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Mult Scler Relat Disord. 2017 Nov;18:144-151. doi: 10.1016/j.msard.2017.09.015. Epub 2017 Sep 25.

Diagnosis and management of Neuromyelitis Optica Spectrum Disorder (NMOSD) in Iran: A consensus guideline and recommendations.

Author information

1
MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Iran; Iranian Center for Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Iran. Electronic address: sahraian1350@yahoo.com.
2
MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Iran.
3
MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Iran; Iranian Center for Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Iran.
4
Institutes of Regional Health Research and Molecular Medicine, University of Southern Denmark, Denmark.
5
Department of Neurology, Firozgar Hospital, Iran University of Medical Sciences, Iran.
6
Department of Neurology, Amiralam Hospital, Tehran University of Medical Sciences, Iran.
7
Scientific Committee, Iranian MS Society, Iran.
8
Department of Neurology, Kashani Hospital, Isfahan University of Medical Sciences, Iran; Isfahan neurosciences research center, Alzahra Hospital, Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran.
9
Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Iran.
10
Department of Neurology, Booalisina Hospital, Mazandaran University of Medical Sciences, Iran.
11
Department of Neurology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Iran.
12
Iranian Center for Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Iran; Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Iran.
13
Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Iran.
14
Department of Internal medicine and Neurology, Ghaem Int. Hospital, Rasht, Iran.
15
Department of Neurology, Golestan Hospital, Ahwaz University of Medical Sciences, Iran.
16
Department of Neurology, Namazi Hospital, Shiraz University of Medical Sciences, Iran.
17
Islamic Azad University, Faculty of Medicine, Khorasan Razavi Branch, Iran.
18
Isfahan neurosciences research center, Alzahra Hospital, Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Neuromyelitis Optica Spectrum Disorder (NMOSD) is a relapsing neuro inflammatory disease of the central nervous system that typically presents with optic neuritis or myelitis and may cause severe disability. The diagnostic criteria have been updated and several immunosuppressive agents have been demonstrated to prevent acute exacerbations. As the disease rarely develops in a progressive course, management of acute attacks and proper prevention of exacerbations may change the long term out-come and prevent future disability. Consensus recommendations and guidelines will help the physicians to improve their practice and unify the treatment approaches in different communities. In order to develop a national consensus and recommendations for the diagnosis and management of NMOSD in Iran, a group of neurologists with long term experience in management of NMOSD were gathered to develop this consensus based on available national and international data. The primary draft was prepared and discussed to suggest the most appropriate treatment for these patients. We propose strategies for early diagnosis and treatment for prevention of relapses and minimizing consequences of attacks as a primary therapeutic goal. Attacks are currently treated with intravenous corticosteroids and, in refractory cases, with plasma exchange. All participants agreed on preventive treatment with currently available immunosuppressive agents such as azothioprin, rituximab and mycofenolate mofetil based on previous positive data in NMOSD in order to reduce attack frequency. The current consensus reviews the previous data and provides the clinicians with practical recommendations and advices for the diagnosis and management of NMOSD based on scientific data and clinical experience.

KEYWORDS:

Devic's disease; NMOSD; Neuromyelitis Optica

PMID:
29141797
DOI:
10.1016/j.msard.2017.09.015
[Indexed for MEDLINE]

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