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Neuromyelitis optica spectrum disorder

Neuromyelitis optica (morbus Devic) · Onemocnění spektra neuromyelitis optica

What it is

Autoimmune attacks on the optic nerves and spinal cord, mostly driven by antibodies against aquaporin-4; attacks are severe and damage adds up, so preventing relapses is everything — it is not multiple sclerosis.

Symptoms & signs

  • Painful loss of vision in one or both eyes
  • weakness and numbness of the legs or all limbs
  • bladder and bowel problems
  • intractable hiccups and vomiting
  • painful spasms

🚩 Get help if…

  • call 112 / 911 now Weakness or numbness of both legs, or loss of bladder control
  • call 112 / 911 now Trouble breathing or swallowing
  • see a doctor soon Sudden pain on moving an eye with blurred or lost vision
  • see a doctor soon Non-stop hiccups or vomiting for over two days

Where it strikes

Medical treatment

  • Aquaporin-4 and MOG antibody tests; MRI
  • high-dose steroids and plasma exchange for attacks
  • Eculizumab, ravulizumab, inebilizumab, satralizumab — relapses cut by roughly 55–98% in trials; complement blockers raise meningococcal risk trials support
  • rituximab (off-label, widely used)
  • azathioprine or mycophenolate
  • Some MS drugs (interferon beta, natalizumab, fingolimod) — can worsen it not confirmed in trials

Natural & lifestyle

  • Physiotherapy
  • bladder care
  • stay active

Emerging & experimental

  • CAR-T cell therapy
  • autologous stem-cell transplantation

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Vitamin D — low levels linked to relapses; untested as treatment early / small studies
  • Anti-inflammatory diet — untested anecdotal / traditional

ICD codes