However, it can also be the first clinical presentation of other acquired demyelinating syndromes (ADS), including multiple sclerosis (MS), aquaporin-4-IgG positive neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) diagnosis [3, 7]. This evidence concerns the gene AQP4 and neuromyelitis optica.