Abstract
MOSD is a rare and disabling immune-mediated inflammatory Astrocytopathic disease characterized by demyelination and axonal destruction, typically involving the spinal cord and the optic nerve. Here we present a case report of a 53-year-old female patient who had a pertinent history of treatment for optic neuritis a few months back, currently diagnosed with Neuromyelitis Optica after she presented with a three-week history of weakness of lower extremity, headache, and neuropathic pain. She was pulsed with methylprednisolone and started on azathioprine, which significantly improved her clinical condition. When patients with optic neuritis and transverse myelitis occur, a high index of suspicion for NMOSD is essential. Establishing a diagnosis based on clinical and MRI findings is crucial for initiating therapy quickly, halting more harm, and avoiding a delay in diagnosis. Our experience treating our patient shows that Azathioprine is still a practical choice in resource-limited setups.