Have you ever heard of neuromyelitis optica , or NMO as we call it for short? Probably not. Because it is not a very common disease in the world. But it is a serious condition that can directly affect our eyesight and the spinal cord. So, it is very important to know about this. Today, we will talk about it in a simple way that you can understand.
Simply put, what is NMO?
NMO has several other names. Some call it Neuromyelitis Optica Spectrum Disorder (NMOSD), while others call it Devic's Disease. This is a very strange thing that happens. Our body's defense system, the immune system, mistakenly starts attacking our own healthy cells. It's like our own army attacking our own country. This attack mainly targets two parts of our central nervous system: the optic nerve, which carries information from the eye to the brain, and the spinal cord, which runs down the spine.
This disease can occur in two main ways:
1. Monophasic NMO: In this, symptoms appear suddenly over a period of days or weeks and resolve in a single attack.
2. Relapsing NMO: This is the most common type. Here, symptoms appear and subside over a period of time. But then, months or even years later, another attack may occur. The symptoms may get worse with each attack.
Although the first type can affect both men and women, the second type, or relapsing NMO, is more common in women than in men. It can also affect young children.
What are the symptoms of NMO?
The symptoms of NMO fall into two main categories. If you have any of these, it is very important to see a doctor as soon as possible.
| Medical condition | Explanation and symptoms |
|---|---|
| Optic neuritis | This is when the optic nerve in the eye becomes inflamed. You may suddenly feel a sharp pain inside your eye . This can be followed by blurred vision, and sometimes even complete loss of vision. It usually affects one eye, but it can sometimes affect both eyes. |
| Transverse myelitis | This is when the spinal cord in the spine swells. This can cause pain, weakness, numbness, or paralysis in the arms and legs. You may also lose control of your bladder and bowels. In addition, symptoms such as nausea, vomiting, persistent hiccups, neck stiffness, and headaches may also occur. |
If young children develop NMO, they can show severe symptoms such as behavioral changes, impaired consciousness, seizures, or coma.
Is NMO the same as MS (Multiple Sclerosis)?
No. This is a place where many people get confused. MS, which stands for Multiple Sclerosis, is another disease that affects the nervous system and is caused by the activity of the immune system. In the past, doctors thought that NMO was a type of MS. But now research has found that these two diseases are completely different.
Here are some of those changes :
| Factor | NMO (Neuromyelitis Optica) | MS (Multiple Sclerosis) |
|---|---|---|
| The speed of onset of the disease | Symptoms are usually very rapid and severe. | Symptoms usually develop more slowly, over a longer period of time. |
| Blood tests | There is a specific blood test (antibody test) to diagnose NMO. | There is no specific blood test like this to diagnose MS. |
| MRI scan of the brain | Early in the disease, a brain MRI scan may appear normal. | In MS, changes are usually seen on MRI scans of the brain. |
| Other features | Symptoms such as nausea, vomiting, and hiccups are common. | These symptoms are not usually seen in MS. |
What causes NMO?
In fact, doctors still don’t know the exact cause of NMO. There’s no evidence that it’s passed down from generation to generation. But one thing is clear. Many people with NMO have other autoimmune diseases , or their family members have them. Simply put, it’s a condition where our body’s defense system, the immune system, mistakenly attacks our own healthy cells. Diabetes (Type 1 Diabetes), rheumatoid arthritis, psoriasis, and vitiligo are just a few examples of such diseases.
How is the disease diagnosed?
After asking about your symptoms, your doctor will examine you. This will include testing your thinking ability, eyesight, speech, body strength, and reflexes.
In addition, these tests may also be performed:
- Blood tests: More than 70% of people with NMO have a specific protein, called an antibody, in their blood. This can be detected with a blood test.
- Spinal fluid test: Sometimes it may be necessary to take fluid from the spine and test it.
- MRI scan: An MRI ( magnetic resonance imaging ) is a test that uses a large magnet and a computer to take clear pictures of the inside of your body. This can help to see if your spinal cord is swollen.
- Eye exam: You may be referred to an ophthalmologist, who will perform special tests such as OCT (Optical Coherence Tomography) to check for damage to the optic nerve.
What are the treatments for NMO?
This is the most important part. There is no cure for NMO yet. But there are very effective treatments that can help control symptoms and prevent future attacks.
- Anti-seizure drugs: There are several new drugs recently approved for NMO. Eculizumab (Soliris), inebilizumab-cdon (Uplizna), and satralizumab-mwge (Enspryng) are some of these drugs. These drugs work by targeting the antibodies that attack our healthy cells and stopping them from working. In addition, your doctor may prescribe other drugs that suppress the immune system.
- Steroids: Steroid medications are given to reduce inflammation in the body. These are usually given through a vein (IV).
- Plasma exchange: Also called plasmapheresis, this is like a blood purifier. A special machine separates the plasma from your blood, which contains harmful antibodies, and removes it. Then, a substitute is added and the purified blood is put back into your body.
Take-Home Message
- NMO is a rare but serious autoimmune disease that affects our eyes and spine.
- If you experience symptoms such as sudden eye pain, vision loss, weakness or numbness in your limbs, seek medical advice without delay.
- NMO is a different disease from MS (Multiple Sclerosis). A special blood test can distinguish the two.
- Although it cannot be completely cured, there are very effective treatments available today to control symptoms and prevent future attacks.
- If you or someone you know has any doubts or questions about this, please speak openly with your doctor.
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