Neuromyelitis optica and tuberculosis

ABSTRACT

Neuromyelitis optica [NMO] or Devic's syndrome is defined by Gault and Devic as a retrobulbar neuritis or papillitis accompanied by acute myelitis and occasionally other neurological symptoms or sings not restricted to the spinal cord or optic nerves. Infectious aetiology was suggested but never recognised. We report a 36-year-old woman with NMO which revealed a multisystemic tuberculosis with fatal issue. We discuss this case with review of literature and try to demonstrate that tuberculosis can be considered as NMO's aetiology directly by Mycobacterium Tuberculosis [BK] infestation, or indirectly by immune mediated response to BK. We conclude to search tuberculosis in patients with NMO, especially in countries where tuberculosis is endemic and a great problem of public health, and not to consider it only as a variant of multiple sclerosis because of different therapeutical options