Radicular Pain as an Initial Presentation in Neuromyelitis Optica: A casereport

Neuromyelitis optica is a rare demyelinating disease. Radicular pain as the initial presentation of monophasic neuromyelitis optica has not been previously reported. We present a case of monophasic neuromyelitis optica in a 69-year-old female who suffered 1 year (from 2004/6 to 2005/5) from back pain that radiated to the lower extremities. Fifth lumbar radiculopathy was the first diagnosis. Despite treatment with laser discectomy on 2005/2/15, her pain, lower extremity weakness, and bilateral visual acuity worsened. Three weeks after surgery, she came to our hospital for help and was admitted for evaluation. The diagnosis of neuromyelitis optica was confirmed later. Prednisolone was prescribed and the patient's motor function recovered rapidly but her visual acuity remained poor. The rarity of radicular pain as an initial presentation of neuromyelitis optica might lead to its misdiagnosis and loss of the opportunity for early treatment. However, early diagnosis and treatment are possible through continuous follow-up and complete history taking.