Citations 1
Unveiling Misdiagnosis: Rethinking Seronegative NMOSD
Lang, Mary V. , Welk, Grant M., Tajfirouz, Deena , Chodnicki, Kevin D. , Pittock, Sean J., Chen, John J. , Tajfirouz, Deena , Flanagan, E P , Chen, John J , Welk, Grant M. , Lang, Mary , Pittock, Sean J., Flanagan, Eoin P.
Multiple Sclerosis Journal | August 16, 2025 | Volume: 31 | Issue: 11 | Pages: 1381-1384
Seronegative neuromyelitis optica spectrum disorder (NMOSD) is a diagnostic challenge. This study aimed to characterize misapplication of the 2015 international criteria for seronegative NMOSD. We reviewed 35 consecutive seronegative NMOSD referrals to a tertiary center. Two (6%) met formal criteria, and 2 (6%) were clinically suspected of NMOSD without fulfilling radiologic supportive criteria. Alternative diagnoses were common including multiple sclerosis (37%), optic neuritis (14%), functional neurologic disorder (11%), and other (38%). Immunosuppression with rituximab was used in 3 of 4 patients with functional neurologic disorder. Misapplication of the 2015 criteria is common, and alternative explanations in seronegative NMOSD patients should be strongly considered.