Neuromyelitis optica – a cause for longitudinally extensive transverse myelitis: a rare case report from Nepal and literature review

Neuromyelitis optica spectrum disorder (NMOSD), being more common in middle-aged group (30-45 years); can occur in younger age group as per our case. Specialized AQP4 detection is often constrained in many parts of Nepal which is a big challenge, especially in resource-limited settings. This case highlights that positive AQP4 testing helps in reaching a definitive diagnosis and timely initiation of high-dose steroids and immunosuppressive therapy that brings out substantial recovery at 2 months - consistent with literature showing that early aggressive therapy prompts to better outcomes.