Neuromyelitis optica

The combination of optic neuritis and myelitis, the so-called Neuromyelitis optica is an uncommon pattern of demyelinating disorder. In 1870, Sir Thomas Clifford Allbutt first reported the association and Erb published a comparable report. Gowers and Dreschfeld described other instances in the 19th century. This paper attempts to review the syndrome to consider whether it merits recognition as a disease, sui generis, or rather as a syndrome symptomatic of multiple sclerosis, acute disseminated encephalomyelitis, and other immunological disorders. Two forms are distinguished: a monophasic illness, and a relapsing form. The claimed differential features separating it from classical multiple sclerosis are appraised. Modern immunology suggests an antibody-dependent, complement-mediated pathogenesis.