Neuromyelitis Optica (NMO): A Case Study

Neuromyelitis Optica (NMO) is a rare but severe inflammatory process of the central nervous system. NMO “is characterized by longitudinally extensive transverse myelitis, which can leave one quite debilitated at presentation, and unilateral or bilateral optic neuritis (TMA, 2015).” The condition “attacks on the optic nerves and spinal cord. Patients may experience these attacks at the same time or at different times (Cleveland Clinic, 2015).” NMO can affect children as young as 3 years old and adults as old as 90 years old (TMA, 2015). NMO affects approximately 1 to 2 per 100,000 people worldwide. Women are affected by this condition more than men (GHR, 2015).
Testing for NMO “may include MRI scan of your brain and spinal cord. Taking samples of your blood and spinal fluid, and tests to check on how well their optic nerves are working (John Hopkins Medicine, 2015).” NMO signs and symptoms vary from person to person. The most signs and symptoms that are related to NMO are: loss or blurring of vision in one or both eyes, loss of color vision, paralysis or paraparesis of a limb or limbs, loss of sensation, loss of bladder or bowel control, profound bladder retention, intractable nausea and vomiting, intractable
“In NMO, the likelihood of recurrence of disease activity is greater activity is greater than 90%. Attacks in NMO are devastating, and about 50% of those diagnosed with NMO and untreated are dependent on a wheelchair and functionally blind by 5 years. Therefore, it is generally thought that ongoing treatment with medications that suppress the immune system is necessary. There are no FDA-approved medications for maintenance in NMO, so anything prescribed is done off-label. The three primary therapies used in the US are mycophenolate (CellCept), rituximab (Rituxan), and azathioprine (Imuran) (TMA, 2015).” This medication can increase their risk of infections, with upper respiratory infections and urinary tract