Devic's Disease (Neuromyelitis Optica)
(Also Called 'Devic's Disease (Neuromyelitis Optica)')
What is Devic's disease?
Devic's disease (neuromyelitis optica) is an unusual variant of multiple sclerosis (MS). It is characterized by immune attacks of the optic nerve, which connects the eye to the brain and spinal cord.
Potential symptoms of this disease include:
- Loss of vision
- Bladder/bowel problems
A spine MRI usually shows areas of inflammation, while brain MRIs generally show minimal changes. The cerebrospinal fluid (CSF) in Devic’s disease differs from that of typical MS in that it usually has a large number of white blood cells, no oligoclonal bands, and normal intrathecal immunoglobulin G (IgG) synthesis.
Is Devic's disease a type of multiple sclerosis?
Devic's disease is probably a variant of MS. However, the immune system attack is primarily restricted to the optic nerve and spinal cord. Devic's disease also differs from MS in that the bouts of inflammation are more damaging to the tissues. Finally, patients with Devic's disease often do not respond well to the typical injectable therapies for MS, including interferons (Avonex, Betaseron, and Rebif) or glatiramer acetate (Copaxone).
What treatments are available?
Currently, research is being done to find the cause, treatment, and cure for Devic's disease. A variety of treatments have been tried. Steroids or plasmapheresis are useful for acute relapses of Devic's disease.
Devic's disease seems to be more steroid-dependent than MS is, meaning that patients with Devic's sometimes need regular steroid treatments and can relapse when steroids are tapered off.
Plasma exchange might help a person recover from a relapse of symptoms when steroids have not helped sufficiently.
In terms of preventive therapies, it appears that the standard therapies for MS (the interferons and glatiramer acetate) are much less effective in Devic's disease. Rather, experience suggests that azathioprine (Imuran) and possibly mitoxantrone (Novantrone) are more helpful.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/30/2008...#9858