What is Neuromyelitis Optica?

Neuromyelitis Optica is a rare autoimmune central nervous system disorder characterized by transverse myelitis (in which the fatty, protective covering of the spinal cord breaks down) and optic neuritis (in which inflammation of the optic nerve causes loss of vision and eye pain). This disorder is considered a special form of multiple sclerosis with a severe and rapid course. Neuromyelitis Optica affects the nerves in the spinal cord and the optic nerve.Neuromyelitis Optica is also known as Devic's Syndrome, NMO.

Causes of Neuromyelitis Optica:

The causes of this disorder are unknown. Its clinical and pathological features consider it as an autoimmune variant of Multiple Sclerosis (MS). A high prevalence of serum auto antibodies suggests that Neuromyelitis Optica may be driven primarily by B cell dysfunction.

Symptoms of Neuromyelitis Optica:

  Symptoms of Neuromyelitis Optica may include attacks of acute optic neuritis, usually in both eyes (bilateral). The symptoms of NMO include marked loss of vision in both eyes (optic neuritis) followed by numbness, muscle weakness, spasticity, incoordination, ataxia, urinary, bowel, sexual and autonomic dysfunction in parts of the trunk and limbs served by nerves exiting the spine below the spinal lesion.

Diagnosis of Neuromyelitis Optica:

The diagnosis of this disorder requires several steps including a medical history detailing past infections, unusual diseases and family illnesses. Following steps are mainly used in the  diagnosis of Neuromyelitis Optica

• Neurological examination
• Magnetic resonance imaging (MRI) scan
• Evoked potentials
• Spinal tap (lumbar puncture)
• Serology

Treatment of Neuromyelitis Optica:

Currently there is no standard treatment for Neuromyelitis Optica. But There are several ways to treat this disorder:

1. Intravenous steroids and oral medications - In the early stage of the disease steroids, (given through a vein in the arm) are used to manage acute attacks of NMO.
2. Medications - Intravenous methylprednisolone is used to manage acute attacks of Neuromyelitis Optica. Then, combinations of prednisone and azathioprine are used to prevent future attacks.
3. Plasma exchange – After researches scientists suggests that patients who fail to respond to intravenous steroids who have had acute, recent, severe attacks, may rapidly improve after plasma exchange.