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Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4
09:29

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Neuromyelitis optica.

Dean M Wingerchuk1, Brian G Weinshenker

  • 1Dean M. Wingerchuk, MD, MSc, FRCP(C) Department of Neurology, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA. wingerchuk.dean@mayo.edu.

Current Treatment Options in Neurology
|March 8, 2008
PubMed
Summary
This summary is machine-generated.

Neuromyelitis optica (NMO) is an inflammatory CNS disorder distinct from MS, characterized by optic neuritis and transverse myelitis. Early immunosuppression is crucial for NMO-IgG positive patients to prevent relapses and disability.

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Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
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Published on: April 14, 2014

Area of Science:

  • Neuroimmunology
  • Demyelinating Diseases
  • Autoimmune Disorders

Background:

  • Neuromyelitis optica (NMO), also known as Devic's syndrome, is a severe inflammatory demyelinating central nervous system (CNS) disorder.
  • NMO is characterized by optic neuritis and transverse myelitis, often with spinal cord lesions spanning three or more vertebral segments.
  • Unlike multiple sclerosis (MS), NMO typically spares the brain, has a relapsing course in over 90% of patients, and is associated with the NMO-IgG autoantibody targeting aquaporin-4.

Purpose of the Study:

  • To outline the distinct characteristics of NMO compared to MS.
  • To recommend treatment strategies for acute relapses and long-term management of NMO.
  • To emphasize the importance of early immunosuppression in high-risk NMO patients.

Main Methods:

  • Review of clinical characteristics, diagnostic markers (NMO-IgG), and disease course of NMO.
  • Analysis of treatment outcomes for acute relapses using intravenous corticosteroids and plasmapheresis.
  • Evaluation of long-term immunosuppressive therapies including azathioprine, mycophenolate mofetil, and rituximab.

Main Results:

  • NMO is a severe, relapsing CNS disorder distinct from MS, with NMO-IgG as a specific biomarker.
  • Acute relapses are treated with corticosteroids and plasmapheresis for refractory cases.
  • Long-term management involves immunosuppression, with specific recommendations based on disease severity and patient history.

Conclusions:

  • Humoral autoimmune mechanisms are central to NMO pathogenesis, necessitating systemic immunosuppression.
  • Early and prolonged immunosuppression (≥5 years) is recommended for NMO-IgG seropositive patients with longitudinally extensive transverse myelitis due to high relapse risk.
  • Treatment choices (oral agents vs. rituximab) depend on disease severity and response to initial therapies.