Neuromyelitis Optica (Devic's Disease)

Neuromyelitis optica is a disease that affects the myelin sheath, the insulation around nerves that helps send signals to and from the brain. Depending on the location of the attacked area, it can cause different symptoms, including paralysis and blindness.

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Understanding Neuromyelitis Optica (Devic's Disease)

What is neuromyelitis optica?

Neuromyelitis optica (NMO) is a rare autoimmune disease that affects the central nervous system. It's also called Devic's disease. NMO specifically affects the myelin, which is the insulation around the nerves. NMO mainly affects the spinal cord and optic nerves — the nerves that carry signals from the eyes to the brain. As a result, the disease can cause paralysis and blindness.

NMO most often strikes between the ages of 30 and 39. But it can also start during childhood. It can also affect adults who are in their 40s. It’s especially common in young women, but men can develop it, too.

Experts used to think that NMO was a type of multiple sclerosis. They now think it may be a different condition. The conditions do have some similar symptoms. But they are usually more severe in NMO. Vision problems with multiple sclerosis usually affect one eye at a time, while NMO may affect both eyes at the same time.

There are two types of NMO:

  • Relapsing form, which has periodic flare-ups, with some recovery in between. This is the more common kind. Women are far more likely to have this form than men.

Monophasic form, which involves a single attack that lasts a month or two. Men and women get this type equally.

What causes neuromyelitis optica?

With NMO, your immune system attacks a substance in your body called myelin — the insulation around your nerves. Specifically, the myelin cells in the spinal cord and optic nerves are attacked. Usually, people with NMO have flare-ups of the disease that may strike months or years apart. Between these flare-ups, people may have some recovery.

What are the symptoms of neuromyelitis optica?

These are possible symptoms of NMO:

  • Pain in the eyes.

  • Loss of vision.

  • Weakness or numbness in the arms and legs.

  • Paralysis of the arms and legs.

  • Difficulty controlling the bladder or bowels.

  • Uncontrollable vomiting and hiccups.

How is neuromyelitis optica diagnosed?

Your healthcare provider may do a variety of tests if he or she suspects NMO, such as:

  • MRI scan of your brain and spinal cord.

  • Tests to check on how well your optic nerves are working.

  • Samples of your blood and spinal fluid to check for signs of the disease.

How is neuromyelitis optica treated?

Experts don't consider this condition curable. But your healthcare provider can prescribe medicines or other treatments to reduce the effects of the disease and relieve symptoms. These may include:

  • Corticosteroid drugs to halt the immune system's effect on your nerves.

  • Immunosuppressant medicines.

  • A process called plasmapheresis, which removes proteins from the blood that may be playing a role in the condition.

  • Other treatments to address symptoms such as pain and loss of bowel and bladder control.

You may also need help to cope with blindness and paralysis.

What are possible complications of neuromyelitis optica?

There are several possible complications of NMO including:

  • Visual impairment or blindness.

  • Paralysis or weakness of one or more limb.

  • Stiffness or muscle spasms.

  • Loss of bowel or bladder control.

  • Depression.

  • Fatigue.

Living with neuromyelitis optica

Disability from NMO may become worse over time. Most people with NMO develop weakness in their arms and legs. Others may have more severe symptoms. Some people with NMO need to start using a ventilator. This is a machine that helps them breathe. They may also need to work with an occupational therapist or social worker to address their disabilities. 

If you or a family member is diagnosed with NMO, it is important to build a support system that includes family, friends, professionals, and support groups. A person with major disabilities may need the support of neurologists who specialize in NMO, occupational therapists, physical therapists, and social services professionals.

When should I call my healthcare provider?

Call your healthcare provider if you:

  • Notice sudden changes or find you need more help than usual.

  • Have a change in mood.

  • Have symptoms of depression or feelings of suicide.

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