Devic's Disease

Differences between Devic's Disease
and Multiple Sclerosis

In well-established cases of Devic's disease, it is usually possible to accurately distinguish it from MS. However, early in the course of these two conditions, it may be difficult to definitively separate these two conditions. The distinction is important to ensure the most appropriate treatment.

There are several important differences:

• Clinically, Devic's disease affects only the optic nerves and spinal cord, whereas MS affects the brain as well.
• Attacks of Devic's disease tend to be more frequent and severe than attacks of MS, though this is not always the case.
• An MRI of the brain is typically normal in Devics disease, although this is not always the case; in MS the MRI of the brain typically shows many areas of inflammation.
• An MRI of the spinal cord shows continuous extensive inflammation of the spinal cord whereas spinal cord inflammation in MS typically occurs in much smaller patches.
• Spinal fluid in Devic's disease usually lacks the typical elevation of antibodies detected in patients with MS, although occasional patients may show this abnormal pattern of antibodies.
• The autoantibody NMO-IgG is specific for Devic's disease but is undetected in 30 percent of patients.