Sagittal T2 weighted Magnetic Resonance Imaging (MRI) of the cervical and upper thoracic spinal cord revealed a contiguous T2 brightness throughout most of the cervical spinal cord and the top half of the thoracic cord (over ten segments), representing a longitudinally extensive lesion/transverse myelitis, a finding characteristic of NMOSD and not typically seen in multiple sclerosis. NMOSD, neuromyelitis optica spectrum disorder.