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Is Neuromyelitis Optica Worse Than MS & Can You Have MS And Neuromyelitis Optica?

Is Neuromyelitis Optica Worse Than MS?

Neuromyelitis optica and multiple sclerosis are the autoimmune diseases and both affect the nervous system However, there are some differences between the pathophysiology and symptoms. The attack of neuromyelitis optica is believed to be more severe than multiple sclerosis.

Is Neuromyelitis Optica Worse Than MS?

Can You Have MS And Neuromyelitis Optica?

Many-a-times neuromyelitis optica and multiple sclerosis provide a similar set of symptoms but they are altogether distinct conditions. However, it is not clear if both the condition may simultaneously exist in a single patient. Following are some of the differences between the two:

  • Both are autoimmune, but in neuromyelitis optica, the immune system targets specific protein while there is no specific target protein in multiple sclerosis2.
  • The severity of neuromyelitis optica increases through a relapse, while the severity of multiple sclerosis increases through progression.
  • In some cases, the brain may be affected in neuromyelitis optica while multiple sclerosis is characterized by brain damage.
  • Pathophysiology of both neuromyelitis optica and multiple sclerosis are different. While neuromyelitis affects primarily the optic nerve and spinal cord, multiple sclerosis affects the brain and spinal cord.

Neuromyelitis Optica

Neuromyelitis Optica is also known as Devic’s disease. The condition affects the optic nerve of the eye and also the spinal cord. Although the exact cause of the condition is not known, it is believed that it is possibly caused due to the attack of the immune system on the optic nerve and spinal cord. The disease is most commonly seen after an infection when the immune system is hyperactive or in the presence of autoimmune diseases1.

The condition may also have an impact on the brain. The more specific cause of this condition is the attack of the immune system on aquaporin-4 (AQP4) water channel which is present in the spinal cord and optic nerves2.

Severity Of Neuromyelitis Optica

The severity of neuromyelitis does not occur due to the progression of the disease rather the severity increases with relapse of attack. Thus, for reducing the damage to the optic nerve and spinal cord, it is essential to diagnose the disease in its initial stage, to get the symptoms managed. The relapse of such attacks may also be managed through the optimum treatment strategy. The increased attack may result in incremental loss of function in both optic nerve and spinal cord.3 With the increased frequency of relapse, some lesions may also be found in the brain. Although mild relapse of neuromyelitis optica can be managed through steroids, plasma exchange therapy is required in case of more severe attacks.

Multiple Sclerosis

Multiple sclerosis is an autoimmune disorder. Multiple sclerosis affects primarily the brain and spinal cord and optic nerve are also gets affected in most cases. Multiple sclerosis is a progressive neurological disorder and the condition when not managed o poorly managed may lead to serious complications. The immune system attacks the nerve cells, more specifically the myelin sheath of neurons, resulting in abnormal conduction of impulses. When the conditions affect the brain and spinal cord, it leaves a scar, which may also be termed as lesions.4 Various type of multiple sclerosis occurs in different patients such as primary progressive, secondary progressive, relapse-remitting, and clinically isolated. The symptoms experienced by the patient include weakness, vision problems, poor bladder control, sexual dysfunction, poor coordination, and memory problems.

Severity Of Multiple Sclerosis

Multiple sclerosis is a progressive disease and the severity of condition gradually increases. Most people in the initial phase of the disease have a relapsing-remitting type and the severity of the condition depends upon the are of the brain affected. Further, the condition of the patient worsens day-by-day during the relapsing-remitting type.

People with this type of multiple sclerosis may progress into a primary and secondary progressive disease which has increased severity. In primary progressive multiple sclerosis, the symptoms are ill-defined and no medications work to manage symptoms.5 With a considerable time spend in the relapsing-remitting phase, many patients progress into secondary progressive multiple sclerosis. People who are not able to recover from relapse have a higher risk of shifting to secondary progressive condition.


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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 17, 2019

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