Neuromyelitis optica in a Ugandan woman: a case report

INTRODUCTION: Few cases of neuromyelitis optica have been reported in Africa. This is the first case report of neuromyelitis optica in Uganda. It highlights the need to have a high index of suspicion to promptly identify and appropriately treat these patients. CASE PRESENTATION: We present the case of a 24-year-old woman of Bantu origin who presented initially with bilateral loss of vision and weakness of the lower limbs in 2010 that resolved completely after a few days. Eight months later, she presented with bilateral lower limb weakness and urinary incontinence that improved completely following steroid use. This was followed four months later with an episode of quadriparesis that was treated with steroids and azathioprine with some improvement currently using a walking aide. CONCLUSIONS: The patient described here represents a phenotypic expression of a recurrent (multiphasic), steroid-sensitive, inflammatory demyelinating disorder of the central nervous system occurring in a black Ugandan woman. This case highlights the occurrence of Devic’s disease within our setting and the need to properly diagnose this condition even in a resource-limited setting to prevent disability.