Neuromyelitis optica is a disorder of demyelination and loss of protective covering of the optic nerve and spinal cord occurs in it. The myelin sheath of the cranial nerves in the central nervous system is formed of a special type of cells known as oligodendrocyte, otherwise, in the peripheral nervous system, it is formed of cells. The attack of own immunity on it due to various proteins or antigens of the cells be recognized as non-self-results in the inflammation. The usual presentation of a patient of neuromyelitis optica is optic neuritis in 75% cases and the rest of the present as myelitis or other nervous symptoms. The condition is also known by the name of Devic disease.
Life Expectancy Of Someone With Neuromyelitis Optica
The life expectancy of the patient suffering from neuromyelitis optica depends upon various factors. Three of the most important of them are the severity of the autoimmune reaction in the first episode, a number of episodes or relapses occurred within 2 years of the first diagnosis of the disorder and the age at which the disorder had presented in the first episode. The patient who suffers from a serious and severe first episode of the disorder experiences many relapses during the first two years after the diagnosis of disease and is detected in the elderly age group are more likely to suffer from a fatal form of the disease. The life expectancy of the disorder greatly reduces with these factors and the fatality rate increases with about 25 to 50% deaths.
It the in two forms known as monophasic neuromyelitis optica and relapsing neuromyelitis optica. In the monophasic form, the disorder usually occurs in younger age and is characterized by only one episode of it. The disease goes into remission with the subsequent treatment of the episode and usually do not relapse until the treatment is left midway or not taken at all. It has got a good prognosis and fewer complications with a life expectancy not much affected in it
In the biphasic form of neuromyelitis optica, there is a relapse of the disease even after aggressive treatment of it and the relapses make it even worse symptomatically as well as immunologically. Usually, these are seen in two years of a first diagnosis of the disorder and the age of presentation is also more likely to be late adulthood and elderly. There are much more complications associated with this forma and the prognosis is also poor. The life expectancy of the patient decreases to a large extent with extending the severity of the disease and may also prove fatal in many cases.
The fatal complication of neuromyelitis optica arises from the loss of myelination of the upper part of the spinal cord that is in the cervical region and sometimes it may extend up to lowermost part of the brain that is in Schwannmedulla. It results in the failure of respiratory muscles and respiratory drive resulting in loss of respiratory function which in turn proves fatal and is unbeatable. According to data, 25 to 50% of cases usually suffer from death within the first few years of diagnosis of the disease.
It is a rare disorder and prognosis is not a favorable one because once the autoimmunity develops against the self-antigens it usually does not subsides and the subsequent relapses or episodes are more serious and life-threatening than the previous ones because of antibody build up in the body against the same antigen due to the memory of the immune system. Many of the cases suffer from vision loss after a few episodes and loss of sensations and balance in the involvement of the spinal cord. Life expectancy reduces to a great extent with increasing age of the diagnosis and if it is left untreated in earlier episodes.
Early reporting of the symptoms such as vision loss etc. will help to counter the autoimmune response and symptoms in early age and life expectancy would be much less affected in those cases.
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