Neuromyelitis Optica (NMO)

Your Path

  • Neuromyelitis Optica (NMO)


  • Autoimmune disorder affecting the spinal cord, optic nerve, brainstem (doesnt have to affect all)
  • Antibodies against aquaphorin-4 protein

Risk Factors

  • Mean age 40
  • Other autoimmune disorder: SLE, Sjogrens, RA


  • Sub-acute onset weakness, numbness below level of cord that's affected
  • Optic neuritis, with visual loss (painful), typically unilateral
  • In comparison with transverse myelitis, NMO affects longer segments (i.e. > 3 spinal levels)
  • Sometimes incontinence
  • Symptoms are severe (i.e. profound extremity weakness, numbness)
  • Sometimes intractable hiccoughs, N, V, dizziness (brainstem related)

Physical Exam Findings

  • Visual loss w/evidence optic nerve inflammation on ophthalmosocopy
  • Sensory level below affected area of cords
  • Weakness to flaccid paralysis at and below affected level
  • Loss of reflexes