Neuromyelitis Optica Or Devic’s disease

What is Neuromyelitis Optica or Devic’s disease?

It is an immunological disorder that may be confused with Multiple Sclerosis (MS). Devic’s disease is often characterized by immune attacks on the optic nerves (which transmit what you see to your brain) and the spinal cord. Patients may experience these attacks at the same time or at different times. They may also have problems with the optic nerves alone or problems with the spinal cord alone and still have Devic’s disease.

There are two forms of Neuromyelitis Optica or Devic’s disease:-
• A single attack extending over a month or two
• Recurring – more common (with multiple attacks)

What are the causes of Neuromyelitis Optica?

More than 95% of patients with Neuromyelitis Optica report no relatives with the disease, but approximately 3% report having other relatives with the condition. There is a strong association with a personal or family history of autoimmunity, which is present in 50% of cases. Neuromyelitis Optica is regarded as an autoimmune disease though the exact cause for the autoimmunity is unknown.

Autoimmune disorders occur when the body’s natural defenses against diseases or invading organisms (such as bacteria), for unknown reasons, suddenly begin to attack healthy tissue. These defenses, for reasons not all understood, attack proteins in the central nervous system, especially aquaporin-4.

What are the symptoms of Devic’s disease?

Potential symptoms of this disease include:

Visual symptoms (due to damage of optic nerves)
• Swelling and inflammation
• Loss or blurring of vision in one or both eyes
• Loss of color vision
Spinal cord inflammation (due to damage to the spinal cord)
• Weakness, numbness (loss of sensation)
• Loss of function (paralysis)
• Loss of bowel or bladder control, retention of urine
• Spasticity (increased tone or stiffness in the extremities)
• Shooting pain or tingling in the neck, back or abdomen
• Strong nausea and vomiting, fatigue
• Seizures or coma can occur in children

How is Devic’s disease diagnosed?

In general, the test for Oligoclonal bands (a test that is often positive in MS) is usually negative in the spinal fluid in Devic’s disease. Oligoclonal bands are immunoglobulins (or antibodies), proteins produced by the immune system to fight off invaders like bacteria or viruses.

A blood test known as the NMO-IgG (Antibodies to Aquaporin-4) blood test is positive in 70% of patients diagnosed with Devic’s disease. This test, in general, is negative in patients with multiple sclerosis. This has become an important marker for Devic’s disease and has helped improve our understanding of this disorder.

Testing for Devic’s disease may include MRI (magnetic resonance imaging) scans to show inflammation of the spinal cord. MRI uses a large magnet, radio waves and a computer to produce images. In a person with Devic’s disease, the MRI scan may show inflammation in a long segment of the spinal cord.

In Devic’s disease, the MRI scan of the brain may be normal or show relatively mild changes. The optic nerve MRI may show areas of abnormality.

Another difference in the findings for Devic’s disease as compared to MS is that cerebrospinal fluid may show a greater increase in white blood cells than in MS patients, and may show a type of cell (neutrophil) that is not usually seen in MS.

If you or your family members are facing any of these symptoms consult your doctor immediately.

Public awareness initiative by NeuroUNO – A super specialty division by Metropolis

Test Name Details Test Code Sample Schedule Report on
NMO (Aquaporin 4) – IgG Neuromyelitis Optica Antibodies N0030 3 ml CSF Tue, Fri: 9am Next day 5pm
NMO (Aquaporin 4) – IgG Neuromyelitis Optica Antibodies N0029 3 ml Serum Tue, Fri: 9am Next day 5pm
NMO (Aquaporin 4) NMO IFA from CSF and Serum sample N0048 3 ml CSF OR 3 ml Serum Tue, Fri: 9 am Next day 5pm
NMO with MOG Antibody Profile for CSF IFA N0060 CSF (2 ml in plain container) Tue, Fri: 9am Next day 5pm
NMO with MOG Antibody Profile for serum IFA N0059 Serum 2 ml Tue, Fri: 9am Next day 5pm