RT Journal Article
SR Electronic
T1 NEUROMYELITIS OPTICA IN SOUTH WALES AND THE SOUTH WEST OF ENGLAND
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP A15
OP A15
DO 10.1136/jnnp-2012-304200a.57
VO 83
IS Suppl 2
A1 Luppe, S
A1 Harding, KA
A1 Cossburn, M
A1 Ingram, G
A1 Palace, J
A1 Kitley, J
A1 Leite, MI
A1 Jacob, A
A1 Robertson, NP
YR 2012
UL http://jnnp.bmj.com/content/83/Suppl_2/A15.2.abstract
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.