Abstract
BACKGROUND: Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system and is characterized by severe optic neuritis and transverse myelitis. CASE PRESENTATION: The patient was a 74-year-old man with pneumonia. On admission, he exhibited lower limb weakness and rapid respiratory deterioration in the form of tachypnea. Subsequently, he was transported to the Emergency Center of our hospital. High-signal lesions were observed from the cervical spinal cord to the thoracic spinal cord on T2-weighted spinal magnetic resonance images. Neuromyelitis optica was suspected, and the patient received steroid pulse therapy and immunoadsorption plasmapheresis. Serum samples obtained upon transfer were positive for anti-aquaporin-4 antibodies, which confirmed the diagnosis of neuromyelitis optica. Thereafter, the patient was transferred to a rehabilitation hospital. CONCLUSION: Rapid respiratory failure in neuromyelitis optica is rare, and care is needed while treating these cases.