Abstract
Neuromyelitis optica, also known as Devic's disease is an autoimmune disease of the central nervous system characterized by attacks of optic neuritis and myelitis. After the discovery of disease specific antibodies against aquaporin 4 (AQP4-IgG/NMO-IgG) the spectrum of clinical symptoms of this disease was broadened.
In particular, these symptoms include singultus, vomiting, cranial nerve palsy and disorders of osmotic balance in hypothalamus involvement. Determination of AQP4-IgG in serum along with magnetic resonance imaging of the brain and spinal cord are indispensable in diagnosis of this disease at the time of the first manifestation of the disease.
On the other hand, AQP4 negativity does not exclude the diagnosis of NMO-IgG, which then requires a broader differential diagnosis in clinical practice