Recurrent episodes of syncope requiring pacemaker implantation as an initial presentation of neuromyelitis optica spectrum disorder

• Published in: Multiple sclerosis and related disorders Vol. 45; p. 102423
• Main Authors: Tsouris, Zisis, Dastamani, Metaxia, Siokas, Vasileios, Aloizou, Athina-Maria, Zagouras, Alexandros, Provatas, Antonios, Tsimourtou, Vana, Dardiotis, Efthimios
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-10-2020
• Subjects: Acute myelitis; Adult; Anti-AQP4; Aquaporin 4; Autoantibodies; Humans; Intractable hiccups; Male; Nausea; Neuromyelitis Optica - complications; Neuromyelitis Optica - diagnostic imaging; Neuromyelitis Optica - therapy; NMOSD; Optic neuritis; Pacemaker, Artificial; Syncope; Syncope - etiology; Syncope - therapy; aquaporin-4; Syncope; Anti-AQP4; Optic neuritis; Acute myelitis; Intractable hiccups; NMOSD
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2020.102423

Neuromyelitis Optica Spectrum Disorders (NMOSD) can manifest with a variety of heterogeneous symptoms, mainly encompassing optic neuritis, acute myelitis and area postrema syndrome (hiccups, nausea, and vomiting). Syncopal episodes have rarely been described as an initial manifestation of NMOSD. Here, we report a case of a 42-year-old male who was diagnosed with NMOSD after initially presenting with intractable hiccups and recurrent episodes of syncope. This report is of particular interest, as it suggests that NMOSD should be included in the differential diagnosis of patients with intractable hiccups and heart rhythm disorders.