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Klin Monbl Augenheilkd 2022; 239(11): 1315-1324
DOI: 10.1055/a-1918-1824
DOI: 10.1055/a-1918-1824
Übersicht
Diagnostik der Neuromyelitis-optica-Spektrum-Erkrankung (NMOSD) und der MOG-Antikörper-assoziierten Erkrankung (MOGAD)
Article in several languages: deutsch | English
Zusammenfassung
Die Aquaporin-4-Antikörper-positive Neuromyelitis-optica-Spektrum-Erkrankung (engl. NMOSD) und die Myelin-Oligodendrozyten-Glykoprotein-Antikörper-assoziierte Erkrankung (engl. MOGAD) sind Autoimmunerkrankungen des zentralen Nervensystems. Typische Erstmanifestationen sind bei Erwachsenen Optikusneuritis und Myelitis. Eine Beteiligung auch von Hirn und Hirnstamm, spätestens im weiteren Verlauf, ist häufig. Während die NMOSD nahezu immer schubförmig verläuft, nimmt die MOGAD gelegentlich einen monophasischen Verlauf. Die Differenzialdiagnostik ist anspruchsvoll und stützt sich auf u. a. auf radiologische und serologische Befunde. Die Abgrenzung von der häufigeren neuroinflammatorischen Erkrankung, Multiple Sklerose (MS), ist von erheblicher Bedeutung, da sich Behandlung und langfristige Prognose von NMOSD, MOGAD und MS wesentlich unterscheiden. Die vielfältigen Symptome und die umfangreiche Diagnostik machen eine enge Zusammenarbeit zwischen Ophthalmologie, Neurologie und Radiologie erforderlich. Dieser Artikel gibt einen Überblick über typische MRT-Befunde und die serologische Antikörperdiagnostik bei NMOSD und MOGAD. Zwei illustrative Fallberichte aus der ärztlichen Praxis ergänzen die Darstellung.
Schlüsselwörter
Optikusneuritis - Myelitis, Neuromyelitis-optica-Spektrum-Erkrankung (NMOSD) - Myelin-Oligodendrozyten-Glykoprotein (MOG) - MOG-Antikörper-assoziierte Erkrankung (MOGAD) - Aquaporin-4 (AQP4) - Antikörper - Magnetresonanztomografie - Serologie - DiagnosePublication History
Received: 24 July 2022
Accepted: 26 July 2022
Article published online:
21 November 2022
© 2022. Thieme. All rights reserved.
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