The limited demyelinating diseases: the voyage of optic neuritis and transverse myelitis to multiple sclerosis and neuromyelitis

Abstract

The spectrum of idiopathic inflammatory-demyelinating disorders of the CNS is classified based on clinical symptoms and signs, clinical severity, lesion distribution, neuroimaging features and cerebrospinal fluid characteristics. There is a wide variety of conditions in this broad spectrum. In some cases, the dissemination in the CNS is limited to the optic nerves and spinal cord. Neuromyelitis optica (NMO) and the NMO spectrum disorders have a predilection for the optic nerves and spinal cord. Clinical, MRI, cerebrospinal fluid and neuropathological features show that NMO could be considered as a distinct disease rather than as a variant of multiple sclerosis. Accurate and early diagnosis is critical to facilitate initiation of immunosuppressive and/or immunomodulatory therapy to prevent attacks and disability progression.

Keywords::

• acute transverse myelitis
• aquoporin-4 antibody
• multiple sclerosis
• neuromyelitis optica
• NMO-IgG
• NMO spectrum disorders
• optic neuritis
• opticospinal multiple sclerosis

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

AQP4: Aquaporin 4; CSF: Cerebrospinal fluid; LETM: Longitudinally-extensive transverse myelitis; MS: Multiple sclerosis; NMO: Neuromyelitis optica; SLE: Systemic lupus erythematosus.