Neuromyelitis optica (NMO) or Devic’s disease is an uncommon idiopathic demyelinating disease of the central nervous system with selective involvement of the optic nerves and spinal cord. There are no scientifically proven guidelines on treatment of this condition either in the acute attacks or on a long-term basis. We present the case of a young girl who presented with the classical features of NMO and who did not show any improvement with intravenous high dose steroid injection, which has traditionally been the first line of treatment in the acute attacks of NMO. She was subjected to 5 cycles of plasmapheresis starting from the 12th day after the last dose of steroids. Patient had dramatic improvement of her symptoms in close temporal relationship with the starting of plasmapheresis. This case highlights the potential role of plasmapheresis as a rescue therapy in the management of steroid unresponsive acute attacks of NMO.
Read More: ‘Rescue’ plasmapheresis in a case of severe steroid unresponsive devic’s neuromyelitis optica