Neuromyelitis optica spectrum disorder (NMOSD)

Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare autoimmune disease of the central nervous system that mainly damages the optic nerve and spinal cord.

The disease is most common in women between the ages of 30 and 40 and affects fewer than five in 100,000 people worldwide.1

Symptoms can be severe, as follows:

In most cases, NMOSD progresses in relapses. Often, patients do not fully recover between NMOSD episodes, so that symptoms gradually develop and do not go away. Severe relapses can lead to permanent neurological damage, visual impairment and disability.

It is therefore important to diagnose NMOSD as early as possible and to start treatment quickly to prevent further relapses (relapse prophylaxis). In the treatment of NMOSD, a distinction is made between the treatment of acute relapses and relapse prophylaxis, which is intended to prevent further relapses.

Since NMOSD is a progressive disease, the symptoms increase with each relapse. Within five years

of the people affected need a wheelchair

are practically blind or do not have sufficient vision.

Because the symptoms of NMOSD worsen in episodes, affected patients used to be wrongly diagnosed withIn MS, the symptoms also occur in relapses, but patients often recover better between relapses. This is different with NMOSD, where the patient's condition worsens with each relapse. In individual cases, the deterioration in the health of NMOSD patients can occur very quickly. The misdiagnosis of MS can sometimes have dramatic consequences for patients with NMOSD, because certain drugs for MS often worsen the symptoms of NMOSD.

For the acute treatment of a relapse, cortisone-containing preparations are usually used, which have an anti-inflammatory effect and are infused into the vein in high doses during the first few days and then administered in tablet form. The dose is then gradually reduced.

Some patients do not respond well to cortisone preparations. Plasmapheresis is a therapeutic procedure that removes unwanted proteins, immunoglobulins or antibodies from human blood plasma. In this way, harmful antibodies can be removed from the patient's blood.

An immunoadsorption in which the patient's blood is passed into a special device that separates the blood cells from the blood plasma. Harmful antibodies are removed from the plasma using special compounds. The purified plasma is mixed with the blood cells and returned to the patient's body via a vascular access.

To counteract further relapses, so-called immunotherapeutics (immunosuppressants) are used. These drugs can inhibit the excessive activity of the body's own defence system in NMOSD patients.

There is lively research activity in the field of NMOSD. Different treatment approaches are being investigated. The availability of several therapeutic options with different mechanisms of action could lead to "tailor-made" treatment for people with NMOSD in the future.

Physical activity is important for everyone - but especially for people with NMOSD. Exercise, physiotherapy and sport offer a whole range of benefits:

  • Posture and balance improve, the risk of falling decreases.

  • Muscle strength and fitness increase.

  • Heart, circulation and breathing are trained.

  • Joint and bone health is promoted.

  • You have more energy and can cope better with everyday tasks.

  • It is easier to maintain a healthy body weight.

  • Mood and self-confidence increase, stress levels decrease.

  • Exercise in a group of nice people is usually more fun and provides an opportunity to make new friends.


  1. Papadopoulos MC et al. Treatment of neuromyelitis optica: state-of-the-art and emerging therapies. Nat Rev Neurol 2014; 10(9): 493-506.

  2. Kessler RA et al. Early indicators of relapses vs pseudorelapses in neuromyelitis optica spectrum disorder. Neurol Neuroimmunol Neuroinflamm 2016; 3: e269.

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