Neuromyelitis optica (NMO) is a central nervous system disorder that causes inflammation in nerves of the eye and the spinal cord.
NMO is also called neuromyelitis optica spectrum disorder (NMOSD) and Devic disease. It occurs when the body's immune system reacts against its own cells. This happens mainly in the optic nerves that connect the retina of the eye with the brain and in the spinal cord. But it sometimes occurs in the brain.
The disorder may appear after an infection. Or it can be associated with another autoimmune condition. Irregular antibodies bind to proteins in the central nervous system and cause damage.
Neuromyelitis optica is often misdiagnosed as multiple sclerosis (MS) or seen as a type of MS. But NMO is a different condition.
Neuromyelitis optica can cause blindness in one or both eyes, weakness or paralysis in the legs or arms, and painful spasms. It also can cause loss of sensation, uncontrollable vomiting and hiccups, and bladder or bowel problems from spinal cord damage. Children can have confusion, seizures or comas.
Relapses are common. Preventing recurrent attacks is a key to averting disability. Neuromyelitis optica flare-ups might be reversible, but they can be severe enough to cause permanent visual loss and problems with walking.
Neuromyelitis optica care at Mayo Clinic
Nov. 23, 2022
- Wingerchuk DM, et al. Neuromyelitis optica spectrum disorder. New England Journal of Medicine. 2022; doi:10.1056/NEJMra1904655.
- Daroff RB, et al. Multiple sclerosis and other inflammatory demyelinating diseases of the central nervous system. In: Bradley's Neurology in Clinical Practice. 8th ed. Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 25, 2022.
- Yanoff M, et al., eds. Inflammatory optic neuropathies and neuroretinitis. In: Ophthalmology. 5th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Aug. 25, 2022.
- Glisson CC. Neuromyelitis optica spectrum disorders. https://www.uptodate.com/contents/search. Accessed Aug. 25, 2022.
- Symptoms and diagnosis of NMO. National Multiple Sclerosis Society. http://www.nationalmssociety.org/What-is-MS/Related-Conditions/Neuromyelitis-Optica-(NMO)/Symptoms-and-Diagnosis. Accessed Aug. 25, 2022.
- Wingerchuk DM, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015; doi:10.1212/WNL.0000000000001729.
- Nimmagadda R. Allscripts EPSi. Mayo Clinic. July 6, 2022.
- Costello F. Neuromyelitis optica spectrum disorders. Continuum (Minneapolis, Minn.). 2022; doi:10.1212/CON.0000000000001168.
- Jarius S, et al. Neuromyelitis optica. Nature Reviews Disease Primers. 2020; doi:10.1038/s41572-020-0214-9.
- Held F, et al. Drug treatment of neuromyelitis optica spectrum disorders: Out with the old, in with the new? ImmunoTargets and Therapy. 2021; doi:10.2147/lTT.S287652.
- Lennon VA, et al. A serum autoantibody marker of neuromyelitis optica: Distinction from multiple sclerosis. The Lancet. 2004; doi:10.1016/S0140-6736(04)17551-X.
- Tahara M, et al. Safety and efficacy of rituximab in neuromyelitis optica spectrum disorders (RIN-1 study): A multicentre, randomized, double-blind, placebo-controlled trial. The Lancet Neurology. 2020; doi:10.1016/S14744422(20)30066-1.
- Pittock SJ, et al. Eculizumab in aquaporin-4-positive neuromyelitis optica spectrum disorder. New England Journal of Medicine. 2019; doi:10.1056/NEJMoa1900866.
- Yamamura T, et al. Trial of satralizumab in neuromyelitis optica spectrum disorder. New England Journal of Medicine. 2019; doi:10.1056/NEJMoa1901747.
- Traboulsee A, et al. Safety and efficacy of satralizumab monotherapy in neuromyelitis optica spectrum disorder: A randomized, double-blind, multicentre, placebo-controlled phase 3 trial. The Lancet Neurology. 2020; doi:10.1016/S14744422(20)30078-8.
- Cree BAC, et al. Inebilizumab for the treatment of neuromyelitis optica spectrum disorder (N-Momentum): A double-blind, randomized placebo-controlled phase 2/3 trial. The Lancet. 2019; doi:10.1016/S0140-6736(19)31817-3.