DEVIC’S DISEASE

DEVIC’s DISEASE

It is also known as Neuromyelitis optica. It is the occurrence of Transverse myelitis and Bilateral Optic neuritis.

Most of the cases are associated with antibody to AQUAPORIN 4.

It causes damage to myelin sheath results in decrease in Nerve conduction. It can also damage nerve fibres. Exact mechanism is unknown.

Clinical features:

  1. Pain in the eye
  2. Vision loss
  3. Numbness and weakness of limbs
  4. Some cases have paralysis of upper limbs or lower limbs or Both depending on the site of involvement of Spinal cord.
  5. Sensory loss
  6. Loss of bladder and bowel movements.

NOTE: First two symptoms due to optic neuritis and remaining due to transverse myelitis. All symptoms may not present at a time, it is progressive.

Radiological features:

Brain MRI: High-signal lesions restricted to periventricular regions.

Spinal MRI: Lesions typically longer than three spinal segments.

NOTE: Brain changes may or may not be seen

Treatment

  • Immunosuppressives
    • Steroids
    • Azathioprine
    • Cyclophosphamide
  • Plasmapheresis : It is Most Effective treatment. It can be done along with course of Immunosuppressives
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