PT  - JOURNAL ARTICLE
AU  - S Luppe
AU  - KA Harding
AU  - M Cossburn
AU  - G Ingram
AU  - J Palace
AU  - J Kitley
AU  - MI Leite
AU  - A Jacob
AU  - NP Robertson
TI  - NEUROMYELITIS OPTICA IN SOUTH WALES AND THE SOUTH WEST OF ENGLAND
AID  - 10.1136/jnnp-2012-304200a.57
DP  - 2012 Nov 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - A15--A15
VI  - 83
IP  - Suppl 2
4099  - http://jnnp.bmj.com/content/83/Suppl_2/A15.2.short
4100  - http://jnnp.bmj.com/content/83/Suppl_2/A15.2.full
SO  - J Neurol Neurosurg Psychiatry2012 Nov 01; 83
AB  - Objectives To study disease frequency, clinical disease course and relapse rate, in a population-based cohort of patients with NMO and to examine currently employed treatment strategies. Methods Patients were identified from seven neurology departments in S Wales and SW England by a multi-source ascertainment strategy. Clinical records were scrutinised and patients interviewed according to a standardized proforma to confirm demographic details including dates of clinical events and therapeutic interventions. Detailed neurological examination including disability assessment was undertaken and patients entered into a structured prospective clinical study. Results 36 patients were identified fulfilling established criteria for NMO or NMO spectrum disorders, 31(86%) were anti-AQP4 positive, 3(8%) were non-Caucasian. F : M ratio was 9 : 1, median age at onset 38.1 years (range 4–77), mean disease duration 9 years (SD=9.2), and a mean annual relapse rate 0.84 (SD=0.62). Clinical presentation was heterogeneous: optic neuritis (34%), transverse myelitis (59%), brainstem syndrome (6%). Median delay from onset to EDSS 4 was 7 years. 79% had received long-term immunosuppressive therapy with the use of 10 different therapeutic interventions. Conclusion This study provides data on the disease course, relapse rate and disability accrual in NMO in a cohort of 36 patients. Our data suggest a high variability of treatment regimes. After analysis and consultation with other UK groups we propose a unified treatment algorithm for management of patients with this disorder.