Medical history emale patient, 29 years old, diagnosed with rheumatoid arthritis six years ago, currently in clinical remession, without impairments. Began in December 2014 with severe bilateral low visual acuity, paresthesia and paresis of limbs, progressing to ataxia in April 2015. In July of the same year, was admitted to the Hospital due to paraplegia, hypoesthesia with sensory level in C4 and paroxysmal tonic spasms. Showed partial improvement after pulse therapy with methylprednisolone for 05 days. She was referred to the demyelinating disease clinic of the HC-UFMG, where the following imaging tests were performed.Image 1: Magnetic Resonance Imaging of the brain, weighted in T2/FLAIR, sagittal view.Image 2: Magnetic Resonance Imaging of the cervical and thoracic spinal cord, weighted in T1 and T2, respectively, sagittal view.Image 3: Magnetic Resonance Imaging of the thoracic spinal cord, weighted in T2, axialImage 4: Magnetic Resonance Imaging of the skull, optic nerve window, weighted in T1, coronal view.Question:Taking into consideration the clincal evolution of the patient and the images showed, what is the main diagnostic hypothesis? Optical Neuromyelitis Multiple Sclerosis Amyotrophic Lateral Sclerosis CNS vasculitis Time is Up! Time's up
