Acute callosal disconnection syndrome as an initial manifestation of neuromyelitis optica spectrum disorders

Abstract

We present a 76-year-old ambidextrous man with acute callosal disconnection syndrome accompanied by acquired stuttering and right hemiparesis. Brain magnetic resonance imaging showed edematous pancallosal lesions and a spotty lesion in the left precentral gyrus. We diagnosed him as having neuromyelitis optica spectrum disorders according to the seropositivity for anti-aquaporin-4 antibody. Callosal disconnection syndrome presented unique laterality as a result of ambidexterity, and was outstanding even during the acute attack as a result of massive and selective corpus callosum involvement. Measurement of anti-aquaporin-4 antibody can be useful for differential diagnosis of patients presenting acute callosal disconnection syndrome.