A 35 year old female came with bilateral lower limb weakness with stiffness associated with numbness in bilateral lower limbs associated with bowel and bladder incontinence with loss of bladder sensations with blurring of vision in the right eye since 12 days. Patient had history of similar complaints in tha past 2015,2021. With mixed diet consumption, sleep adequacy , with no addictions , With no significant family history . Vitals -stable , no head to to findings significantly . On examination power 4/5 in both lower limbs increased tone with exaggerated reflexes in lower limbs with decreased sensations of all modalities in both lower limbs , with 6/18 visual aquity in right eye ,colour normal , fundus showed pale disc with sharp margins in right eye , cerebellar examination normal. Upper limb examination normal. Loss of lower abdominal reflexes, plantars extensor bilaterally. Anal reflex is lost , beevor sign negative. Skull and spine normal. Investigations done - aquaporin 4 antibodies positive, mri spine showed hyperintesnsities in thoracic spine from d2 to d6. What is diagnosis?
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Dr. U N Sahoo
General Medicine Specialist
· Bhubaneswar
The diagnosis is neuromyelitis optica spectrum disorder (NMOSD), also known as Devic's disease.