Devic’s Disease / MS
Devic’s Disease, also known as NMO (Neuro Myelitis Optica), is an inflammatory disease of the central nervous system in which there are episodes of inflammation and damage to the myelin (fatty, protective covering of nerves) that almost exclusively affect the optic nerves and spinal cord. It usually causes temporary blindness, occasionally permanent, in one or both eyes. It can also lead to varying degrees of weakness or paralysis in the legs or arms, loss of sensation, and/or bladder and bowel dysfunction from spinal cord damage. Common complaints are headache, neck or back pain sensitivity to hot and cold, and pain surrounding the abdomen called ‘Banding’.
It appears that there are two major types of Devic's disease. In the first type, optic neuritis, (inflammation of the optic nerve), and myelitis, (inflammation of the spinal cord), episodes tend to come very close together often within days or weeks. In the second form, repeated episodes of optic neuritis and myelitis occur that are separated by months or years.
It is thought that Devic's can be fatal in as many as 80% percent of the cases, depending on where the damage to the spinal cord is.
Differences from Multiple Sclerosis
- Devic's disease normally only affects the optic nerves and spinal cord, whereas MS affects the brain as well.
- Attacks of Devic's disease tend to be more frequent and severe (even fatal), than in MS, though this is not always the case.
- An MRI of the brain is typically normal in Devics disease, although this is not always the case; in MS the MRI of the brain typically shows many areas of inflammation.
- An MRI of the spinal cord shows large extensive areas of inflammation of the spinal cord whereas in MS typically the areas are much smaller.
- Spinal fluid studies tend not to show the typical elevation of antibodies detected in patients with MS, although occasional patients may show this abnormal pattern of antibodies.
The treatment for Devic’s is different to that for for MS. Therefore it is important to make a correct diagnosis as soon as possible. There is a test for Devic’s called an NMO-IGG that has proven to be very accurate, but not perfect. At first the test was only available through the Mayo Clinic in the U.S.A. Now it is available in Australia; contact your neurologist for more information.
Research is continuing at the Walton Centre in the U.K. Recent studies show that up to 25% of African Americans that have been diagnosed with MS actually have Devic’s. It’s worse for the Asian population, 33% of those diagnosed with MS are thought to have Devic’s.
