Symptomatic and restorative therapies in neuromyelitis optica spectrum disorders

On-behalf of the Guthy-Jackson Foundation NMO International Clinical Consortium

Research output: Contribution to journalReview articlepeer-review


Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune inflammatory conditions that primarily target the optic nerves, spinal cord, brainstem, and occasionally the cerebrum. NMOSD is characterized by recurrent attacks of visual, motor, and/or sensory dysfunction that often result in severe neurological deficits. In recent years, there has been a significant progress in relapse treatment and prevention but the residual disability per attack remains high. Although symptomatic and restorative research has been limited in NMOSD, some therapeutic approaches can be inferred from published case series and evidence from multiple sclerosis literature. In this review, we will discuss established and emerging therapeutic options for symptomatic treatment and restoration of function in NMOSD. We highlight NMOSD-specific considerations and identify potential areas for future research. The review covers pharmacologic, non-pharmacologic, and neuromodulatory approaches to neuropathic pain, tonic spasms, muscle tone abnormalities, sphincter dysfunction, motor and visual impairment, fatigue, sleep disorders, and neuropsychological symptoms. In addition, we briefly discuss remyelinating agents and mesenchymal stem cell transplantation in NMOSD.

Original languageEnglish (US)
Pages (from-to)1786-1801
Number of pages16
JournalJournal of Neurology
Issue number4
StatePublished - Apr 2022


  • Mesenchymal stem cells
  • NMO
  • Neuromyelitis optica
  • Neuropathic pain
  • Remyelination
  • Symptomatic
  • Tonic spasms

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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