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Neuromyelitis Optica Spectrum Disorder
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory condition that causes damage to a person’s spinal cord and/or optic nerve and can also cause changes in the brain.
The Neuromyelitis Optica Program at UT Southwestern is recognized as a world leader in the research and treatment of NMOSD. We work in conjunction with the Transverse Myelitis Association and the Guthy-Jackson Charitable Foundation to provide comprehensive care to patients with NMOSD, serving patients from around the world.
World Leaders in Treating a Range of Inflammatory Symptoms
NMOSD is a central nervous system disorder that affects adults and children. The true incidence of this condition is unknown, but there are an estimated 10,000 individuals with NMOSD in the U.S.
In most patients a specific antibody, anti-Aquaporin 4 (AQP4), can be found in the blood. Some patients with an anti-myelin oligodendroglial glycoprotein (MOG) antibody can have a syndrome that looks very similar to NMOSD caused by the anti-AQP4 antibody.
Patients with NMOSD usually present with symptoms of spinal cord inflammation (transverse myelitis) or symptoms of optic nerve inflammation (optic neuritis). Over time, untreated, patients with NMOSD can go on to have recurrent attacks that cause disability.
UT Southwestern’s Neuromyelitis Optica Program addresses the wide range of symptoms that can make NMOSD difficult to treat. Patients have access to specialists in virtually every discipline related to diagnosis and treatment.
We also treat other autoimmune diseases, such as transverse myelitis (TM), multiple sclerosis (MS), and autoimmune encephalitis.
Symptoms of Neuromyelitis Optica Spectrum Disorder
Symptoms of NMOSD can vary widely from patient to patient, and they often fluctuate over time. Patients usually have symptoms of spinal cord damage or optic nerve damage.
Symptoms can include:
- Balance disorders
- Bladder or bowel problems
- Changes in gait
- Depression or other emotional changes
- Difficulties with muscle coordination
- Numbness or tingling
- Sexual dysfunction
- Vision changes
Diagnosing Neuromyelitis Optica Spectrum DisorderAccurate diagnosis and timely treatment of NMOSD is critical. UT Southwestern experts collect information from a variety of tests and imaging studies to find evidence of damage to the spinal cord and or optic nerves. Testing for the anti-AQP4 and anti-MOG antibody is crucial for diagnosis.
We conduct a careful medical history, a neurologic exam, and a variety of tests that can include:
- Blood tests
- Evoked potentials (EP)
- Optical coherence tomography (OCT)
- Magnetic resonance imaging (MRI)
- Spinal fluid analysis
Treating Neuromyelitis Optica Spectrum DisorderOnce a diagnosis of NMOSD is confirmed, the goal of treatment is to ensure that all active inflammation is extinguished and then focus on recovery and symptom management. In addition to finding the best medications for each individual, we also empower patients by treating symptoms of NMOSD with nutrition, exercises, and assistive devices.
Our individualized, multidisciplinary treatment plans work to maximize each person’s abilities and minimize disabilities. A patient’s care team might include:
- Clinical nurses
- Advanced practice providers (physician assistants and nurse practitioners)
- Neuropsychologists and psychiatrists
- Occupational therapists
- Physical therapists
- Rehabilitation specialists
- Social workers
- Registered dietitians
Acute therapy includes high doses of corticosteroids and, in some patients, plasma exchange therapy. Other interventions are considered on an individual basis. Beyond the anti-inflammatory therapies, rehabilitation for patients with spinal cord damage is essential to recovery.
Once NMOSD is diagnosed, especially when anti-AQP4 antibodies are present, we develop a treatment plan to prevent relapses. While immunosuppression has been used for more than a decade in NMOSD, multiple trials for NMOSD-specific treatments are increasing and showing promise in their ability to prevent relapses.
The UT Southwestern Neuromyelitis Optica Program works closely with the Transverse Myelitis Association and the Guthy-Jackson Charitable Foundation to help people with NMOSD and their families stay educated about new treatments and new research.
Transverse Myelitis Association NMOSD Support Group
The TMA sponsors a network of support groups around the nation and several in Texas. Visit the TMA website for a listing of support groups and contact information.
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