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Neuromyelitis optica (NMO) is a particular disease within the NMOSD spectrum. It is characterised by optic neuritis and longitudinally extensive myelitis. In more than 80% of NMO cases, the cause is immunoglobulin G autoantibodies to aquaporin 4 ( anti-AQP4 ), the most abundant water channel protein in the central nervous system.
Standard multiple sclerosis, the most known and extended variant. Devic's disease and neuromyelitis optica (NMO) (sometimes previously called optic-spinal MS) Acute disseminated encephalomyelitis or ADEM, a closely related disorder in which a known virus or vaccine triggers autoimmunity against myelin.
Some cases of aquaporin-4-seronegative neuromyelitis optica: NMO derived from an antiMOG associated encephalomyelitis, [22] Some cases of acute disseminated encephalomyelitis, specially the recurrent ones (MDEM) [25] Some cases of McDonalds-positive multiple sclerosis [24] [26] [23] [27] isolated optic neuritis or transverse myelitis [24]
Encephalomyelitis disseminata, a synonym for multiple sclerosis. AntiMOG associated encephalomyelitis, one of the underlying conditions for the phenotype neuromyelitis optica [3] [4] and in general all the spectrum of MOG autoantibody-associated demyelinating diseases. [5]
Anti-AQP4 diseases, are a group of diseases characterized by auto-antibodies against aquaporin 4.. After the discovery of anti-AQP4 autoantibody in neuromyelitis optica, it was found that it was also present in some patients with other clinically defined diseases, including multiple sclerosis variants like optic-spinal MS.
In neuromyelitis optica higher AQP4 autoantibody levels are associated with the occurrence of optic neuritis. [16] Less common causes are: papilledema, brain tumor or abscess in the occipital region, cerebral trauma or hemorrhage, meningitis, arachnoidal adhesions, sinus thrombosis, liver dysfunction, or late stage kidney disease.
Brain lesions associated with a clinically isolated syndrome may be indicative of several neurological diseases, like multiple sclerosis (MS) or neuromyelitis optica. In order for such a diagnosis , multiple sites in the central nervous system must present lesions, typically over multiple episodes, and for which no other diagnosis is likely.
This disease is considered one of the borderline forms of multiple sclerosis because some authors consider them different diseases and others MS variants. Other diseases in this group are neuromyelitis optica (NMO), Balo concentric sclerosis and Marburg multiple sclerosis. [4]