Neuromyelitis optica (NMO)

What is neuromyelitis optica?

Neuromyelitis optica (NMO)—sometimes referred to as neuromyelitis optica spectrum disorder (NMOSD) or Devic’s disease—is a rare autoimmune disease of the central nervous system that causes inflammation in the eyes and spinal cord. An autoimmune disease occurs when your body’s immune system mistakenly targets healthy tissue. With NMO, damage is caused when irregular antibodies bind to proteins in the central nervous system, affecting your eyesight and ability to move.

For many years, NMO was considered a variant of multiple sclerosis (MS), an autoimmune disease that affects the brain and spinal cord. However, NMO is rarer than MS and the cause is unknown.

Neuromyelitis optica is treated by a doctor who specializes in neurological disorders called a neurologist. Neurologists at Penn Medicine are among the leading neurology providers in the greater Philadelphia and South Jersey region. With decades of expertise, we're committed to helping you treat and manage NMO.

Neuromyelitis optica symptoms

Patients with NMO experience inflammation of the optic nerve, spinal cord, or brainstem, which each cause different symptoms.

  • Inflammation of the optic nerve: Called optic neuritis, symptoms include blurred vision, difficulty seeing in low light, eye pain, and vision loss in one or both eyes.
  • Inflammation of the spinal cord: Called myelitis, symptoms include the loss of bladder and bowel control, muscle weakness or paralysis in the arms or legs, numbness and tingling, painful spasms, sexual dysfunction, or difficulty walking.
  • Inflammation in the brainstem: Symptoms include dizziness, double vision, facial nerve pain, facial paralysis, hearing loss, uncontrollable hiccups, itching, or vomiting.

In addition, some people with NMO experience the following:

  • Fatigue
  • Increased urination
  • Nausea
  • Pain while urinating
  • Signs of infection like fever or muscle aches
  • Signs of an upper respiratory infection like coughing or a sore throat
  • Unexpected weight changes

People with NMO symptoms may experience repeated bouts of inflammation separated by periods of remission that can last weeks, months, or years. Penn Medicine specialists are dedicated to providing the best care for patients every step of the way.

What causes neuromyelitis optica spectrum disorder?

Neuromyelitis optica can affect anyone at any age, but it’s most common in people assigned female at birth in their 30s and 40s. Most patients don’t have a family history of the disease, though some have other autoimmune diseases, which may trigger the onset of NMO.

Living with neuromyelitis optica

Talk to your provider about steps you can take to have the best possible outcome while living with NMO, including the following: 

  • Attend checkups: Your doctor will monitor the effects of this condition and do regular blood testing to evaluate your immune system.
  • Avoid getting sick: Do your best to stay away from people who have contagious illnesses like a cold, COVID-19, the flu, or pneumonia, especially if you’re taking immune-suppressing medications.
  • Take medications as prescribed: Medications can prevent or reduce the potential damage from recent or future attacks.

Neuromyelitis optica: Why choose Penn Medicine?

Penn Neurology is the oldest neurology department in the United States. When you work with our healthcare teams, you can expect:

  • Researchers dedicated to scientific discoveries: Penn Medicine continues to advance the field of neuromedicine by offering innovative approaches and treatments for neurological disorders. 
  • End-to-end support: Our specialists have extensive knowledge of the available options and can guide you through the process—from working with our pharmacists to navigating insurance. We also offer an onsite outpatient infusion clinic if you need IV medication administration.
  • Multidisciplinary care: Penn specialists work with experts in other fields, including rehabilitation medicine, physical therapy, psychiatry, and other areas to support you and improve your overall well-being.

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