- October 21, 2019 at 11:55 am #25401
Neuromyelitis Optica Spectrum Disorder (NMOSD), also known as Devic disease, is a chronic disorder of the brain and spinal cord caused by the inflammation of the optic nerve and inflammation of the spinal cord. It is often considered as a monophasic illness, consisting of episodes of inflammation of one or both optic nerves and the spinal cord over a short period of time.
SYNONYMS OF NMOSD
(Asian, Japanese) opticospinal MS
SIGNS AND SYMPTOMS
Optic neuritis or myelitis is the characteristic symptom of NMOSD. The patient might feel pain inside the eye, followed by loss of vision. Usually, only one eye is affected, however, in some instances, both the eyes may be involved simultaneously.
Inflammation of the spinal cord, a condition called transverse myelitis, is other condition associated with this disease. The symptoms tend to affect some or often all motor, sensory, and autonomic functions below a certain level on the body.
Although not frequently, symptoms may be confined to one side of the body.
Affected individuals may experience pain in the spine or limbs, mild to severe paralysis of the lower limbs, and loss of bowel and bladder control.
The individuals might even have a stiff neck, back of limb pain, and/or headaches.
More than 95% of the patients report no family members with this condition, but about 3% of them had this condition in the family. NMOSD is considered an autoimmune disease; however, the exact cause of the autoimmunity is unknown.
Symptoms of NMOSD can be similar to the following conditions; hence, the differential diagnosis should be considered.
Acute disseminated encephalomyelitis- a CNS disorder characterized by inflammation of the brain and spinal cord.
Multiple sclerosis- a chronic condition of the brain and spinal cord.
Systemic lupus erythematosus- an inflammatory condition that affects body parts, including joint, skin, and internal organs.
Paraneoplastic disorders- a condition in which patients develop inflammation or cell injury caused by autoimmune reactions to cancer that leads to the production of autoantibodies.
Sarcoidosis- a granulomatous disorder affecting optic nerves and spinal cord that affects CNS.
Diagnosis of NMOSD is based on detailed patient history, a thorough clinical evaluation, identification of characteristic [hysical findings and certain tests which include blood tests, an examination of CSF, spinal taps, X-ray procedures like MRI and CT.
AQP4-IgG is a highly specific blood test for NMOSD. This test detects antibodies that are specific for an astrocyte protein, aquaporin-4.
For acute attacks, the standard treatment is corticosteroids (i.v), typically prednisolone. For patients not responding to corticosteroids, consider plasma exchange- a technique that involves removing some blood and mechanically separating the blood cells from the plasma.
Immunosuppressive drugs are regarded as first-line therapy by many clinicians.
Corticosteroids, azathioprine, mycophenolate mofetil, and rituximab are the most widely prescribed treatments.
Symptom treatment may also include low doses of carbamazepine to control paroxysmal (sudden) tonic spasms that often occur during attacks of NMOSD and antispasticity agents to treat long term complications of spasticity that frequently develops in those with permanent motor deficits. For more info https://wcts.app/nPazE
- November 2, 2019 at 11:32 am #25942
- You must be logged in to reply to this topic.