泛視神經脊髓炎

泛視神經脊髓炎(neuromyelitis optica spectrum disorder, NMOSD)為中樞神經發炎性疾病，因侵犯神經系統而有不同臨床表現，且與多發性硬化症症狀類似，故臨床診斷上不易。由於常見於侵犯視神經、脊髓及大腦等部位，易導致神經系統之損傷與失能之風險，須早期辨識與診斷、並給予治療。本案例是一位27歲女性，因吸入性肺炎而入院，經進一步之詳細病史詢問與身體檢查，以及安排腦部磁振造影後，高度懷疑為泛視神經脊髓炎，與神經科醫師討論後，予以檢測水通道蛋白4免疫球蛋白G抗體(Aquaporin-4 immunoglobulin G antibodies, AQP4-IgG)而確立診斷，給予類固醇治療後臨床症狀改善。臨床上許多疾病之初始症狀並不具特異性，需要進一步詳細病史詢問與身體檢查，依鑑別診斷給予抽血檢測和影像檢查，以即早診斷與治療並改善預後。

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disease of the central nervous system with various clinical presentations due to its involvement of the nervous system, often mimicking multiple sclerosis, making clinical diagnosis challenging. NMOSD commonly affects areas such as the optic nerve, spinal cord, and brain, posing a significant risk of neurological damage and disability. Early recognition, diagnosis, and treatment are essential. In this case, a 27-year-old female patient was admitted to the hospital for aspiration pneumonia. Following a detailed review of her current illness, physical examination, and MRI findings, NMOSD was highly suspected. The diagnosis was confirmed after the AQP4-IgG test returned positive and following consultation with a neurologist. The patient's condition improved with steroid treatment. This case underscores the importance of recognizing that many clinical diseases initially present with nonspecific symptoms. Accurate diagnosis often requires a thorough evaluation of present symptoms, comprehensive physical examination, and collaboration with multiple specialists to ensure timely and effective treatment.