Riwanti Estiasari

1. Progressive cognitive impairment with AQP4 antibody positive 2. NMOSD with anti MOG positive

A-35-year-old female came to hospital due to communication and swallowing difficulty. She only said 1-2 words without any expression on her face. She also not able to walk and her both leg were spastic. Her symptoms was started with memory impairment since 3 years ago. The memory problem progress was quite fast enough until she cannot work as high school teacher in 1 year. Her ability in doing daily activity also decreased and all her extremities become spastic. Six years ago she has experienced of auditory hallucination and went to psychiatrist. She got haloperidol for couple weeks and the hallucination disappeared. No history of head trauma, fever or other disease. Physical examination revealed GCS E4M6 V(cognitive impairment), no hemiparesis, physiological reflex increased with Achilles clonus positive. Brain MRI with contrast showed bilateral periventricular hyperintens lesion in T2 with brain atrophy. Cervical MRI within normal limit. Laboratory result, AQP4 antibody serum positiv

H.323 , Vidyo