What is Optic Neuromyelitis?

Optic neuromyelitis is an inflammatory demyelinating disease that affects the optic and spinal nerves. Let’s take a closer look at the characteristics of optic neuromyelitis, which can be confused with multiple sclerosis. 

Autoimmune diseases are characterized by cells that defend the body attacking its own organ tissues. This is the case with optic neuromyelitis (NMO). The disease involves demyelination in specific areas of the central nervous system (CNS).

A substance called myelin or myelin covers the entire CNS and is involved in the precise transmission of nerve impulses. In optic neuromyelitis, certain antibodies bind to aquaporin 4, a water channel protein, preventing it from functioning properly.

This condition, also known as Debick’s disease, has a recurrent form.

Similarities and Differences Between Optic Neuromyelitis and Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disease that attacks the central nervous system and is easily confused with optic neuromyelitis. For years, experts have considered optic neuromyelitis as a type of multiple sclerosis.

Both these diseases are demyelinating diseases that occur in the central nervous system and affect the spinal cord. However, while multiple sclerosis can change several brain structures, optic neuromyelitis only changes the optic nerve.

On the other hand, the symptoms appearing in patients are very similar because both diseases are repetitive and singular. In addition, since patients with multiple sclerosis also suffer from optic neuritis and myelitis, visual or sensory problems often occur.

The main difference between these two diseases is the fluid changes in optic neuromyelitis. Studies have shown that patients with optic neuromyelitis have anti-aquaporin 4 antibodies, which is very rare in patients with multiple sclerosis.

Multiple sclerosis is more common and affects less locally. And the disease can cause loss of walking ability.

Symptoms of Optic Neuromyelitis

As already explained, the clinical symptoms of patients with optic neuromyelitis are related to optic neuritis and transverse myelitis. It can be bilateral or singular, in addition to altering the structure of the optic nerve, called the optic plexus. The most relevant ophthalmic symptoms are:

• poor vision
• loss of sight
• eye pain
• eye strain
• eye movement dysfunction

In addition, the spinal cord is affected by inflammatory processes in at least three areas. Therefore, neurological symptoms may accompany it. The main symptoms are:

• Inability to move one or more limbs
• change in sensitivity
• Inability to control sphincter
• crick
• nausea and vomiting

Patients with optic neuromyelitis experience recurrence within 2 to 3 years after the initial onset. The condition is more common in women over the age of 39, and studies have shown that movement disorders in women are usually more severe than in men.

Diagnosing Optic Neuromyelitis

Patients with optic neuromyelitis experience recurrence within 2 to 3 years after the initial onset. The disease is more common in women over the age of 39, and doctors must distinguish its symptoms from other neurological disorders.

Anti-Aquaporin 4 Antibody

Accurately diagnosing this disease can be challenging for doctors. And to make a diagnosis, several tests must be performed. In addition, this antibody is found in more than 70% of patients with optic neuromyelitis. Therefore, the existence of this antibody cannot but be conclusive evidence.

This molecule is responsible for the destruction of aquaporin 4 in the central nervous system and subsequent demyelination. Although this is a recent finding, it has proven to be very useful for the early diagnosis of optic neuromyelitis.

imaging examination

This molecule is responsible for the destruction of aquaporin 4 in the central nervous system and subsequent demyelination. Although this is a recent finding, it has proven to be very useful for the early diagnosis of optic neuromyelitis.

Patients with optic neuromyelitis usually show obvious lesions of the spinal cord in the second spine. In addition, it is repeated in three consecutive spinal cord segments. In this situation, imaging tests can determine if the only affected brain structure is the optic nerve.

Cerebrospinal fluid (CSF) study

The healthcare provider may extract a small amount of cerebrospinal fluid for CSF analysis. In the presence of neuritis, the amount of protein and white blood cells in this body fluid increases. And that figure is higher than in patients with multiple sclerosis.

Existence of diagnostic approaches

Since 1999, a set of approaches has been established for patients with optic neuromyelitis. And that approach was revised in 2006. A total of three final approaches so established indicate the presence of the following diseases:

• Optic Neuromyelitis
• acute myelitis
• Absence of clinical disorders other than the spinal cord and optic nerve

Blindness is one of the serious consequences of optic neuromyelitis.

Optic Neuromyelitis Treatment

Symptoms of this disease are caused by inflammatory processes. Therefore, the use of corticosteroids can help relieve the symptoms. What’s more, these types of drugs prevent future recurrences.

Plasma exchange may be necessary if corticosteroids do not relieve symptoms. This is a procedure that removes blood from the body and then replaces the plasma in the body with fresh ones. The plasma exchange procedure can take several hours and is a process that must be performed multiple times.

Finally, your doctor may prescribe immunosuppressants. These inhibitors reduce the activity of the immune system, thereby reducing damage to the structures of the central nervous system.

Dietary recommendations for patients with optic neuromyelitis

All patients diagnosed with optic neuromyelitis should make healthy lifestyle changes. Only in this way can the progression of the disease be stopped or slowed. And this case, diet is especially important.

Therefore, nutritionists should closely monitor patients to ensure that they follow an appropriate dietary plan. Here are some recommendations they can follow.

• Increase your intake of vegetables, fruits and grains
• Cut down on foods rich in saturated fat and carbohydrates
• Drink 5 to 8 glasses of water or sugar-free beverages daily
• Stop drinking alcohol and coffee

Difficult-to-diagnose Optic Neuromyelitis

In conclusion, optic neuromyelitis is an inflammatory disease affecting the optic and spinal nerves. Although it is easy to confuse this disease with other central nervous system diseases, diagnostic methods have made great strides so far.

Unfortunately, there is no specific treatment for this disease yet. However, corticosteroids and immunosuppressants can improve the patient’s condition. In addition, patients must make lifestyle changes to prevent disease progression and recurrence.