Neuromyelitis Optica Spectrum Disorders (NMOSD)

Purpose of review The term neuromyelitis optica spectrum disorders (NMOSD) encompasses a constellation of potentially devastating inflammatory maladies of the central nervous system that predominantly affect the optic nerve(s) and spinal cord. Neurologic disability occurs as a result of severe, immune-mediated demyelination and irreversible axonal damage. Significant advances have been made in defining the clinical characteristics of NMOSD, including key examination findings and specific imaging and laboratory indicators. This review will provide the clinician with critical knowledge to allow for both early diagnosis, and consideration of available treatment strategies. Recent findings As attacks of NMOSD tend to be severe and irreversible, relapse prevention is essential to the mitigation of permanent neurologic disability. Newly FDA-approved monoclonal antibodies have become available for the management of NMOSD; these may provide clinical stability and reduction in relapses over time. Summary NMOSD frequently causes irreversible neurologic disability, and therefore early diagnosis and appropriate pharmacologic intervention are essential. Several previously established as well as newer medications are available for the treatment of acute attacks and for relapse prevention.