Neuromyelitis Optica (NMO) [Symptoms, Diagnosis, MRI Findings, Treatment, Clinical Trial Results]

[@khitir1500]

I am a medical student and have been diagnosed with NMO. I have been watching all of your videos religiously. Thank you man, they benefit a lot!

[@DrBrandonBeaber]

Thanks. I focus on MS and this is my sole video on NMO, but hopefully it was helpful.

[@mengisteabkassahun5088]

Hope U know some random stranger is routing for u

[@Shelley550]

​@@DrBrandonBeaberThank you 🙏🏽l also was diagnosed with NMO in 2021" & treated..

[@LisaKovanda]

MOG here. Thank you for this wonderful video to help others understand!

[@DrBrandonBeaber]

Thanks Lisa. I may do a video on anti-MOG related disease at some point. It's still a relatively poorly understood entity in my view.

[@Wyomi]

Interesting that you did this video at this time. I just went in for a second opinion and the medical team is thinking that I was misdiagnosed with MS and they are investigating other things that it could be. NMO was mentioned originally and I found it very frightening. Thank you for the videos you put together, they are definitely appreciated.

[@DrBrandonBeaber]

I'm glad you got something out of it Janice, and good luck finding a definitive answer.

[@Wyomi]

@@DrBrandonBeaber Thank you. To be completely honest I have thought from the get-go that I have clinically isolated syndrome. Maybe I’m just in denial, but that’s what I think.

[@Shelley550]

@@Wyomi scary business indeed!! I was diagnosed & hospitalised with NMO in 2021". You'd know IF you had it!!..

[@motokitty]

@@Shelley550my niece has been dealing with NMO for over 4yrs and is very depressed. Do you have any support groups she can attend online? Or do you know any resources for her?

[@Shelley550]

@@motokitty what country are you from? How old is she, & has she been treated? OR what condition is she currently in?.. It was May 2021" l woke up half blind half paralysed, in other words Transverse myelitis & optic neuritis.. Thankfully my vision returned, & im walking normally🙏🏽 l was treated with high doses of corticosteriods iv 🤯 & plasma blood transfusions, after the 2nd plasma l could wiggle my toe, & continued to improve with plasma.. Amazing!! then relapsed after i got out of hospital a month later. However l do have a long lesion on my spine & can relapse at anytime, but so far so good🤞🏼 l do have severe neuropathy in legs ñ feet a constant icy burn but nothing can be done for nerve damage!! I do have continual follow up @ppointments with my neurologist & immunologist, unfortunately some countries dont even have treatment!!.. I'm a ¥ogi, & l do believe that helped in my recovery, so do my neurologists. I have immunosuppresant infusions every 6 months for life to prevent relapse..🙏🏽 Im glad you reached out as this is a very rare disease ~ she needs to be stress free & try to keep a positive mind set, the depression hit me bad in hospital while on corticosteriods, yet i was determined to not live in a wheelchair!💞

[@paul6150]

Asked if I could get tested for NMO at my second opinion, just to rule that out. They agreed because it could have been a rare presentation of the disease. Glad I can cross that of the list. Spinal form of PPMS it is. Well I do not fit that criteria yet, but it is the best match.

[@lenushpopa]

Thank you so much for sharing this information! Keep up the good work, sir!

[@TexAg009]

Dr. Beaber, I really enjoy your videos, as a fellow (and now 1st year attending) still learn a lot from you. I was wondering if you could share the original article for the ARR comparison chart among MMF, AZT, and RTX. Thanks!

[@DrBrandonBeaber]

I am having trouble finding it but here is a related article: onlinelibrary.wiley.com/doi/abs/10.1111/ene.15355

[@jamiedecker7853]

I'm here bc ive suffered from vision problems for 2.5 yrs now. Just finding out I have chronic optic neuropathy in both eyes. What sucks is I went to 2 hospitals and multiple doctors and specialists and nobody did squat to help me, or even look into my symptoms. Now I'm left with atrophied nerves and messed up vision. Why do they say it is an emergency and to go to the er or your doctor if you have double vision or sudden vision loss if they won't help you? Makes no sense. I just don't even wanna around anymore if I can't do the things I used to.

[@mollywest3087]

Would NMO be eliminated as a possibility if the spinal lesions were smaller and only occupied one vertebrae rather than being longer?

[@DrBrandonBeaber]

Not completely eliminate. "Short transverse myelitis is not uncommon in NMOSD" Source: jamanetwork.com/journals/jamaneurology/fullarticle/1921781 (see figures 1 and 2)

[@angeliquetamsinpotgieter1165]

Was diagnosed with MS in 2022 after over 10 ON attacks over 2 years, 6 bilateral, they tested for NMO said was negative so did a MRI and Lumber Puncture then said MS. Nobody can understand why my Optic Nerves were so viciously attacked to the point they have become chalky white. Thin and atrophied, legally blind in right eye completely. Bit more vision in left, I'm only 32 and terrified, thoughts???

