King Abdullah Bin Abdulaziz university hospital, Saudi Arabia
Dr. Jameelah Saeedi is a certified Saudi Neurologist who specializes in Multiple Sclerosis and Neuroimmunological Diseases. She received her medical qualification from King Abdulaziz University in Saudi Arabia in 2001 followed by two-boards in Neurology from Saudi Commission for Health Specialties and the Jordanian Medical Council in 2007. Dr. Saeedi is alumni of University of British Columbia where she pursued her fellowship and training in Neuroimmunology and Multiple Sclerosis with Prof. Peter Rieckman in 2009. In 2010 she received two more fellowships in Electromyography and Boutlinum Toxin Injection treatment from the University of Toronto .She is one of few leading pioneers who holds vast knowledge, experience, sub-specializes and practices Multiple Sclerosis and Neuroimmunological Diseases in Saudi Arabia. She has been working at King Fahad Medical City as a Subspecialty Consultant and KFMC Comprehensive Neuroimmunology Program Director .She is currently working at King Abdullah Bin Abdulaziz university hospital in Saudi Arabia
Neuromyeltis optica (NMO) is an immune-mediated inflammatory disease of the central nervous system (CNS)
It typically affects the optic nerves and spinal cord, causing recurrent, severe optic neuritis and/or transverse myelitis. NMO was initially described as a variant of multiple sclerosis (MS). However, it is currently considered a separate disease entity that shares some clinical and radiological features with MS. Some reports have suggested that NMO was misdiagnosed as MS in 30%–40% of cases, especially before aquaporin (AQP)-4 testing was available.
In 2004, NMO-IgG was first reported to be associated with the disease, and its antigenic target is the most abundant CNS water channel termed AQP-4. Since this discovery, the disease spectrum has significantly widened, and some patients are being diagnosed with the disease even without manifesting the typical involvement of the optic nerve and spinal cord.
Multiple diagnostic criteria have evolved over the years, and in 2015, new diagnostic criteria were published, wherein a unified term, NMO spectrum disorder with either positive or negative AQP-4 antibodies, has been used.
Although approximately 80% of NMO patients are positive for serum AQP-4 antibodies, some can exhibit negative results despite using the most sensitive available technique. In this negative group of patients, a new antibody targeting myelin oligodendrocyte glycoprotein (MOG)—a protein expressed in myelin and on the surface of oligodendrocytes in the CNS—has been described.
During my presentation, I will go over the new diagnostic criteria for NMO, the radiological features of the disease, the differences between anti-MOG NMO and anti–AQP-4 NMO, as well as some practical points in the diagnosis and management of the disease. I will also present real cases that I have encountered during my practice.