Pencil-thin ependymal enhancement in neuromyelitis optica spectrum disorders

Mult Scler. 2012 Jul;18(7):1050-3. doi: 10.1177/1352458511431730. Epub 2011 Dec 19.


AQP4 water channels are thought to be the target of autoimmune attack in neuromyelitis optica-spectrum disorders (NMOsd). AQP4 are highly expressed on ventricular ependyma. The objective of this study was to describe a novel pattern of linear, 'pencil-thin' enhancement of ventricular ependyma in NMOsd. We report two NMOsd patients with pencil-thin ependymal enhancement along the frontal and occipital horns of lateral ventricles. Differential diagnosis of ependymal enhancement should include NMOsd alongside with infectious and neoplastic etiologies. Pencil-thin ependymal enhancement may be a helpful radiological marker of NMOsd that can be used to differentiate this condition from multiple sclerosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Ependyma / pathology*
  • Female
  • Humans
  • Middle Aged
  • Multiple Sclerosis / diagnosis
  • Neuromyelitis Optica / diagnosis*