[@limelightpictures3382]

Hi doctor I'm from England. In 2010 i had an attack of adem , recovered from it . Then in 2018 woke up with blurred vision was diagnosed with bi optic neuritis had another relapze which gave me drop foot in feet. But surprisingly my vision has come back it was 20/200 now is 20/25 due to Plex . Theyve given me a diagnosis of atypical ms or seronegative nmo. Due to me not having the moh antibody or the aqaporin 4

[@DrBrandonBeaber]

Thanks for sharing. Neuromyelitis optica can in some cases associated with diffuse brain lesions suggestive of ADEM.

[@bigansingh2761]

@@DrBrandonBeaber which treatment will be better for this allopathic,homeopathic or Ayurveda for this disease....for better recovery rate.... And does this medication like mofetil or prednisone have any other side effects and for how long I have to take medication....

[@DrBrandonBeaber]

@@bigansingh2761 I'm not familiar with potential homeopathic or ayurvedic treatments of NMO. Mycophenolate mofetil and prednisone suppress the immune system and cause other side effects. Many experts recommend long-term treatment of NMO.

[@bigansingh2761]

@@DrBrandonBeaber sir can I get your email address plz..

[@bigansingh2761]

@@DrBrandonBeaber sir what are the chances of recovery if my aquaporin 4 is weakly positive....and for how long I have to take medication

[@zeljkacuk4498]

amazing lecture! thank you!

[@BenerjiChanu]

What is the most valuable examination results in the neuromyelitis optica? Is it CNS MRI scanning or CSF AQP4

[@Shelley550]

MRI & spinal tap

[@DJMetzler337]

Can AQP4 only be tested at the Mayo Clinic or do specialists have the ability to run it?

[@DrBrandonBeaber]

There are multiple labs which can test for anti aquaporin 4 antibody (AQP4)

[@suziegau2245]

Hello Doctor! Thank you for your video. I was diagnosed with Nmo May 2021. I have a long segmented spinal cord lesion from T2-T12. However, my lab result came out negative for Aquaporin 4 and Mog antibodies. Positive ANA. I dont have optic neuritis. Do I have seronegative Nmo or just a Transverse Myelitis? My condition is very stable at the moment. No other attack so far.

[@DrBrandonBeaber]

I can't give you personal advice here. There are people with NMO who do not have either anti-MOG or anti-AQP4. The official Diagnostic criteria for NMO without antibodies requires two core characteristics of the condition (please see this publication table 1: www.ncbi.nlm.nih.gov/pmc/articles/PMC4515040/

[@suziegau2245]

@@DrBrandonBeaber Thank you for the article. Very interesting and very informative.

[@alleviated1289]

@@suziegau2245 hows everything going? I hope everything is going well for you! my sister sadly recently got diagnosed with NMO and im trying to get informed as much as I can with this disease as it is scary but im praying for a recovery here soon Godwilling. ill also keep you in my prayers! god bless yall!

[@Shelley550]

​@@suziegau2245l was also diagnosed with NMO May 2021" long lesion on spine, & optic neuritis in one eye

[@drroussakis]

Soliris...Is this not the same drug that is used against myasthenia gravis?

[@DrBrandonBeaber]

Yes it is.

[@rikudousennin6807]

Hello dr its the first time i see your channel :) what do you think about walhs protocol?

[@DrBrandonBeaber]

Here is my review of the Wahls protocol: kzbin.info/www/bejne/eKjboJmoiZ6dp9k Here is a summary of her recommendations: kzbin.info/www/bejne/mZ6vlZmhppl1prs

[@Sophia-of1xq]

Dr. Beaber, do you have any thoughts about taking a Covid-19 vaccine while being on Rituximab therapy every 6 months? Current B-cell report is 0.0L.

[@christopherchamberlain]

I have retuximab infusions every 6 months and I have also have had both of my covid jabs. I was absolutely fine, didn't feel ill one bit.

[@Shelley550]

Im on retuximab every 6 months, & definitely would not have jab!!

[@mikeellement1567]

@@Shelley550 I've been taking rituximab once a year for NMO for 9 years [and plasmapheresis about 6 times a year until a couple years ago] and I've had all the covid vaccines and boosters without a problem. Of course you should check with your neurologist. Mine said there would be no problem.

[@Shelley550]

@@mikeellement1567 the experimental jab is the worse thing you could put in your body... l wouldnt have it by choice!! My Neurologist, Immunologist & GP also agreed....

[@Shelley550]

@@mikeellement1567 l didnt have the "experimental jab" by choice.. Probably the worse thing you could put in your body!!.. My Neurologist, Immunologist, & GP even agreed..

[@frankchiaramonte5323]

Hi Doc all your videos are great and informative i was just diagnosed Devic’s disease could not get an appointment with a neurologist here in the US for two months so i went to Mexico as my wife is from there and the Doctor put me on 25mg prednisone for ten days then 12.5 for another ten days they also prescribed me Nucleo CMP Forte twice a day for 30 days Do you think this treatment will help it from progression?

[@DrBrandonBeaber]

Sorry. I can't give you personal advice here. oral prednisone is one of the treatments of NMO. It is usually not used on a long-term basis due to the potential side effects (weight gain, hypertension, elevated blood sugar, etc).

