AQP4 and neuromyelitis optica: Neuromyelitis optica has expanded to the term neuromyelitis optica spectrum disorder as there have been numerous manifestations recognized in a range of diseases associated with the serum AQP4-IgG in up to 80% of those diagnosed with the disease [1,2]. It has also been associated with another antigenic target called myelin oligodendocyte glycoprotein (MOG) [4]. It is an autoimmune, inflammatory CNS syndrome that affects females more proportionally than males, typically in those between the ages of 30 to 40, similar to the patient discussed here [3].