Testing for Neuromyelitis Optica (NMO)
It is essential that an accurate diagnosis of NMO be made, and that it be made early. Misdiagnosing NMO as MS leads to inappropriate treatment. NMO is treated by immunosuppressant therapies. These therapies include azathioprine or CellCept, also known as mycophenolate mofetil. These medications are generally used in association or combination with prednisone. If these medications are not successful at prevention of attacks, then some patients begin rituximab therapy.
In contrast, multiple sclerosis is treated using immunomodulatory medications such as glatiramer acetate, interferon beta, or, more recently, natalizumab. There is some data to suggest that immunomodulated therapies that are used for MS may, in fact, make NMO worse. Untreated or treated inappropriately, 50% of NMO patients lose functional vision in at least 1 eye or become unable to walk within 5 years. This underscores the importance of making the diagnosis of NMO or an NMO spectrum disorder early, initiating appropriate treatment, preventing attacks and, thus, hopefully preventing longer term disability.
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