Pruritus as an initial symptom of neuromyelitis optica spectrum disorder. A peruvian case report

Background: Neuromyelitis Optica (NMO) is an autoimmune and demyelinating disease characterized by severe optic neuritis and myelitis. The discovery of anti-aquaporin 4 (AQP4) antibodies has led to an increased understanding of the NMO Spectrum Disorder (NMOSD). Case presentation: We reported the case of a 23-year-old woman who experienced pruritus and right facial paresthesia. The symptoms were initially thought to be from a psychiatric disorder however, the presence of abnormalities on the neurological exam warranted a further work-up. The MRI showed hyperintense lesions in the spinal cord and the AQP4 antibodies were positive. The diagnosis of NMOSD was made, and the patient received immunosuppressive treatment. Conclusions: We are reporting the first Peruvian case of NMOSD complaining pruritus as initial symptom.