{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:24:24Z","timestamp":1783689864829,"version":"3.55.0"},"reference-count":24,"publisher":"FapUNIFESP (SciELO)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Neuro-Psiquiatr."],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:p>Neuromyelitis optica (NMO) is an inflammatory disease of central nervous system classically characterized by acute, severe episodes of optic neuritis and longitudinally extensive transverse myelitis, usually with a relapsing course. The identification of an autoantibody exclusively detected in NMO patients against aquaporin-4 (AQP-4) has allowed identification of cases beyond the classical phenotype. Brain lesions, once thought as infrequent, can be observed in NMO patients, but lesions have different characteristics from the ones seen in multiple sclerosis. Additionally, some AQP-4 antibody positive patients may present with a variety of symptoms not being restricted to optic neuritis and acute myelitis during the first attack or in a relapse. Examples are not limited to, but may include patients only with brain and\/or brainstem lesions, narcolepsy with hypothalamic lesions or patients with intractable hiccups, nausea and vomiting. The prompt identification of NMO patients with atypical presentations may benefit these patients with institution of early treatment to reduce disability and prevent further attacks.<\/jats:p>","DOI":"10.1590\/s0004-282x2011000600019","type":"journal-article","created":{"date-parts":[[2011,10,29]],"date-time":"2011-10-29T04:12:27Z","timestamp":1319861547000},"page":"824-828","source":"Crossref","is-referenced-by-count":24,"title":["Atypical presentations of neuromyelitis optica"],"prefix":"10.1590","volume":"69","author":[{"given":"Douglas","family":"Sato","sequence":"first","affiliation":[{"name":"Tohoku University Graduate School of Medicine,  Japan; University of S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Fujihara","sequence":"additional","affiliation":[{"name":"Tohoku University Graduate School of Medicine,  Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1212\/WNL.53.5.1107","article-title":"The clinical course of neuromyelitis optica (Devic's syndrome)","volume":"53","author":"Wingerchuk DM","year":"1999","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s004150200020","article-title":"Eug\u00e8ne Devic (1858-1930)","volume":"249","author":"Miyazawa I","year":"2002","journal-title":"J Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0340-5354","issn-type":"print"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1212\/WNL.0b013e3181d31e35","article-title":"Neuromyelitis optica in France: a multicenter study of 125 patients","volume":"74","author":"Collongues N","year":"2010","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/1352458509353651","article-title":"Recurrent neuromyelitis optica in Brazilian patients: clinical, immunological, and neuroimaging characteristics","volume":"16","author":"Adoni T","year":"2010","journal-title":"Mult Scler","ISSN":"https:\/\/id.crossref.org\/issn\/1352-4585","issn-type":"print"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1212\/WNL.0b013e3181e2414b","article-title":"Astrocytic damage is far more severe than demyelination in NMO: a clinical CSF biomarker study","volume":"75","author":"Takano R","year":"2010","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1093\/brain\/awm047","article-title":"Loss of aquaporin 4 in lesions of neuromyelitis optica: distinction from multiple sclerosis","volume":"130","author":"Misu T","year":"2007","journal-title":"Brain","ISSN":"https:\/\/id.crossref.org\/issn\/0006-8950","issn-type":"print"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"2106","DOI":"10.1016\/S0140-6736(04)17551-X","article-title":"A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis","volume":"364","author":"Lennon VA","year":"2004","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1084\/jem.20050304","article-title":"IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel","volume":"202","author":"Lennon VA","year":"2005","journal-title":"J Exp Med","ISSN":"https:\/\/id.crossref.org\/issn\/0022-1007","issn-type":"print"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.bbrc.2009.06.085","article-title":"Neuromyelitis optica: passive transfer to rats by human immunoglobulin","volume":"386","author":"Kinoshita M","year":"2009","journal-title":"Biochem Biophys Res Commun","ISSN":"https:\/\/id.crossref.org\/issn\/0006-291X","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1002\/ana.21837","article-title":"Neuromyelitis optica: pathogenicity of patient