There is no cure for neuromyelitis optica, but there are therapies to treat
an attack while it is happening, to reduce symptoms, and to prevent relapses.
Doctors usually treat an initial attack of neuromyelitis optica with a
combination of a corticosteroid drug (methylprednisolone) to stop the
attack, and an immunosuppressive drug (azathioprine) for prevention of
subsequent attacks.
If frequent relapses occur, some individuals may need to continue a low
dose of steroids for longer periods.
Plasma exchange (plasmapheresis) is a technique that separates
antibodies out of the blood stream and is used with people who are
unresponsive to corticosteroid therapy.
Pain, stiffness, muscle spasms, and bladder and bowel control problems
can be managed with the appropriate medications and therapies.
Individuals with major disability will require the combined efforts of
occupational therapists, physiotherapists, and social services professionals
to address their complex rehabilitation needs.
What is neuromyelitis optica?
Neuromyelitis optica (NMO) is an uncommon disease syndrome of the central nervous system (CNS) that affects the optic nerves and spinal cord.
What are the symptoms of neuromyelitis optica?
Individuals with neuromyelitis optica develop optic neuritis, which causes pain in the eye and vision loss, and transverse myelitis, which causes weakness, numbness, and sometimes paralysis of the arms and legs, along with sensory disturbances and loss of bladder and
bowel control.
Neuromyelitis optica leads to loss of myelin, which is a fatty substance that surrounds nerve fibers and helps nerve signals move from cell to cell. The syndrome can also damage nerve fibers and leave areas of broken-down tissue. In the disease process of
neuromyelitis optica, for reasons that aren't yet clear, immune system cells and antibodies attack and destroy myelin cells in the optic nerves and the spinal cord.
How is neuromyelitis optica diagnosed?
Historically, neuromyelitis optica was diagnosed in patients who experienced a rapid onset of blindness in one or both eyes, followed within days or weeks by varying degrees of paralysis in the arms and legs. In most cases, however, the interval between optic neuritis and transverse myelitis is significantly longer, sometimes as long as several years. After the initial attack,
neuromyelitis optica follows an unpredictable course. Most individuals with the syndrome experience clusters of attacks months or years apart, followed by partial recovery during periods of remission. This relapsing form of
neuromyelitis optica primarily affects women. The female to male ratio is greater than 4:1. Another form of
neuromyelitis optica, in which an individual only has a single, severe attack extending over a month or two, is most likely a distinct disease that affects men and women with equal frequency. The onset of
neuromyelitis optica varies from childhood to adulthood, with two peaks, one in childhood and the other in adults in their 40s.
In the past, neuromyelitis optica was considered to be a severe variant of multiple sclerosis (MS) because both can cause attacks of optic neuritis and myelitis. Recent discoveries, however, suggest it is a separate disease.
Neuromyelitis optica is different from MS in the severity of its attacks and its tendency to solely strike the optic nerves and spinal cord at the beginning of the disease. Symptoms outside of the optic nerves and spinal cord are rare, although certain symptoms, including uncontrollable vomiting and hiccups, are now recognized as relatively specific symptoms of
neuromyelitis optica that are due to brainstem involvement.
The recent discovery of an antibody in the blood of individuals with
neuromyelitis optica gives doctors a reliable biomarker to distinguish
neuromyelitis optica from MS. The antibody, known as NMO-IgG, seems to be present in about 70 percent of those with
neuromyelitis optica and is not found in people with MS or other similar conditions.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Optic neuritis is inflammation of the optic nerve, the structure that connects the eye to the brain. The precise cause of optic neuritis is unknown, but it is thought to be a type of autoimmune disorder. Optic neuritis most commonly develops due to an autoimmune disorder that may be triggered by a viral infection.
Hiccups are a sudden, involuntary contraction of the diaphragm muscle. In general hiccups are just a temporary condition. Some of the causes of hiccups include certain medications, surgery, eating or drinking too much, spicy foods, diseases or conditions that irritate the nerves controlling the diaphragm, strokes, brain tumors, liver failure, and noxious fumes.
There are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence, and overflow incontinence. Urinary incontinence in men may be caused by prostate or nerve problems. Treatment depends upon the type and severity of the UI and the patient's lifestyle.
Blindness is the state of being sightless. Causes of blindness include macular degeneration, stroke, cataract, glaucoma, infection and trauma. Symptoms and signs may include eye pain, eye discharge, or the cornea or pupil turning white. Treatment of blindness depends upon the cause of the blindness.
Bowel or fecal incontinence refers to the loss of voluntary control of stool, or bowel movements. The condition can include partial incontinence, in which a person loses only a small amount of liquid waste, to complete incontinence, in which the entire bowel movement cannot be controlled. Diet changes and elimination of certain medications can help patients to regain bowel control. Treatment involves a combination of medication, biofeedback, and exercise.
Millions of women suffer from urinary incontinence (UI). UI occurs twice as often in women as in men. There are many types of urinary incontinence: stress incontinence, urge incontinence, overactive bladder, functional incontinence, overflow incontinence, transient incontinence, and mixed incontinence.
Urinary incontinence in children (enuresis) is twice as common in boys as in girls and may occur during the daytime or nighttime. Nighttime urinary incontinence is also called bedwetting and sleepwetting. The cause of nighttime incontinence in children is unknown. Daytime incontinence in children may be caused by an overactive bladder. Though many children overcome urinary incontinence naturally, it may be necessary to treat incontinence with medications, bladder training and moisture alarms, which wake the child when he or she begins to urinate.
Nighttime wetting (nocturnal enuresis) is more common than daytime wetting (diurnal enuresis).
Most urinary incontinence is nonorganic and resolves without intervention.
Persistent primary enuresis and secondary enuresis may require further medical
evaluation.
Treatment for most cases of enuresis involves behavioral modification.
Bedwetting alarms are very effective.
Medications should be reserved for select children.
Less than 1% of all affected children have persistent incontinence into adulthood.
What is urinary incontinence?
Very simply stated, urinary incontinence is
defined as the loss of complete control of the act of urination or the
involuntary emptying of the bladder. It is also referred to as enuresis. It can
be caused by any number of factors,...
Neurology RSS
Healthy Living Tips
This site complies with the