Regaining walking and restoring corticospinal tract excitability after neuromyelitis optica spectrum disorder: A case report

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disease causing axonal damage with corresponding functional deficits. In this case report, we prospectively tracked walking recovery and corticospinal excitability of a female diagnosed with NMOSD through six months after her inpatient rehabilitation (IPR) stay. She recovered independent walking function in home and community settings. Neurophysiological measures acquired using transcranial magnetic stimulation showed two temporal evolution patterns. There was a remarkably reduced intra-cortical inhibition and increased intra-cortical facilitation at the early recovery phase whereas increased corticospinal pathway excitability was noted at 6 months after IPR discharge.