NEUROMYELITIS OPTICA (NMO)

Neuromyelitis Optica (“NMO”) also known as Devic’s Syndrome was previously thought to be a fulminant form of Multiple Sclerosis (“MS”).  It is an autoimmune disorder that involves lesions in both the eyes and spinal cord that apparently targets aquaporin-4 (“AQP4”) antigens in the body.  In 2004, the aquaporin-4 antibody was discovered.  Involvement of three or more segments of the spinal cord is suspicious for NMO even in the absence of eye involvement.  A positive antibody test confirms the diagnosis.  However, an initially negative antibody can become positive later in the course of the disease.

Common symptoms are those associated with optic neuritis such as vision loss and pain in the eye along with symptoms diagnostic for transverse myelitis such as weakness, paralysis of the arms and legs along with loss of bladder and bowel control.  Most people with NMO experience clusters of attacks days to months, and sometimes, years apart that is followed by partial recovery during periods of remission. 

There is no cure for NMO and the main goal of treatment is to reduce symptoms and prevent relapses.  The long term effect of NMO can vary, with unpredictable relapses of symptoms.  Each attack may lead to new damage in different areas of the central nervous system.  Most patients will experience some degree of permanent limb weakness and/or vision loss.  Reducing attacks may prevent accumulation of these disabilities.