Devic’s Disease: It Acts Like MS, But it’s Not

Coyle Patricia K. Coyle, MD, FAAN, FANA
Director, Multiple Sclerosis
Comprehensive Care Center

Dr. Coyle is the founding director of the Stony Brook Multiple Sclerosis Comprehensive Care Center. She is an expert in neuroimmunology, which is the diagnosing and treatment of neurological disorders caused by inflammation or autoimmune conditions in the nervous system. As a physician and researcher, she has lectured around the world on this topic.

What is Devic’s disease?
Devic’s disease, also known as neuromyelitis optica (NMO) spectrum disorder, is a rare neuro-immune disorder that affects your eyes and your spinal cord. It may also attack the brain. Neuroimmune means that the immune system mistakenly attacks the nervous system as if it were a threat. Devic’s disease/NMO causes damage to the optic nerves located at the back of your eyes. It produces swelling and inflammation that cause eye pain and loss of vision. It also causes damage to the spinal cord resulting in weakness or numbness in your legs or arms, loss of sensation, paralysis of your arms and legs, and difficulty controlling your bladder or bowels. It can cause uncontrollable vomiting and hiccups, too.

What symptoms does it have in common with MS?
A vision problem is often the first noticeable symptom of MS. The same is true of Devic’s disease/NMO. Both can cause acute (chronic) spinal cord attacks, with weakness, numbness/pain and bladder issues.

What are some of the differences?
People all over the world get Devic’s disease/NMO while those who live in temperate climates tend to get MS. Also, Devic’s disease/NMO tends to strike later in life than MS, and is more common in women than MS.
Other differences include:
• Devic’s disease/NMO most often affects only the optic nerve and spinal cord at first.
• With MS, changes in memory, reasoning, problem solving and depression are also common.
• Vision loss with MS usually affects one eye at a time, but Devic’s disease/NMO may affect both eyes at the same time.
• Symptoms are generally more severe for the Devic’s disease/NMO attack than the MS attack.
• A specific blood marker that is found in people with Devic’s disease/NMO is not found in people with MS.
• In MS, individual episodes are usually mild. Over time, they may or may not cause progressive disability. In Devic’s disease/NMO, episodes tend to be severe, so early diagnosis is critical. Devic’s disease/NMO attacks can have devastating, irreversible effects on how a person can function.

How are Devic’s disease/NMO and MS diagnosed?
Both involve central nervous system lesions, with damage to central nervous system cells. These lesions can be seen via a magnetic resonance imaging (MRI) scan. In people with Devic’s disease/NMO, these lesions are typically found on the spinal cord and optic nerves, while MS often affects other brain areas.

Why choose Stony Brook for diagnosis and treatment of either?
There is no cure for Devic’s disease/NMO at this time, but there is an FDA-approved drug treatment. We do know that Devic’s disease/NMO is made worse by certain MS therapies, so it’s very important not to misdiagnose these two disorders. Stony Brook has knowledgeable and experienced physicians who can diagnose and treat not just MS, but Devic’s disease/NMO as well.

To make an appointment with Dr. Coyle at the Stony Brook Multiple Sclerosis Comprehensive Care Center, call
(631) 444-2599.