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(NMOSD; Neuromyelitis Optica; Devic Disease)

Definition

Neuromyelitis optica spectrum disorder (NMOSD) is a problem with the immune system. The body attacks and harms healthy tissue. The spinal cord and nerves of the eyes are most often affected. There may also be bladder problems.

Causes

NMOSD causes bad antibodies to appear. This triggers the immune system to harm healthy nerves.

It is not known why this happens. Genes may play a role.

Risk Factors

NMOSD is more common in women. It is most common in people who are in their 30s.

Symptoms

Problems may be:

  • Decreased eyesight
  • Eye pain
  • Problems moving the legs or both the arms and the legs
  • Loss of bowel or bladder control
  • A shock feeling that runs down the spine
  • Spasms and shaking
  • Back pain
  • Weak muscles in the face
  • A feeling of spinning when you are standing still

Diagnosis

You will be asked about your symptoms and health history. An exam will be done.

NMOSD problems are like those for multiple sclerosis (MS). Tests will be done to rule out MS.

Tests may be:

  • Blood tests—to check for antibodies and inflammation markers
  • Lumbar puncture—to test the fluid around your brain and spine
  • MRI scan—to take pictures of your brain, spine, and eyes

Treatment

NMOSD cannot be cured. The goal of treatment is to ease symptoms and stop flare-ups.

Choices are:

Medicines

These may be given:

  • Corticosteroid drugs—to ease inflammation during a flare-up
  • Medicine to slow or adjust the immune system

Plasma Exchange

This procedure takes antibodies out of the blood. It may slow or stop harm.

Rehabilitation

Therapy may help with changes. It can help a person adjust to sight and movement problems.

Prevention

There are no steps to lower the risk of NMOSD.

RESOURCES

National Multiple Sclerosis Society   https://www.nationalmssociety.org 

National Organization for Rare Disorders  https://rarediseases.org 

CANADIAN RESOURCES

Canadian Organization for Rare Disorders  https://www.raredisorders.ca 

Health Canada   https://www.canada.ca 

References

Kessler RA, Mealy M, et al. Treatment of neuromyelitis optica spectrum disorder: acute, preventive, and symptomatic. Curr Treat Options Neurol. 2016 Jan;18(1):2. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807395/. Accessed September 7, 2018.

Neuromyelitis optica. Genetic and Rare Diseases Information Center website. Available at: https://rarediseases.info.nih.gov/diseases/6267/neuromyelitis-optica. Accessed September 7, 2018.

Neuromyelitis optica. National Organization for Rare Disorders website. Available at: https://rarediseases.org/rare-diseases/neuromyelitis-optica/. Published 2015. Accessed September 7, 2018.

Neuromyelitis optica information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Neuromyelitis-Optica-Information-Page. Updated June 18, 2018. Accessed September 7, 2018.

Neuromyelitis optica (NMO). National Multiple Sclerosis Society website. Available at: https://www.nationalmssociety.org/What-is-MS/Related-Conditions/Neuromyelitis-Optica-(NMO)#section-1. Accessed September 7, 2018.

Neuromyelitis optica spectrum disorder (MDOSD). Myelitis website. Available at: https://myelitis.org/neuromyelitis-optica-spectrum-disorder-nmosd/. Accessed September 7, 2018.

Popescu BF, Guo Y, et al. Diagnostic utility of aquaporin-4 in the analysis of active demyelinating lesions. Neurology. 2015;84(2):148-158.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 05/2020
  • Update Date: 05/12/2020