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Tonic spasms and short myelitis in an elderly woman—unique onset of neuromyelitis optica
  1. Shahd Hamid1,
  2. Liene Elsone1,
  3. Kerry Mutch1,
  4. David P J Hunt2,
  5. Katy Murray3,
  6. John M Reid4,
  7. Anu Jacob1
  1. 1Neurology Department, The Walton Centre NHS Foundation Trust, Liverpool, UK
  2. 2Neurology Department, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
  3. 3Neurology Department, Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK
  4. 4Department of Neurology, Aberdeen Royal Infirmary, Aberdeen, UK
  1. Correspondence to Dr Shahd Hamid, Neurology Department, The Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK; shahd.hamid{at}


Neuromyelitis optica typically presents at a median age of 40–50 years. The myelitis is usually of acute onset, long (>3 vertebral segments) and causes severe sensorimotor and bladder and bowel disturbances. We describe a 73-year-old Caucasian woman with aquaporin-4 antibody-positive neuromyelitis optica whose index event was intermittent paroxysmal tonic spasms (and no other myelitis features) that recurred for 6 months and was associated with a short spinal cord lesion on MRI. This case reiterates recent observations that neuromyelitis optica can occur in older persons, and its myelitis can be ‘short’ and clinically mild.

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