Neuromyelitis Optica or Devic's Disease
What is Neuromyelitis Optica?
Neuromyelitis Optica (NMO), also known as Devic’s disease or Devic’s syndrome, is an autoimmune disorder that affects the optic nerves and the spinal cord. It causes immune system cells and antibodies to mistakenly attack and destroy myelin cells in the optic nerves and the spinal cord. Myelin is a fatty substance that surrounds nerve fibers and helps move nerve signals from cell to cell.
NMO causes damage to the optic nerve, which results in inflammation, pain, and loss of vision. The damage done to the spinal cord causes loss of sensation, bladder, and bowel function problems, and weakness or paralysis in the arms and legs.
Two Forms of Neuromyelitis Optica
NMO typically occurs in one of two ways: either a single attack that lasts about a month or two, or recurring attacks over many years. Most people have clusters of attacks followed by a remission period with partial recovery.
Our attorneys are currently representing a number of patients in the National Vaccine Injury Compensation Program who developed Neuromyelitis Optica following a vaccination.
Vaccination and Neuromyelitis Optica
The cause of NMO is still unknown, although experts believe it’s the result of a dysfunction in immune tolerance. Immune tolerance is the body’s ability to distinguish its own cells or proteins from foreign materials. Even more, some studies show a possible link between the influenza vaccine and vaccines for human papillomavirus (HPV).
A German study conducted by researchers at Heinrich Heine University showed at least four patients had symptoms of NMO a few months after receiving the HPV vaccine. Others reported they developed NMO after receiving the flu vaccine. Some studies have show a possible link between the influenza and HPV vaccines, and NMO.
Neuromyelitis Optica Vaccine Injury Case Results
Our firm is currently representing patients in the National Vaccine Injury Compensation Program who developed Neuromyelitis Optica following a vaccination. Review recent case results below and read the actual decisions handed down by the Vaccine Court. Remember, each case is different and the results of this case don’t guarantee or predict a similar result in future cases.
What is the Difference Between NMO and Multiple Sclerosis?
It was once thought that NMO was a variant of multiple sclerosis, or MS, because both conditions affect the central nervous system and can cause attacks of optic neuritis and myelitis. But research has concluded they are distinct illnesses that require different treatments.
Recently an antibody was discovered that helps doctors distinguish NMO from MS. In NMO, the immune system sees the aquaporin 4 molecule, a membrane protein, as foreign. It creates an antibody, known as NMO-IgG, to attack those cells. It is found in about 70 percent of people with NMO, and is something doctors are able to test for. This antibody is not found in people with MS. Other differences include:
- Symptoms after an NMO attack tend to be more severe than what’s experienced with MS.
- NMO tends to only strike the optic nerves and the spinal cord at the beginning of the disease. MS usually affects the brain in addition to the spinal cord and optic nerve.
- Episodes of NMO are usually more severe than those experienced with MS.
- NMO does not typically have the secondary progressive stage that occurs with MS. The disabilities that arise from NMO happen due to the acute attacks.
- Fatigue associated with NMO is usually an indirect result of the disease and is considered secondary fatigue. With MS, fatigue is a direct result of the disease and is considered primary fatigue.
Who is Affected by NMO?
- It is estimated that about 4,000 people in the United States have NMO, and worldwide it is estimated that around half a million people are affected.
- The single-episode form of the syndrome affects men and women equally. However, more than 80 percent of people with the recurring form are women.
- Neuromyelitis Optica strikes at almost any age, starting as young as 3 years old. However, it most commonly strikes during childhood and between the ages of 40 and 50.
What are the Treatment Options for NMO?
There is no cure or FDA-approved treatment specifically indicated for this syndrome. However, there are some therapies available to treat attacks, control symptoms and help prevent future episodes. A high-dose IV corticosteroid is usually the first treatment given to reduce disease activity and restore neurologic function. Some people may need to stay on a low dose of steroids for a longer period if they experience relapses. Other options include immunosuppressant drugs or monoclonal antibodies.
Plasma exchange, or plasmapheresis, is used on some patients who are unresponsive to steroid treatments. The process separates antibodies out of the blood stream. There are also several medications and treatments available to manage the symptoms and complications associated with NMO.