Abstract Details

Title Diagnosis and Treatment of Neuromyelitis Optica in Ethiopia

Topic Global Health and Neuroepidemiology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-042

Objective To document a case of Neuromyelitis Optica diagnosed at St. Paul’s Hospital Millenium Medical College in Addis Ababa, Ethiopia and discuss diagnosis and treatment in the context of geographical differences including limited resources.

Background Neuromyelitis Optica is an inflammatory disorder of the central nervous system involving the optic nerves and spinal cord. This and other demyelinating disorders are rare in Eastern Africa. Both diagnosis and treatment is limited by restricted access to diagnostic modalities and medications.

Design/Methods Case report, literature review

Results A 27 year old woman with a history of recurrent vision loss presented with progressive weakness evolving to quadriplegia. MRI obtained 9 days after admission revealed T2 hyperintensity and enhancement of the spinal cord. Visual evoked potentials were consistent with a bilateral demyelinating process. Aquaporin-4 antibody from the serum was sent to Germany and ultimately resulted positive. She was treated with 3 days of 500 mg of methylprednisolone daily followed by a prednisone taper. Azathioprine was started for long term immunosuppression. She received physical therapy. Occupational therapy and inpatient rehabilitation were not available. She had long term catheterization as materials for sterile self in-and-out catheterization were not available.

Conclusions Neuromyelitis optica is a rare diagnosis in Eastern Africa. We present a case diagnosed and treated in an academic hospital in Addis Ababa, Ethiopia. Diagnosis was delayed by access to advanced imaging and serological testing. Treatment was limited by resource availability.

Authors/Disclosures
Katherine E. Heaton, MD PRESENTER	No disclosure on file
Mohamed T. Shabana, MD (Neurology Consultants of Dallas)	Dr. Shabana has nothing to disclose.
Mehari Gebreyohanns, MD, FAAN (UT Southwestern Medical Center)	Dr. Gebreyohanns has nothing to disclose.

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