Neuromyelitis optica

Overview

Neuromyelitis optica (NMO), also known as Devic's disease, is a rare condition where the immune system damages the spinal cord and the nerves of the eyes (optic nerves).

NMO can affect anyone at any age, but it's more common in women than men.

Symptoms of NMO

Each person will experience different symptoms, which can range from mild to severe.

These symptoms may include:

eye pain
loss of vision
colours appearing faded or less vivid
weakness in the arms and legs
pain in the arms or legs – described as sharp, burning, shooting or numbing
increased sensitivity to cold and heat
tight and painful muscle spasms in the arms and legs
vomiting
bladder, bowel and sexual problems

In many people with NMO, the spinal cord becomes swollen and irritated (inflamed). This is called transverse myelitis.

The optic nerve from the eye to the brain can also become inflamed – a condition called optic neuritis.

Some people may only experience transverse myelitis or optic neuritis but, if they have a specific antibody associated with NMO (AQP4) in their blood, they will be said to have NMO spectrum disorder (NMOSD).

NMO-UK has more information about the symptoms of NMO.

NMO relapses

NMO can be one-off or relapsing. Some people may only have one attack of optic neuritis or transverse myelitis, with good recovery and no further relapses for a long time.

But if NMO is very severe, more attacks can follow. A relapse can take from several hours up to days to develop. The attacks can be unpredictable and it's not fully understood what triggers them.

NMO-UK has more information about NMO relapses

When to get medical help

See a GP if you have any of the symptoms of NMO.

The GP will refer you to a neurologist (a specialist in conditions that affect the nerves) for further testing to confirm the diagnosis and rule out any other conditions with similar symptoms, such as multiple sclerosis.

You'll have an MRI scan of your brain and spinal cord, and blood tests. You may also have a lumbar puncture, where a sample of the fluid surrounding your spine is removed using a thin needle and tested.

NMO-UK has more information about how NMO is diagnosed.

Treatments for NMO

There's no cure for NMO, so treatment can help to ease symptoms, prevent relapses and slow down the condition's progression.

You may be prescribed:

steroids to reduce the inflammation
medication to suppress your immune system and ease your symptoms, such as azathioprine, mycophenolate or methotrexate
rituximab, a newer type of drug to reduce inflammation

Rehabilitation techniques, such as physiotherapy, can also help if you have problems with your mobility.

Therapies and support groups are available.

NMO UK has more information about treatments for NMO.

Causes

NMO is an autoimmune condition. This means the body's immune system reacts abnormally and attacks the body's healthy tissues, causing the symptoms of NMO.

NMO is usually not inherited, but some people with NMO may have a history of autoimmune disorders in the family and may have another autoimmune condition themselves.

Driving

Optic neuritis may affect your ability to drive. You have a legal obligation to tell the Driver and Vehicle Licensing Agency (DVLA) about any medical condition that could have an effect on your driving.

See GOV.UK for more information about driving with a disability or health condition.