Neuromyelitis optica spectrum disorders
Journal: Clinical Medicine Journal; March 1, 2019
Author(s): Saif Huda, Dan Whittam, Maneesh Bhojak, Jayne Chamberlain, Carmel Noonan, Anu Jacob and Rachel Kneen
A review of NMOSD
This article reviews the pathogenesis, clinical features, diagnosis and management of NMOSD. It includes a short patient case study and discusses the history, genetic factors and populations affected, clinical presentation, diagnostic considerations, and treatment options. Key take-home messages are as follows:
- Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing central nervous system disease associated with aquaporin-4 antibodies.
- Common presentations include longitudinally extensive myelitis, severe optic neuritis, and area postrema syndrome.
- Prompt and aggressive treatment of relapses with high dose steroids with/without plasma exchange improves outcomes.
- All patients with aquaporin-4 antibodies should be immunosuppressed indefinitely to prevent further attacks.
- The NMOSD service based in Liverpool (Walton Centre NHS Foundation Trust) and Oxford (John Radcliffe Hospital) provides a quaternary service for all NMOSD patients in the UK. Referrals are accepted from GPs and all medical specialties.
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