Neuromyelitis Optica

Neuromyelitis Optica (NMO) is another autoimmune demyelinating disease of the central nervous system disease that differs from the most common form, multiple sclerosis (MS). The inflammatory attack here is limited to the optic nerves and the spinal cord. Patients develop loss of vision or transverse myelitis, an inflammatory spinal cord injury. Unlike MS patients, they often have a severe attack and do not fully recover. 80% of patients relapse and 60% of them do so in the first year, so this is a very active disease process with early disability.

Unlike in MS, a specific antibody has been found that correlates with NMO disease course. It binds to aquaporin 4 which is the main water channel in the central nervous system and is called the NMO antibody. Finding an antibody can be used to diagnose and follow the disease course. Since relapses are severe, patients need treatment which is different than the medications we use for typical multiple sclerosis. We need to see these patients early and get them on appropriate treatment and closely following their response.

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