What Is Neuromyelitis Optica (NMO) Spectrum Disorder?
Neuromyelitis optica spectrum disorder is a family of inflammatory central nervous system (CNS) diseases that may be associated with the Aquaporin-4 antibody. Like multiple sclerosis (MS), NMO is a neuroinflammatory disorder, however, these conditions are rarer than MS. NMO affects far more women than men: for every man with NMO, nine women have it. It can occur at any age but often begins in the 30s or 40s.
NMO relapses are more severe than those associated with MS. Many people experience disability when relapses occur. Treatments for NMO spectrum disorder work to prevent further relapses and disability.
NMO Spectrum Disorder Symptoms
Symptoms of NMO include vision problems and eye pain. In addition, one of the criteria for a diagnosis of NMO spectrum disorder is transverse myelitis, a spinal condition that causes:
- Weakness in one or more limbs
- Numbness and tingling
- Bladder and/or bowel dysfunction
- Pain
Diagnosis of Neuromyelitis Optica (NMO) Spectrum Disorder
Diagnosing NMO spectrum disorder early and correctly is crucial. If left untreated or improperly treated, NMO can cause severe damage to the central nervous system.
NMO spectrum disorder is diagnosed using:
- Neurologic exam
- MRI
- Blood tests
- Lumbar puncture
- Eye and vision tests
NMO Spectrum Disorder Treatment at Penn
Treatments for NMO have two primary goals. First, to preserve remaining function by preventing future relapses. Second, to address damage that has already occurred and boost quality of life.
Immune therapies for NMO differ from those for MS – and some MS medications can actually worsen NMO spectrum disorder. Currently, there are three FDA-approved medications that effectively treat NMO spectrum disorder:
- Soliris (Eculizumab), an intravenous infusion that is approved only for NMO patients who test positive for the aquaporin-4 antibody.
- Uplinza (Inebilzumab), an intravenous infusion that is approved for NMO patients with or without the aquaporin-4 antibody.
- Enspryng (Satralizumab), a self-administered injection that is approved for all patients with NMO.
These are all are monoclonal antibodies that target the biological pathways of NMO and were shown in clinical trials to dramatically reduce the likelihood of an NMO relapse. Penn Medicine researchers were part of the investigation of one of these medications. Our specialists have extensive knowledge of the available options and can guide patients through the process – from working with our pharmacists to navigating insurance. We also offer an onsite outpatient infusion clinic for patients who need intravenous medical administration.
What’s more, our specialists work with experts in other fields, including rehabilitation medicine, physical therapy, psychiatry, and other areas. By partnering with providers from other disciplines, we can help patients prevent a potentially devastating relapse and improve their overall well-being.
The Penn MS and Related Disorders Center also offers a number of patient support programs and resources, which play a crucial role in the management of NMO.