Devic's Disease

Diagnosis

Diagnosis of Devic's disease requires several steps including a medical history detailing past infections, unusual diseases and family illnesses.

Neurological Examination

The neurologist systematically examines parts of the nervous system including gait (manner of walking), muscle strength, reflexes, coordination and balance, sensation, vision, speech and cognitive (memory and thinking) function.

Magnetic Resonance Imaging (MRI) Scan

In this procedure, a cylinder-shaped MRI scanner creates tissue-slice images on a computer from data generated by a powerful magnetic field and radio waves. Examinations of the brain, neck, spinal cord and soft tissues are best seen by an MRI scan. Physicians may be able to see areas of the nervous system where damage to myelin has occurred. A typical MRI takes approximately 45 minutes.

Evoked Potentials

Evoked potentials, sometimes called evoked responses, are tests that record the brain's responses to sound, touch and light. A technologist uses a gel to position small disks (electrodes) on the scalp and, in some cases, on the earlobes, neck, shoulders and back. The electrodes are attached to equipment that records the brain's responses to certain stimuli. Each test takes approximately 45 to 60 minutes to perform. Evoked potential testing is harmless, painless, and very sensitive in detecting lesions or damaged areas in the brain and brain stem.

Spinal Tap (Lumbar Puncture)

This procedure determines the concentration of immune cells, total proteins and antibodies in cerebrospinal fluid, the fluid that surrounds the brain and spinal cord. A physician uses a thin, hollow needle to remove small samples of the cerebrospinal fluid from within the spinal canal for laboratory analysis.

In Devic's disease the spinal fluid may show a marked elevation of white blood cells during attacks, although this does not consistently occur. Also, oligoclonal bands and elevated immunoglobulin production occur commonly in MS but rarely in Devic's disease. This test may be used to differentiate Devic's disease from MS.

Serology

A novel antibody, NMO-IgG, was discovered at Mayo Clinic. This antibody is 70 percent sensitive but nearly 100 percent specific for NMO and NMO-related disorders such as recurrent transverse myelitis and recurrent optic neuritis. Read more about NMO-IgG test.