Marios Papadopoulos, MD – St. George’s University of London:
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. It can be quite disabling because it causes weakness or paralysis of the arms and the legs. It also affects other functions. For example, it causes numbness or loss of feeling below the level of the damage. It also causes problems with urinary bladder and bowel control, as well as sexual function.
Patients go on to have an MRI scan, which typically shows a long region of damage in the spinal cord, which is called longitudinally extensive transverse myelitis and is a characteristic feature of neuromyelitis optica. In terms of treatment for an acute attack, patients are put on high dose steroids, which basically switches off the production of the bad antibody, which is the cause of the damage in the spinal cord. And if they don’t respond to steroids, then they have plasmapheresis, which is a procedure by which the bad antibody is filtered out of the bloodstream. And then patients are put on longterm medication to stop them having another attack, and these medication works by dampening down the immune system.