NMOSD vs MS Symptom Presentations & MRI Scans | For HCPs

Clinical Presentation	MS	NMOSD
Vision loss
Blindness
MRI	Unilateral optic neuritis	Unilateral or bilateral optic neuritis

Clinical Presentation	MS	NMOSD
Spasms
Limb weakness
Sensation loss
Paralysis
Loss of bladder/ bowel function
MRI	Longitudinal, short-length spinal cord lesion	LETM involving >50% of the spinal cord, centrally

Clinical Presentation	MS	NMOSD
Hiccups
Nausea
Vomiting
MRI	Ovoid, white matter lesions	Periventricular and circumventricular lesions

Area postrema syndrome is a core clinical characteristic of NMOSD that can appear both at disease onset and throughout the clinical course⁷

The spectrum of NMOSD symptoms is broad and includes nausea, vomiting, and intractable hiccups^7,8

4 out of 10 NMOSD attacks of the area postrema include all 3 symptoms⁷

Due to symptom severity, ~80% of patients with NMOSD-related area postrema syndrome are hospitalized⁷

See adverse outcomes associated
with misdiagnosis Clinical Course

Gd, gadolinium; LETM, longitudinally-extensive transverse myelitis.

References
Beekman J, Keisler A, Pedraza O, et al. Neuromyelitis optica spectrum disorder: patient experience and quality of life. Neurol Neuroimmunol Neuroinflamm. 2019;6:1-14. doi:10.1212/NXI.0000000000000580

National Multiple Sclerosis Society Website. Accessed November 21, 2022. https://www.nationalmssociety.org/Symptoms-Diagnosis

NORD rare disease database. Accessed on November 21, 2022. https://rarediseases.org/rare-diseases/neuromyelitis-optica/

Dutra BG, da Rocha AJ, Nunes RH, Martins Maia Júnior AC. Neuromyelitis optica spectrum disorders: spectrum of MR imaging findings and their differential diagnosis. RadioGraphics. 2018;38:169-193.

Kim HJ, Paul F, Lana-Peixoto MA, et al. MRI characteristics of neuromyelitis optica spectrum disorder: an international update. Neurology. 2015;84:1165-1173. doi:10.1001/jamaneurol.2015.1276

de Carvalho Jennings Pereira WL, Reiche EMV, Kallaur AP, Kaimen-Maciel DR. Epidemiological, clinical, and immunological characteristics of neuromyelitis optica: a review. J Neurol Sci. 2015;355:7-17.

Shosha E, Dubey D, Palace J, et al. Area postrema syndrome: frequency, criteria, and severity in AQP4-IgG–positive NMOSD. Neurology. 2018;19:e1642-e1651.

Sellner J, Boggild M, Clanet M, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur Neurol. 2010;17:1019-1032.