Recurrent episodes of syncope requiring pacemaker implantation as an initial presentation of neuromyelitis optica spectrum disorder

Mult Scler Relat Disord. 2020 Oct:45:102423. doi: 10.1016/j.msard.2020.102423. Epub 2020 Jul 25.

Abstract

Neuromyelitis Optica Spectrum Disorders (NMOSD) can manifest with a variety of heterogeneous symptoms, mainly encompassing optic neuritis, acute myelitis and area postrema syndrome (hiccups, nausea, and vomiting). Syncopal episodes have rarely been described as an initial manifestation of NMOSD. Here, we report a case of a 42-year-old male who was diagnosed with NMOSD after initially presenting with intractable hiccups and recurrent episodes of syncope. This report is of particular interest, as it suggests that NMOSD should be included in the differential diagnosis of patients with intractable hiccups and heart rhythm disorders.

Keywords: Acute myelitis; Anti-AQP4; Intractable hiccups; NMOSD; Optic neuritis; Syncope; aquaporin-4.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Aquaporin 4
  • Autoantibodies
  • Humans
  • Male
  • Nausea
  • Neuromyelitis Optica* / complications
  • Neuromyelitis Optica* / diagnostic imaging
  • Neuromyelitis Optica* / therapy
  • Pacemaker, Artificial*
  • Syncope / etiology
  • Syncope / therapy

Substances

  • Aquaporin 4
  • Autoantibodies