Neuromyelitis optica spectrum disorder presenting initially with depression and delusion： a case report
10.11886/scjsws20260126002
- VernacularTitle:以抑郁、妄想为首发症状的视神经脊髓炎谱系疾病1例
- Author:
Wanqi LUO
1
;
Yinghui ZHONG
2
;
Aiping LIANG
1
;
Xudong LUO
1
Author Information
1. Affiliated Hospital of Guangdong Medical University， Zhanjiang 524000， China
2. The Guangxi Zhuang Autonomous Region Brain Hospital， Liuzhou 545005， China
- Publication Type:Journal Article
- Keywords:
Neuromyelitis optica spectrum disorder;
Depression;
Delusion;
Psychiatric symptoms
- From:
Sichuan Mental Health
2026;39(4):381-384
- CountryChina
- Language:Chinese
-
Abstract:
This report describes the clinical course， diagnosi and treatment of a patient with neuromyelitis optica spectrum disorder （NMOSD） who presented initially with depression and delusion. The patient was a 38-year-old woman who initially presented with low mood， accompanied by nausea and vomiting. Mental examination revealed delusions of jealousy and psychomotor retardation. Subsequently， she developed fever and decreased muscle strength. Magnetic resonance imaging (MRI） revealed lesions involving pons and upper cervical spinal cord. Cerebrospinal fluid testing was positive for aquaporin 4 （AQP4） antibodies， and metagenomic sequencing of cerebrospinal fluid detected DNA fragments of Escherichia coli and Klebsiella pneumoniae. Following treatment with glucocorticoid pulse therapy combined with anti-infective therapy， the patient's mood， psychiatric symtoms， and neurological symptoms improved. This case suggests that psychiatric symptoms including depression and delusion may be the presenting features of NMOSD， and that infectious factors might play a role in triggering autoimmune responses. These observations offer valuable clinical clues for the early identification of NMOSD.
