Neuromyelitis Optica and Spectrum Disorder

  • Demyelinating disease due to antibodies against aquaporin-4 (on oligodendrocytes). 
  • Classically causes optic neuritis and longitudinally extensive transverse myelitis (3 or more spinal segments involved). 
    • Can be more aggressive than MS, and choice of disease modifying therapy often differs 
  • Diagnose with NMO antibodies and MS workup as above. 
  • In the acute setting, exacerbations treated with steroids, but in severe or refractory cases may require PLEX, and disease modifying therapy differs from MS (typically rituximab).
Last updated on