Neuromyelitis Optica Can Result in Severe Disability

Investigators in the United Kingdom and Japan detail the clinical outcomes and prognostic features for 106 patients with neuromyelitis optica (NMO) or NMO spectrum disorder and positive aquaporin-4 (AQP4) antibody testing. NMO includes optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM) with AQP4 antibodies and a nonspecific brain MRI. NMO spectrum disorder includes ON or LETM (but not both), along with antibodies and nonspecific MRI.

Median disease duration was 75 months (range, 3–417 months); 87% were women. The overall mean age of onset was 41 years; mean age at onset was earlier for ON (37) and later for LETM (46). Simultaneous ON and transverse myelitis at onset was uncommon (<5%). Median time to relapse was 14 m…