About Neuromyelitis Optica (Devic's Disease)
The causes of NMO involve the malfunction of the immune system, where antibodies mistakenly attack healthy cells and proteins in the body. In NMO, abnormal autoantibodies bind to a protein called aquaporin-4, leading to inflammation and damage to cells, including the loss of myelin in the brain and spinal cord.
Non-modifiable risk factors are factors that cannot be changed or controlled. As for non-modifiable risk factors, NMO rarely has a genetic connection, with less than 3 percent of people having an affected relative. Additionally, research suggests that NMO primarily affects women in their 30s and 40s.
Modifiable risk factors are factors that can be influenced or changed. Modifiable risk factors include:
- Gastrointestinal infections like H. pylori and C. Diff
- Vitamin D deficiency
- Smoking
- Having other autoimmune diseases
It's important to note that while these factors have been identified in people with NMO, they do not guarantee the development of the condition. Understanding these causes and risk factors can help individuals make informed decisions about their health and potentially mitigate certain modifiable risk factors through lifestyle changes or medical interventions.
The most common early symptoms of NMO include:
- Optic neuritis: Inflammation of the optic nerve, which can cause pain in the eyes and blurred vision. This symptom usually occurs in one eye, but it can affect both eyes.
- Myelitis: Inflammation of the spinal cord, which can lead to loss of motor functions, sensation, and weakness in the legs. It may also cause pain in the spine or limbs, urinary or bowel incontinence, reduced reflex responses, stiff neck, and headache.
As NMO progresses or becomes more severe, additional symptoms may occur. These can include:
- Paralysis: Depending on where the damage occurs in the nervous system, NMO can lead to partial or complete paralysis.
- Loss of vision: The immune system attacks the optic nerves in NMO, which can result in permanent vision loss if left untreated.
- Changes in sensation: NMO can cause alterations in sensation, such as numbness or tingling in different parts of the body.
It's important to note that early and ongoing treatment for NMO can help reduce the chances of experiencing more severe symptoms and complications. If you experience any of these symptoms or suspect you may have NMO, it's essential to consult with a healthcare professional for an accurate diagnosis and appropriate management.
To diagnose NMO, health care providers commonly perform the following examinations, tests, and procedures:
- Physical Exam: The health care provider will conduct a physical exam to look for physical signs of a medical problem, such as pain, swelling, or the presence of masses within the body.
- Lab Tests: Specific lab tests may be ordered to check samples of blood, urine, or body tissues. The type of lab tests ordered will depend on the symptoms and diseases being considered.
- Imaging Studies: Imaging studies like X-rays or MRI scans may be recommended to look inside the body for clues to help diagnose or manage NMO. The type of imaging study chosen depends on the symptoms and the part of the body being examined.
To determine the stage or severity of NMO, additional examinations, tests, and procedures may include:
- Clinical Procedures: Depending on the body system being evaluated, clinical procedures such as hearing tests or other specialized tests may be performed.
It's important to follow up with your health care provider if any symptoms worsen or change after the initial physical exam. They will guide you through the necessary examinations and tests tailored to your individual situation.
The goals of treatment for neuromyelitis optica are to address current attacks, prevent future attacks, and manage symptoms. Here are the different types of treatments and how they work to achieve these goals:
Medication Types:
- Corticosteroids: These medications, such as methylprednisolone, are used to treat acute NMO attacks. They help reduce inflammation and suppress the immune response.
- Immunotherapy: This type of treatment modulates the immune system to prevent future attacks. Medications like azathioprine, mycophenolate mofetil, and rituximab are commonly used for long-term management of NMO.
Therapies:
- Plasma Exchange (PLEX): PLEX removes antibodies from the blood that contribute to NMO attacks. It involves filtering the blood through a machine and replacing the removed plasma with artificial plasma.
Therapeutic Procedures:
- Symptom Management: Various medications can be prescribed to help control symptoms like pain or spasticity associated with NMO. These medications do not treat the disease itself but provide relief from specific symptoms.
It is important to follow your healthcare professional's advice regarding medication adherence, regular follow-up appointments, and maintaining a healthy lifestyle. Consult with your healthcare professional about the most appropriate treatment options for your individual situation. They can provide personalized recommendations based on your specific needs and medical history.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.