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Neuromyelitis optica (NMO) is a rare disease causing inflammation in the spinal cord and optic nerves. The NMO service brings together expertise in diagnostics and clinical management to improve outcomes for this often isolated group of patients.

The diagnostic and advisory service for neuromyelitis optica
Sagittal MRI image of the cervical cord in an NMO patient, showing longitudinally extensive T2 high signal from the cervico-medullary junction to T2

Overview

The main aim of the group is to better characterise the clinical, radiological and laboratory features of NMO and related disorders in order to improve diagnosis and treatment of these conditions. We are interested in clinical features of NMO that may determine disease course and prognosis and have recently published a major paper describing early prognostic characteristics and disability outcomes (Kitley et al, Brain 2012). 

I feel isolated as the condition is so rare, before coming to the service I only had my family as supportT.W, NMO patient

Research

NMO is sometimes difficult to differentiate from other disorders, particularly multiple sclerosis, which is important because the treatment is different. We have been looking at radiological features that may help differentiate these two conditions, and are also studying the clinical and paraclinical features of the ocular and spinal cord inflammation to look for particular characteristics that may enable distinction of NMO from NMO mimics. 

In the laboratory, we are investigating whether measuring serum levels of the NMO disease-specific antibody aquaporin-4 can be useful in determining response to treatment and can help guide management of these patients. We have also been looking for other antibodies in the small number of patients who do not have the aquaporin-4 antibodies. 

We continue to work on improving the diagnostic assay to help diagnose these patients as early as possible. 

Selected publications