JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v4i2.2332 jpsim.v4i2.2332 Case Report A Rare Case of Area Postrema Variant (Intractable Vomiting and Hiccups) of Neuromyelitis Optica Spectrum Disorder (NMOSD) in a 25 Year Female Patient Hussain Jawad Banaras Faizan faizanbanaras958@gmail.com * Tahir Tehrim Fayyaz Ramish Ashfaq Mahnoor Usman Muhammad Raza Ali Allied Ayub Teaching Hospital Abbottabad, KPK *Correspondence: Faizan Banaras (faizanbanaras958@gmail.com) 02 06 2023 2023 4 2 152 154 15 02 2023 22 03 2023 Copyright © 2023 The Author(s) 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Nausea and vomiting are commonest complaints in an emergency department in hospitals. Neuromyelitis optica spectrum disorders (NMOSDs) are CNS autoimmune disorders related to highly specific biomarkers for astrocytic water channel aquaporin-4. Area postrema syndrome (APS) is described as intractable nausea, vomiting, or hiccups that can be intermittent or may persist longer than 48 hours, and other pathologies should be excluded, as may be misdiagnosed with digestive system disorders.

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