Trebst C., Jarius S., Berthele A., Paul F., Schippling S., Wildemann B., Borisow N., Kleiter I., Aktas O., Kumpfel T. Development of extensive brain lesions following fingolimod (fty720) treatment in a patient with neuromyelitis optica spectrum disorder. Failure of natalizumab to prevent relapses in neuromyelitis optica. Kleiter I., Hellwig K., Berthele A., Kumpfel T., Linker R.A., Hartung H.P., Paul F., Aktas O. Promising emerging therapies for NMOSD include monoclonal antibodies and tolerization.Īnti-MOG syndrome aquaporin 4-IgG multiple sclerosis myelin oligodendrocyte glycoprotein neuromyelitis optica spectrum disorders. Attacks are usually treated with steroids, and relapses prevention with immunosuppressive drugs. Acute disseminated encephalomyelitis and bilateral or recurrent optic neuritis are the most frequent anti-MOG syndromes in children and adults, respectively. Other core clinical characteristics include area postrema syndrome, brainstem, diencephalic and cerebral symptoms that may be associated with typical MRI abnormalities. Acute transverse myelitis with longitudinally extensive lesion on spinal MRI is the most frequent inaugural manifestation of NMOSD, usually followed by optic neuritis. On the other hand, anti-MOG syndromes result from damage to myelin oligodendrocyte glycoprotein (MOG), expressed on surfaces of oligodendrocytes and myelin sheaths. NMOSD is frequently associated with antibodies which target aquaporin-4 (AQP4), the most abundant water channel in the CNS, located in the astrocytic processes at the blood-brain barrier (BBB). Some agents used for MS treatment may be deleterious to NMOSD. Early and accurate diagnosis of these distinct conditions is relevant as they have different treatments. Because of their similar clinical manifestations and habitual relapsing course they are frequently confounded with multiple sclerosis (MS). Neuromyelitis optica spectrum disorder (NMOSD) and anti-myelin oligodendrocyte glycoprotein (anti-MOG) syndromes are immune-mediated inflammatory conditions of the central nervous system that frequently involve the optic nerves and the spinal cord.
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