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Neurology Exam Prep Podcast
Episode 61 - Neuromyelitis Optica and Myelin Oligodendrocyte Glyoprotein Associated Disorders
Sep 29, 2023
Explore the topics of neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein-associated disease (MOGAD). Learn about the historical background and classification of neuromyelitis optica, the clinical features and diagnostic criteria of Devic syndrome, treatment options for NMOSD and MOGAD, an overview of NMOSD and MOG-associated disorders, disease-modifying therapies for myelin-oligodendrocyte glycoprotein-associated disease, and a comparison of MOGAD, NMOSD, and MS.
51:14
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Quick takeaways
- NMO is characterized by severe optic neuritis, poor visual recovery, and longitudinally extensive transverse myelitis, while MOGAD presents with bilateral optic neuritis, more severe myelitis, and potential leukoencephalopathy involvement.
- Treatment options for NMO include high-dose IV glucocorticoids, plasma exchange, and disease-modifying therapies, while treatment options for MOGAD are less well-established but may include glucocorticoids, plasma exchange, and various immunosuppressive agents.
Deep dives
Overview of Neuromyelitis Optic Spectrum Disorders (NMO)
Neuromyelitis optic spectrum disorders (NMO) is a subset of inflammatory optic neuropathies characterized by optic neuritis and myelitis syndrome. The Aquaporin-4 (AQP4) protein plays a key role in the pathophysiology of NMO. The diagnosis is based on clinical, radiographic, and serologic findings, with a positive serum test for AQP4-IgG antibodies being crucial. NMO is more common in individuals of African and Afro-Caribbean ancestry, and the age of onset is typically around 40 years. Optic neuritis in NMO is usually severe and bilateral, with poor visual recovery. Longitudinally extensive transverse myelitis is another common feature seen in NMO. Treatment involves high-dose IV glucocorticoids, plasma exchange, and disease-modifying therapies like Eculizumab, Inebelizumab, and Satralizumab.
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