We read with great interest the recent paper by Suthiphosuwan et al.1, reporting on a patient with a spinal arteriovenous fistula and false-positive aquaporin-4 IgG test. This patient was misdiagnosed as having neuromyelitis optica spectrum disorder (NMOSD). Encouraged by that report, we are bringing for discussion another case of longitudinal extensive transverse myelitis in a middle-aged man. This patient was initially considered to have NMOSD or primary progressive multiple sclerosis (MS), but in fact he had Foix-Alajouanine syndrome. Presentation of this case report was approved by the Ethics Committee at Universidade Metropolitana de Santos, and the patient signed a consent for our report, provided that his identity remained confidential.

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