Neuromyelitis Optica and Spectrum Disorder

  • Demyelinating disease due to antibodies against aquaporin-4 (on oligodendrocytes)
  • Classically causes optic neuritis and longitudinally extensive transverse myelitis
    • Can be more aggressive than MS
  • 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)
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