Neuromyelitis optica (NMO)
Overview
Neuromyelitis optica (NMO) is a rare autoimmune condition that affects the nerves in your eyes and spinal cord. There's no cure, but treatments can help manage the symptoms.
Symptoms
Symptoms of neuromyelitis optica (NMO) vary between people, and can be mild or severe. The symptoms can include: eye pain and problems with your eyesight or your colour vision, in one or both eyessharp, burning or shooting pain (nerve pain) in your back, neck, arms or legsweakness, numbness or paralysis in your arms or legsmuscle spasms (where your muscles suddenly tighten)problems with your bladder and bowels, such as incontinence, constipation or not being able to peesexual problems, such as not being able to get an erection or reach orgasmvomiting and hiccups You may have symptoms only affecting your eyes (called optic neuritis), or only affecting your spinal cord (called transverse myelitis). Symptoms start over a few hours or days. They usually last a few days or weeks, before gradually improving. Some people recover well with treatment, while others have longer lasting problems. It's common for symptoms to come back, known as relapses. This can happen after a few weeks, months or years. In some people, relapses lead to permanent problems such as sight loss or mobility problems. You may also be offered medicines to help with any ongoing symptoms, such as: painkillersantidepressant or anticonvulsant medicines that help with nerve pain, such asamitriptylineorgabapentinmuscle relaxant or anticonvulsant medicines to treat muscle spasms, such asbaclofenorcarbamazepinemedicines for bladder problems, such asoxybutyninmedicines for bowel problems, such aslaxatives To help with symptoms such as muscle weakness and mobility problems you may be offered: physiotherapy, including advice on exercises and stretchingoccupational therapyto help with daily activities
Causes
Neuromyelitis optica (NMO) is an autoimmune condition. It happens when your immune system attacks nerves in your eyes or your spinal cord. It's not known what causes it. Sometimes it happens after a virus such as flu. NMO is not an inherited condition. But it's more common in people with other autoimmune conditions, and those with close relatives who have autoimmune conditions. It's more common in women and people of Asian or Black African origin.
Treatment
If you're diagnosed with neuromyelitis optica (NMO) you'll need treatment to stop the inflammation in your nerves and reduce the risk of relapses. When your symptoms first start or if you're having a relapse, where symptoms come back, the main treatments are: high dose steroid injectionsplasma exchange, where some of your blood is removed, treated and then returned to your bodyimmunoglobulins (antibodies in the blood) given through a drip into your vein You'll usually also need to take medicines long term that reduce the activity of your immune system to help prevent relapses. These may include: immunosuppressants, such asazathioprinesteroid tablets, such asprednisolonebiological medicines, such as rituximab You may also be offered medicines to help with any ongoing symptoms, such as: painkillersantidepressant or anticonvulsant medicines that help with nerve pain, such asamitriptylineorgabapentinmuscle relaxant or anticonvulsant medicines to treat muscle spasms, such asbaclofenorcarbamazepinemedicines for bladder problems, such asoxybutyninmedicines for bowel problems, such aslaxatives To help with symptoms such as muscle weakness and mobility problems you may be offered: physiotherapy, including advice on exercises and stretchingoccupational therapyto help with daily activities
Prevention
You'll usually also need to take medicines long term that reduce the activity of your immune system to help prevent relapses. These may include: immunosuppressants, such asazathioprinesteroid tablets, such asprednisolonebiological medicines, such as rituximab