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Symptomatic and restorative therapies in neuromyelitis optica spectrum disorders

2021; Springer Science+Business Media; Volume: 269; Issue: 4 Linguagem: Inglês

10.1007/s00415-021-10783-4

1432-1459

Hesham Abboud, Andrea Salazar-Camelo, Naveen George, Sarah M. Planchon, Marcelo Matiello, Maureen A. Mealy, Andrew Goodman, Raed Alroughani, Ayşe Altıntaş, Metha Apiwattanakul, Nasrin Asgari, Renata Barbosa Paolilo, Jeffrey L. Bennett, Denis Bernardi Bichuetti, Terrence F. Blaschke, Alexey Boykо, Simon Broadley, Edgar Carnero Contentti, Jeffrey A. Cohen, Guillermo Delgado‐García, Irena Dujmović, José Flores‐Rivera, Kazuo Fujihara, Joachim Havla, Kerstin Hellwig, Jyh Yung Hor, Saif Huda, Raffaele Iorio, Sven Jarius, Dorlan Kimbrough, Ilya Kister, Ingo Kleiter, Najib Kissani, Marco Aurélio Lana–Peixoto, Maria Isabel Leite, Michael Levy, Youssoufa Maiga, Yang Mao‐Draayer, Sara Mariotto, Esther Melamed, Veronika E. Neubrand, Celia Oreja‐Guevara, Jacqueline Palace, Anne‐Katrin Pröbstel, Peiqing Qian, Chao Quan, Claire Riley, Marius Ringelstein, María José Sá, Sasitorn Siritho, Terry J. Smith, Ibis Soto de Castillo, Silvia Tenembaum, Pablo Villoslada, Jens Wuerfel, Dean M. Wingerchuk, Bassem Yamout, Michael R. Yeaman,

Fibromyalgia and Chronic Fatigue Syndrome Research

Abstract Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune inflammatory conditions that primarily target the optic nerves, spinal cord, brainstem, and occasionally the cerebrum. NMOSD is characterized by recurrent attacks of visual, motor, and/or sensory dysfunction that often result in severe neurological deficits. In recent years, there has been a significant progress in relapse treatment and prevention but the residual disability per attack remains high. Although symptomatic and restorative research has been limited in NMOSD, some therapeutic approaches can be inferred from published case series and evidence from multiple sclerosis literature. In this review, we will discuss established and emerging therapeutic options for symptomatic treatment and restoration of function in NMOSD. We highlight NMOSD-specific considerations and identify potential areas for future research. The review covers pharmacologic, non-pharmacologic, and neuromodulatory approaches to neuropathic pain, tonic spasms, muscle tone abnormalities, sphincter dysfunction, motor and visual impairment, fatigue, sleep disorders, and neuropsychological symptoms. In addition, we briefly discuss remyelinating agents and mesenchymal stem cell transplantation in NMOSD.