E-Pearl of the Week: The Effect of Pregnancy on the Course of Neuromyelitis Optica

March 20, 2012

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March 20, 2012

The Effect of Pregnancy on the Course of Neuromyelitis Optica

Neuromyelitis Optica, also known as NMO and Devic's disease, is a rare inflammatory demyelinating autoimmune disease of the central nervous system characterized by recurrent optic neuritis and longitudinal extensive transverse myelitis.  An autoantibody against the aquaporin–4 water channel is highly specific for NMO.  In a study in this week's issue, Bourre et al. studied 25 pregnancies in 20 different women with NMO, and noted a statistically significant increase in the Expanded Kurtzke Disability Status Scale (EDSS) score associated with pregnancy, when comparing the EDSS before delivery to the score one year after delivery, suggesting that pregnancy might have an effect on disability in patients with NMO.  Neither epidural analgesia nor breastfeeding seemed to influence the course of the disease in this small group of patients.

Reference

1.  Bourre B, Marignier R, Zéphir H, et al. On behalf of the NOMADMUS Study Group. Neuromyelitis optica and pregnancy. Neurology 2012; 78: 875–879.
2.  Wingerchuk DM, Lennon VA, Lucchinetti CF, et al. The spectrum of neuromyelitis optica. Lancet Neurol 2007;6: 805–815. Review.

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