Video Library

How do Clinicians treat NMO?

Published on April 2, 2010

Dean Wingerchuk, MD – Mayo Clinic:

I think it’s helpful to consider different types of therapy for NMO in different categories. For example, there’s treatment of individual attacks, treatment and prevention of relapses and then treatment of symptoms. When a person has an attack of NMO most of the time treatment is with steroids, IV infusions of steroids and sometimes with a treatment called plasma exchange which is meant to filter the plasma, the liquid part of blood and presumably remove antibodies and other factors that were causing the relapse and improving the person’s function.

That secondary of treatment, which is prevention is extremely important in NMO, because we think that by successfully preventing relapses or attacks, we should be able to keep people stable and even give them a chance to improve from any damage that was done from their prior attacks. Currently most therapies for neuromyelitis optica that are preventative in nature are immune suppressants.

They’re meant to target some arm of the immune system that we think is causing damage in NMO, especially the antibody that’s associated with the disease and there are different types of therapies that appear to be able to do that. These include IV therapies such as rituximab and oral immune suppressant agents, such as azathioprine or mycophenolate.

None of these treatments have been approved by the FDA, but based on experience and collections of series from different hospitals throughout the world, we have a pretty good idea that these medications do make a difference. The third area of treatment is treatment of symptoms. So this could be visual loss, weakness, spasticity, or bladder problems, and these can be treated at any time during the illness, whether it’s in the context of a relapse or after the relapse has recovered.


Posted in

Leave a Comment

More Videos from

Can Tissues injured by NMO be repaired (Regeneration/Remyelination)?

The short answer is yes. The long answer is we don't know how that happens...after a patient relapses and we suppress the inflammation

Currently how is NMO/NMOSD best diagnosed?

Since the discovery of the APQ-4 antibody in 2004 the spectrum of NMO has dramatically changed and evolved to what we now consider NMOSD.

Do NMO treatments have dangerous side effects?

In NMO, the immune system is too active, so all of our treatments are really directed at decreasing the immune system.

Does spinal cord damage occur in NMO?

Spinal cord damage occurs in all patients with NMO, because it's one of the essential diagnostic criteria for NMO.