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Is Neuromyelitis Optica A Serious Condition & Can It Be Reversed?

Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system that predominantly affects the spinal cord and the optic nerves. This is a rare condition with a mean age of onset is estimated at 40 years, but pediatric forms are possible. The sex ratio leans very much towards a female predominance (> 3: 1).
The earlier the disease has been considered a particular form of multiple sclerosis. However, studies have revealed significant clinical, epidemiological, immunological, and pathological differences between multiple sclerosis and neuromyelitis optica.(1)

Is Neuromyelitis Optica A Serious Condition?

Neuromyelitis optica is a disease not to be ignored. It is a serious condition and can be fatal if not treated early enough. Moreover, blindness and paralysis of limbs are some of the other serious consequences.

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Without appropriate treatment, the disease can advance rapidly and leads to blindness and/or major motor paralysis. But unlike MS, this is a direct consequence of relapses and not of a progressive phase.(2)

Associated Complications

Neuromyelitis optica usually causes inflammation of the optic nerve. Failure to treat this disease may result in complete loss of vision to the patient. Especially in children or young people, vision loss can lead to severe mental trauma or depression.

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The development of neuromyelitis optica in children is therefore clearly a disturbing fact. Moreover, whether vision loss will occur in one eye or both the eyes cannot be generally predicted in many cases. Neuromyelitis optica may trigger other disorders of sensory organs or paralysis may occur at different sites of the body. The function of the bladder may be disturbed, causing patients to gastrointestinal irritations.

Neuromyelitis optica can be treated with the help of medication. If the person has lost vision, it cannot be restored as vision loss is usually irreversible. If it comes to mental disorders, the person is dependent on psychological treatment. It usually accompanies with other complications too. In general, the life expectancy of the patient is not adversely affected by the neuromyelitis optica, but death because of lung failure may take place on rare occasions.(3) (4)

Can Neuromyelitis Optica Be Reversed?

Neuromyelitis optica is an autoimmune disease and like other autoimmune disorders, it is very difficult to cure or reverse the conditions. There is no complete cure for the disorder, but early diagnosis and intervention can make it possible to keep the disease under control. Minimizing the symptoms and preventing the recurrence of relapses (attack on new nerve cells) are the two major goals of the treatment. Doctors usually treat an attack of Neuromyelitis Optica using a combination of corticosteroid and immunosuppressive medications.

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If there are frequent relapses, the person may need low dose steroids longer than usual. Plasmapheresis is also a technique that is used for people with optician neuromyelitis who do not respond to steroid therapy. Other symptoms such as pain, muscle spasms, bladder, and intestinal problems can be controlled with appropriate medications.(2)

It Is An Autoimmune Disease?

Neuromyelitis optica (NMO) is an autoimmune disease where the body’s own immune system attacks the healthy tissue of the optic nerve and spinal cord. Medical experts are unclear why autoimmune diseases, such as NMO, manifest themselves. The immune system of a person with NMO attacks the myelin sheath, that is, the protective shell of the spinal cord and optic nerve.

Scientists have discovered that more than two-thirds of patients with NMO have an antibody called NMO IgG (Neuromyelitis Optica Immunoglobulin G) in their blood.

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Scientists base their hypotheses on observations that IgG NMO damages Aquaporin 4, the water channel that surrounds the optic nerve.(1)

Conclusion

Neuromyelitis optica is a rare, yet serious disorder of the central nervous system affecting the optic nerves of the eyes as well as the spinal cord. It has an unpredictable course with relapses that can take months to years. Some people are severely affected by the disease, resulting in complete loss of vision and loss of limb function. Most patients end up with permanent limb weakness, and muscle weakness can lead to breathing problems as well. Immediate start of treatment following the appearance of symptoms can keep the disease in control for the majority of the patients.

References:  

  1. Wingerchuk DM, Hogancamp WF, O’brien PC, Weinshenker BG. The clinical course of neuromyelitis optica (Devic’s syndrome). Neurology. 1999;53(5):1107-1107.
  2. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. The Lancet Neurology. 2007;6(9):805-815.
  3. Pittock SJ, Lennon VA, De Seze J, et al. Neuromyelitis optica and non–organ-specific autoimmunity. Archives of neurology. 2008;65(1):78-83.
  4. Pittock SJ. Neuromyelitis optica: a new perspective. Paper presented at: Seminars in neurology2008.

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