Devic's disease

4 mins read

Introduction
Devic’s disease is an inflammatory disease that occurs due to damage caused to myelin sheath–a layer that shields brain and spinal cord when damaged. It is also known as neuromyelitis optica and is said to be a variation of multiple sclerosis (MS). It is characterized by immune attacks of the optic nerve, which connects the eye to the brain and spinal cord.

As per the statistics of the National Health Service, UK, a greater percentage of people with Asian and African ancestry develop Devic’s disease. This disease can affect almost anybody but is more common among people around 40 years.

Two main types of neuromyelitis optica have been reported.

1. Relapsing Neuromyelitis Optica
An initial attack of optic neuritis and transverse myelitis is followed by subsequent attacks over a period of several years. Sometimes the patient cannot recover fully from the neurological damage the attacks cause to the optic nerve and/or spinal cause and the damage is permanent, causing disability. This type of neuromyelitis optica affects females more frequently than males.

2. Monophasic Neuromyelitis Optica
Few attacks are experienced over a period of days or weeks. There are no subsequent attacks. This form of neuromyelitis optica affects both sexes equally.

Cause
Devic’s disease is hereditary in nature.

Symptoms
The symptoms of Neuromyelitis optica (NMO) depend on several factors and are known to vary. Generally, a person with NMO has the probability to have at least one episode of optic neuritis and transverse myelitis.

  • The optic nerve gets inflamed.
  • Diminished eyesight affects at least one eye. In most cases, it is a temporary phenomenon. However, heat or exercise is likely to cause a permanent loss of vision.
  • Painful eye that tends to worsen with movement. Pain gets more intense after a week, and disappears after few days. The eyes become sensitive in their perception of colors.
  • Patients of optic neuritis face problems while driving vehicles.
  • Swelling of the optic disc.

Symptoms Of Transverse Myelitis (TM)

  • The spinal cord becomes inflamed
  • Back pain and Neck pain
  • Shooting sensations in the limbs and abdomen
  • Patient may undergo sensations in area surrounding the affected part of spinal cord with sensitivity to cold/heat. There is a sign of weakness in the limbs of patients. Some of them may feel that their limbs have become heavy, while few others may get totally paralyzed.
  • Urinary incontinence with frequent urination and difficulty in urinating.
  • Fecal incontinence (bowel incontinence) and difficulty in emptying of the bowels
  • Constipation

Diagnosis
MRI of the spine usually denotes areas of inflammation and MRIs of brain generally show least changes. The cerebrospinal fluid (CSF) in Devic’s disease differs from that of typical MS as it usually has a large number of white blood cells, no oligoclonal bands, and normal intrathecal immunoglobulin G (IgG) synthesis.

Difference Between Devic’s Disease And MS
Devic’s disease is probably a variant of MS. Also, the immune system attack is essentially confined to the optic nerve and spinal cord. Devic’s disease leads to more damaging bouts of inflammation of tissues as opposed to MS disease. Moreover, patients with Devic’s disease mostly fail to respond to typical injectable therapies for MS, such as interferons (Avonex, Betaseron, and Rebif) or glatiramer acetate (Copaxone).

Treatment
Presently, research is being conducted to know the cause, find treatments and cure for Devic’s disease. Several treatments have been carried out so far. Steroids or plasmapheresis are used for treating acute relapses of Devic’s disease.

Plasma exchange is a sign a hope for a patient who has failed to react suitably to steroids. It is mostly used during recovering from a relapse of symptoms.

It has been seen that the standard therapies for MS (the interferons and glatiramer acetate) are much less effective in Devic’s disease. Instead, experience suggests that azathioprine (Imuran) and possibly mitoxantrone (Novantrone) are likely to help better.

Homeopathic Treatment
Argentum nitricum 200 is said to be an effective cure for Devic’s disease. Consult your homeopath for more options and dosage details of this medicine.

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References
1. Zhang, B., Zhong, Y.,  Wang, Y.,  Dai, Y.,  Qiu, W.,  Zhang, L.,  Li, H. and Z. Lu. Neuromyelitis optica spectrum disorders without and with autoimmune diseases. BMC Neurology 2014, 14:162

2. Oh, J. and M. Levy. Neuromyelitis Optica: An Antibody-Mediated Disorder of the Central Nervous System. Neurology Research International. Volume 2012 (2012), Article ID 460825, 13 pages

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