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Peer-reviewedCC BY-NC-NDInternal Medicine

Cerebral Attack With Cortical-Leptomeningeal Involvement and Seizures in AQP4-IgG-Positive Neuromyelitis Optica Spectrum Disorder

  • Miyuki Miyamoto
  • Yuma Sato
  • Nobuyuki Ishii
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Abstract

Neuromyelitis optica spectrum disorder (NMOSD) rarely presents with corticalleptomeningeal involvement. A 47-year-old woman with aquaporin-4 immunoglobulin G (AQP4-IgG)-positive NMOSD developed acute headache, seizures, motor aphasia, and worsening right arm weakness. Brain magnetic resonance imaging revealed a tumefactive-appearing left frontal cortical-subcortical lesion with leptomeningeal enhancement. The clinical and radiological abnormalities improved after immunotherapy. This case illustrates a rare cerebral manifestation of AQP4-IgG-positive NMOSD with cortical-leptomeningeal involvement, seizures, and a tumefactive lesion.

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Cite

BibTeXRIS
BibTeX
@article{miyamoto2026cerebral,
  title = {{Cerebral Attack With Cortical-Leptomeningeal Involvement and Seizures in AQP4-IgG-Positive Neuromyelitis Optica Spectrum Disorder}},
  author = {Miyuki Miyamoto and Yuma Sato and Nobuyuki Ishii},
  journal = {Internal Medicine},
  year = {2026},
  month = oct,
  doi = {10.2169/internalmedicine.7994-26},
  url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7994-26/_article},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Cerebral Attack With Cortical-Leptomeningeal Involvement and Seizures in AQP4-IgG-Positive Neuromyelitis Optica Spectrum Disorder
AU  - Miyuki Miyamoto
AU  - Yuma Sato
AU  - Nobuyuki Ishii
PY  - 2026
DA  - 2026/10/15
JO  - Internal Medicine
DO  - 10.2169/internalmedicine.7994-26
UR  - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7994-26/_article
AB  - Neuromyelitis optica spectrum disorder (NMOSD) rarely presents with corticalleptomeningeal involvement. A 47-year-old woman with aquaporin-4 immunoglobulin G (AQP4-IgG)-positive NMOSD developed acute headache, seizures, motor aphasia, and worsening right arm weakness. Brain magnetic resonance imaging revealed a tumefactive-appearing left frontal cortical-subcortical lesion with leptomeningeal enhancement. The clinical and radiological abnormalities improved after immunotherapy. This case illustrates a rare cerebral manifestation of AQP4-IgG-positive NMOSD with cortical-leptomeningeal involvement, seizures, and a tumefactive lesion.
SN  - 1349-7235
SN  - 0918-2918
ER  -