Neuromyelitis optica: current concepts and prospects for future management

To present an overview on the clinical manifestations and an update on the current management of neuromyelitis optica (NMO).

NMO is associated with a significant risk of neurological, ocular and systemic morbidity. Many cases of NMO assume a relapsing course, which can lead clinicians to mistake the disease for multiple sclerosis. Distinguishing between the two diseases can be accomplished by recognizing the differences in clinical manifestations, observing the clinical course, obtaining serological testing and appreciating the MRI features. It is also important to maintain a high index of suspicion for NMO in the appropriate clinical setting.

Clinical features of NMO include visual loss, decreased coordination, widespread asthenia, paraplegia, quadriplegia, and sensory impairment. Severe cases can result in bladder and bowel impairment or fatal respiratory failure. Symptomatic treatment and the currently available therapeutic agents can control the disease in many patients. However, given the lack of a curative treatment, the prognosis of NMO remains poor in some patients underscoring the need for drug development and controlled clinical trials focused on improved treatment strategies.