ĐẶC ĐIỂM LÂM SÀNG CỦA PHỔ BỆNH VIÊM TỦY THỊ THẦN KINH KHỞI PHÁT MUỘN

Abstract

Objective: To describe the clinical characteristics of late-onset neuromyelitis optica spectrum disorder (LO-NMOSD). Methods: This study included 51 patients aged ≥50 years who were diagnosed with NMOSD and treated at Bach Mai Hospital and Hanoi Medical University Hospital. Results: The disease predominantly affected females (88.2%), with a female-to-male ratio of approximately 7:1 (45/6, p < 0.05). The mean age at onset was 60.0 ± 7.7 years, and 41.2% of patients experienced relapses. All patients developed symptoms within the first month of onset. Motor weakness was observed in 52.9%, sensory disturbances in 58.8%, sphincter dysfunction in 47.1%, blurred vision in 47.1%, persistent nausea and vomiting in 9.8%, and cranial nerve palsy in 2%. The major clinical syndromes included acute transverse myelitis (68.6%), optic neuritis (52.9%), area postrema syndrome (5.9%), and acute brainstem syndrome (2%). Patients with an Expanded Disability Status Scale (EDSS) score ≥6, indicating the need for assistance in ambulation, accounted for 58.8%, with a mean EDSS of 6 ± 2.5. Conclusion: Patients with LO-NMOSD commonly presented with spinal cord, optic nerve, and brainstem involvement, and exhibited a high level of disability.