Neuromyelitis optica (NMO): differentials of LETM

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Neuromyelitis optica (NMO): differentials of LETM. LETM may result from coalescence of smaller MS lesions. Fully referenced neurology checklist.

Muscle sclerosis (MS)

  • LETM may result from coalescence of smaller MS lesions
  • There is more grey matter atrophy in MS than in NMO
  • Plasma complement biomarker levels are higher in NMO

Other inflammatory differentials

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Infections

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Neoplastic

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Metabolic

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Other radiological differentials

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Acronym

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References

  1. Jabbari E, Marshall CR, Longhurst H, Sylvester R. Longitudinally extensive transverse myelitis: a rare association with common variable immunodeficiency. Pract Neurol 2015; 15:49-52.
  2. Trebst C, Raab P, Voss EV, et al. Longitudinal extensive transverse myelitis-it's not all neuromyelitis optica. Nat Rev Neurol 2011; 7:688-698. 
  3. Kitley JL, Leite MI, George JS, Palace JA. The differential diagnosis of longitudinally extensive transverse myelitis. Mult Scler 2012; 18:271-285.
  4. Flanagan EP, Weinshenker BG. Myelitis in neuromyelitis optica spectrum disorder: The long and the short of it. Mult Scler 2017; 23:360-361. 
  5. Eshaghi A, Wottschel V, Cortese R, et al. Gray matter MRI differentiates neuromyelitis optica from multiple sclerosis using random forest. Neurology 2016; 87:2463-2470.
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