[@Shelley550]

I was diagnosed & hospitalised in 2021" for NMO... l hope you've had better treatment now, as this disease needs to be treated asap🙏🏽

[@yahyehassan8067]

So amazing, you discussed it well.

[@DrBrandonBeaber]

Thanks

[@melchieempiales5749]

Hello Doc i just want to ask , Can I stop taking steriod at 5mg?

[@akosimay_ann]

Hi doc just this February 2022 I got diagnosed with NMO. I would just like to know if the numbness in the feet goes to my leg is my permanent? Hoping yoy will find my comment and can get a definite answer. Thank you so much!

[@DrBrandonBeaber]

People often improve from NMO relapses over time, but some people can have residual symptoms. It varies a lot from person-to-person. I wish you the best of luck in your recovery.

[@argentinarodriguez4170]

NMO and MOG Negative. ANA was borderline. Brain MRI showing some demyelination. Back pain and MS Hug very tight. I was placed on a 1000 mgs Methylprednisolone for 5 days and sent home with a 40 mgs per day reducing dosage on a weekly basis. The second day in the hospital I felt much better but since then I have been regressing to the point I can barely walk. Dr. is this MS, please? TIA

[@DrBrandonBeaber]

There would be no way for me to speculate on your particular situation, but I wish you good luck in finding answers

[@melchieempiales5749]

Hello Dr. I’m from the Philippines and i was diagnosed with NMOSD . I want to ask if the itchyness can go away? the left side of my head is really itch . i had this before i was diagnosed. PLEASE RESPOND I NEED AN ANSWER 🙏🙏🙏😭

[@DrBrandonBeaber]

It is difficult for me to comment on this, but sometimes neuropathic pain related to NMO (which can be described as itchiness) can improve over time, especially if it is related to a recent attack. Lesions in the C2 area of the cervical spine are known to cause scalp numbness/neuropathic pain.

[@melchieempiales5749]

Thanks for responding Dr. Do numbness can go away? if treated properly?

[@Majumdar97]

Hello Sir, My mother is an NMO patient, suffering from 2013, can I talk to you?

[@DrBrandonBeaber]

Unfortunately, I would not be able to help her personally, but I wish her good luck in finding a qualified provider.

[@madhavikunja1462]

Hello doctor,,I'm NMO since four yrs ago ,,now in third attack my eyes are effected ,in blurred vision,,in since four yrs I'm took the medications ,,in daily took azoron 50 mg per day twice,,,and legs are week,but still I'm walking ,,but how my legs are normal man ,and my eyes are normal vision ,,😭 please tell me doctor

[@dominicp134]

first practical question to the ,,experts" from europe, why they the doctors and pharma dont offer all available drugs and assign all the quality ones to patients especially like biotin E. G., or only to 1 % the rich people. Thanks Dr. Brandon for the supplements Biotin video in general, why theres a middle age dice of treatments and studies and no uniform, free approach in 2020? Why there are no studies about Hericium intenso and only about chemical trash and garbage drugs? Why docotrs look on vtamins isolatet and dont start to look for combinations. Lost Retro evolution in treatment? Money interest bigger than treatment, man if i code a computer program or microsoft the approach is maximum quality and not maximum money for nothing, when human civilization comes into next age of spyral dynamics? Im not unsatisfied with the work im highly unsatisfied with the management and money allocation and that theres no freedom in treatment. this bureaucratic mismanagement especially in europe stops or blocks develeopment and makes it even harder for coming generations. We need the combinations for solutions, its said womans have MS more often than men? If my fingernails as a man become longer, i have more likely fatique attacks and extreme tireness or other symptoms, dont ask me why. Its only a feel.

[@Mohandas12349]

Sorry sir my friend got optic nueritis problem now sir nmo/mog antibody finding here in Hyderabad L V Prasad Eye hospital sir. So what will we do sir she is taken inj neodrol 1gm 5days taken followed by decreasing 50 mg for 3 day decreasing 40;30;20;10 mg following sir tab neurobia fort for one month advised sir

[@jasminep2640]

Sir i m suffering from Nmo disease and i m taking rituximab injection Is it a cureable disease after taking injection also i m getting replaced again and again

[@irereomio1797]

Thank you for the video sir

[@haianhnguyen4129]

Thank you very much for your videos :*

[@DrBrandonBeaber]

You're very welcome

[@Akikolobo]

Thank you very much for your videos! Interesting how in NMO there isn't a progressive component. This seems to be somewhat of a mystery in MS if I am not mistaken? Initially I thought it was because of the accumulation of attacks but later on I realized it's not just that it seems

[@DrBrandonBeaber]

It is somewhat of a mystery. There is evidence of inflammation mediated by microglia invisible to conventional MRI, failure of cellular mitochondria, and dysfunction of chronically demyelinated axons.

[@skgoswamibhardwaj5242]

Hello sir anti NMO abs report strongly positive

[@ph7346]

Stem Cells people! HSCT

[@mahendrameena6526]

Nmo pesent 6 years hellp me