Research on neuromyelitis optica (Devic’s disease)

On 7 December at 15:00 in a public session of the Doctoral Committee of Medicine, Rīga Stradiņš University, which will take place in the Hippocrates lecture theatre (16 Dzirciema Street, Rīga), Liene Elsone will defend her doctoral thesis “The Clinical and Treatment Characteristics of Neuromyelitis Optica”.

The research is dedicated to neuromyelitis optica (NMO), also known as Devic's disease whict is a topical, though little-researched problem. NMO is an inflammatory and demyelinating (causing damage to the myelin sheath around the nerves) disease of the central nervous system that presents with damage to the optic nerve and spinal cord.

Though, the diagnostics of this disease has been improved, there are still difficulties in recognising this disease, as it is often mistaken for multiple sclerosis (MS) due to the fact that both diseases share similar clinical, laboratory and radiological signs.

If the treatment of Devic’s disease is delayed and medicines suitable for MS are used, there is a high risk of disability and mortality. Due to the severity and high disability of the disease, randomised placebo-controlled treatment trials are unethical, therefore, treatment is based on the analysis of particular cases and doctor’s experience.

Still many clinical peculiarities and those related to the course of the diseases have not been studied yet. Besides, advantages and risks of medicines used in NMO treatment for patients with different course of the diseases have not been studied at a sufficient level.

The aim of this paper was to analyse and characterise clinical features, efficiency of treatment of NMO/NMO, as well as to analyse the data entered into the Latvian MS register with an aim to improve diagnostic accuracy, treatment efficacy, and the outcomes of patients with NMO/NMOS.

Upon summarising the results, firstly, the author analysed less known clinical signs of NMO that would foster timely diagnostics of NMO and early commencement of treatment. Alongside, several treatment directions were analysed offering new opportunities in NMO treatment. What is more, a detailed analysis of quality and quantity of data available from the Latvian MS register was carried out.

At the end of the paper the author singled out suggestions for the improvement of the Latvian MS register, as well as clinically practical recommendations for the improvement of diagnostics and treatment of NMO patients.