primary involvement of the blood\u2010brain barrier by the autoantibodies. 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