EFNS guidelines on diagnosis and management of neuromyelitis optica |
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Authors: | J. Sellner M. Boggild M. Clanet R. Q. Hintzen Z. Illes X. Montalban R. A. Du Pasquier C. H. Polman P. S. Sorensen B. Hemmer |
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Affiliation: | 1. Department of Neurology, Klinikum rechts der Isar, Technische Universit?t München, Germany;2. The Walton Centre for Neurology and Neurosurgery, Liverpool, UK;3. Department of Neurology, Purpan University Hospital, Toulouse, France;4. Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands;5. Department of Neurology, University of Pecs, Pecs, Hungary;6. Unitat de Neuroimmunologia Clínica, MS Centre of Catalonia, Hospital Universitari Vall d′ Hebron (HUVH), Barcelona, Spain;7. Departments of Neurology and Immunology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland;8. Department of Neurology, VU University Medical Center, MS Center, Amsterdam, The Netherlands;9. Department of Neurology, Danish MS Research Center, Copenhagen University and Rigshospitalet, Copenhagen, Denmark |
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Abstract: | Background and purpose: Neuromyelitis optica (NMO) or Devic′s disease is a rare inflammatory and demyelinating autoimmune disorder of the central nervous system (CNS) characterized by recurrent attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM), which is distinct from multiple sclerosis (MS). The guidelines are designed to provide guidance for best clinical practice based on the current state of clinical and scientific knowledge. Search strategy: Evidence for this guideline was collected by searches for original articles, case reports and meta‐analyses in the MEDLINE and Cochrane databases. In addition, clinical practice guidelines of professional neurological and rheumatological organizations were studied. Results: Different diagnostic criteria for NMO diagnosis [Wingerchuk et al. Revised NMO criteria, 2006 and Miller et al. National Multiple Sclerosis Society (NMSS) task force criteria, 2008] and features potentially indicative of NMO facilitate the diagnosis. In addition, guidance for the work‐up and diagnosis of spatially limited NMO spectrum disorders is provided by the task force. Due to lack of studies fulfilling requirement for the highest levels of evidence, the task force suggests concepts for treatment of acute exacerbations and attack prevention based on expert opinion. Conclusions: Studies on diagnosis and management of NMO fulfilling requirements for the highest levels of evidence (class I–III rating) are limited, and diagnostic and therapeutic concepts based on expert opinion and consensus of the task force members were assembled for this guideline. |
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Keywords: | demyelinating diseases diagnosis longitudinally extensive transverse myelitis neuromyelitis optica recurrent optic neuritis treatment |
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