immunoglobulin in vivo","volume":"66","author":"Bradl M","year":"2009","journal-title":"Ann Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0364-5134","issn-type":"print"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1177\/1352458510377908","article-title":"Neuromyelitis optica without typical opticospinal phenotype","volume":"16","author":"Sato D","year":"2010","journal-title":"Mult Scler","ISSN":"https:\/\/id.crossref.org\/issn\/1352-4585","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1212\/01.wnl.0000216139.44259.74","article-title":"Revised diagnostic criteria for neuromyelitis optica","volume":"66","author":"Wingerchuk DM","year":"2006","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/S1474-4422(07)70216-8","article-title":"The spectrum of neuromyelitis optica","volume":"6","author":"Wingerchuk DM","year":"2007","journal-title":"Lancet Neurol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1001\/archneur.63.3.390","article-title":"Brain abnormalities in neuromyelitis optica","volume":"63","author":"Pittock SJ","year":"2006","journal-title":"Arch Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0003-9942","issn-type":"print"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1177\/1352458510376640","article-title":"Characteristic brain magnetic resonance imaging abnormalities in central nervous system aquaporin-4 autoimmunity","volume":"16","author":"Kim W","year":"2010","journal-title":"Mult Scler","ISSN":"https:\/\/id.crossref.org\/issn\/1352-4585","issn-type":"print"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1002\/ana.21753","article-title":"\u201dCloud-like enhancement\u201d is a magnetic resonance imaging abnormality specific to neuromyelitis optica","volume":"66","author":"Ito S","year":"2009","journal-title":"Ann Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0364-5134","issn-type":"print"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1001\/archneur.63.7.964","article-title":"Neuromyelitis optica brain lesions localized at sites of high aquaporin 4 expression","volume":"63","author":"Pittock SJ","year":"2006","journal-title":"Arch Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0003-9942","issn-type":"print"},{"key":"ref18","series-title":"Aquaporin-4 antibody positive male patients: an analysis of 144 cases. Poster presented at the annual meeting of the American Academy of Neurology","author":"Sato D","year":"2011"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1212\/01.wnl.0000183151.19351.82","article-title":"Intractable hiccup and nausea with periaqueductal lesions in neuromyelitis optica","volume":"65","author":"Misu T","year":"2005","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1212\/WNL.0b013e318214332c","article-title":"Neuromyelitis optica unique area postrema lesions: nausea, vomiting, and pathogenic implications","volume":"76","author":"Popescu BF","year":"2011","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref21","first-page":"A168","article-title":"Painful tonic spasm in neuromyelitis optica","volume":"74","author":"Takai Y","year":"2010","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s00415-009-0139-4","article-title":"Narcolepsy as an initial manifestation of neuromyelitis optica with anti-aquaporin-4 antibody","volume":"256","author":"Baba T","year":"2009","journal-title":"J Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0340-5354","issn-type":"print"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1001\/archneurol.2009.264","article-title":"Symptomatic narcolepsy in patients with neuromyelitis optica and multiple sclerosis: new neurochemical and immunological implications","volume":"66","author":"Kanbayashi T","year":"2009","journal-title":"Arch Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0003-9942","issn-type":"print"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1212\/WNL.0b013e3181dd445b","article-title":"Neuromyelitis optica preceded by hyperCKemia episode","volume":"74","author":"Suzuki N","year":"2010","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"}],"container-title":["Arquivos de Neuro-Psiquiatria"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/anp\/v69n5\/a18v69n5.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T01:37:15Z","timestamp":1495849035000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0004-282X2011000600019&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2011,10]]}},"alternative-id":["S0004-282X2011000600019"],"URL":"https:\/\/doi.org\/10.1590\/s0004-282x2011000600019","relation":{},"ISSN":["0004-282X"],"issn-type":[{"value":"0004-282X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10]]}}}