What causes neuromyelitis optica, and how to treat it?

Question

Hello doctor,

I am concerned about my brother, who is 32 years old. He is depressed, as his doctor suspects him to have neuromyelitis optica. A few more tests are remaining for confirmation. He is very anxious, and he says that his vision seems to be blurring. Also, he has general weakness and swelling in his feet and legs.

What are the chances that he might have neuromyelitis optica?
Is that curable, and can he recover from this?
Is this anything serious?
Does this need lifelong treatment?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern for your brother.

Neuromyelitis optica (NMO), also known as Devic's disease, is a rare autoimmune disorder affecting the optic nerves and spinal cord. It can cause visual disturbances, weakness, sensory alterations, and bladder and bowel dysfunction. Your brother's symptoms include blurry vision, general weakness, and swelling in his feet and legs. It is understandable to be concerned about NMO.

Diagnosis involves clinical symptoms, imaging studies, and specific laboratory tests to detect antibodies like aquaporin-4 (AQP4-IgG) or myelin oligodendrocyte glycoprotein (MOG-IgG). These antibodies are typically elevated in patients with NMO, distinguishing it from other conditions like multiple sclerosis (MS).

NMO is typically managed with immunosuppressive therapies to reduce inflammation and prevent further attacks. High-dose corticosteroids are often used during acute attacks, followed by long-term treatments like Azathioprine (an immunosuppressant), Mycophenolate mofetil (an immunosuppressant), Rituximab (a monoclonal antibody), or other immunosuppressants. Plasma exchange may also be considered in severe cases.

The prognosis for NMO varies, with some experiencing recurrent attacks and others having a more stable course. Severe attacks can lead to vision loss and spinal cord damage, emphasizing the need for prompt medical intervention. Long-term treatment is often required to prevent relapses and manage symptoms.

Support from healthcare professionals specializing in neurology or autoimmune diseases is essential for your brother's well-being. While NMO is not curable, many individuals can achieve control with proper medical management. Encourage your brother to continue working closely with his healthcare team to monitor his symptoms, receive treatment, and maintain his overall health.

Let me know if I can assist you further.

Regards.