Intractable Vomiting Caused by Medulla Oblongata Lesions in a NMO-IgG Positive Patient
Ha Young Shin, MD, Jung Whan Lee, MD, Ki Jeong Lee, MD, Il Nam Sunwoo, MD, Seung Min Kim, MD
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
NMO-IgG is highly specific for neuromyelitis optica and reacts with the water channel aquaporin 4, which expressed particularly in the periventricular and periaqueductal areas, including dorsomedial regions of the medulla oblongata, where emetic circuitry may exist. We report an intractable vomiting in a NMO-IgG positive patient. She suffered from recurrent myelitis. Brain MRI revealed a single focal T2 high signal intensity in the area postrema or nucleus tractus solitaries. Intractable vomiting may be caused by neuromyelitis optica spectrum disorder.
Journal of Multiple Sclerosis 2(1):16-19, 2011