6th Edition of Neurology World Conference 2026

Abstract

Background: Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare neuroinflammatory disease characterized by recurrent relapses. The most common signs are myelitis and optic neuritis. Cerebral or brain stem syndromes can also present them. There are still many challenges in its diagnosis and treatment. Indeed, it needed long-term follow-up studies to see the disease course over time.  

Methods: We established an electronic registration system for NMOSD patients in October 2015 at Kashani Hospital, Isfahan, Iran. Every suspected patient was documented and included in the follow-up system to survey their disease course. Anti-aquaporin 4 (AQP4) antibody checked for all by cell-based assay method. All information, such as demographic data, history, addiction laboratory, MRI findings, and disease presentation, had been documented. We followed them regarding relapse, new paraclinical tests, and drug changes. This study is based on definite NMOSD cases (according to the 2015 criteria) characteristics and clinical course during seven years of registration.

Results: The study included 173 NMOSD cases, and 56 were seropositive for AQP4 Ab. Their mean age was 40.02±11.11 years (45.78 in the seropositive group). The mean age at disease onset was about 30.16 years. The mean time of follow-up by our registration system is 55.84 ±18.94 months (54.82 months in seropositive ones). The annual relapse rate is estimated as 0.47±0.36. Long-extended transversal myelitis (LETM) was presented in the baseline MRI of 77 patients (44.5%), while 32 of them didn’t show any related clinical symptoms. One hundred twenty-four patients reveal an abnormality in the first brain MRI. 27 individuals suffer hypothyroidism as the most common comorbid disease. The disease seems to be more prevalent in Isfahan province's west and southwest areas. 

Conclusion: The mean age of onset is higher than Multiple Sclerosis (MS) patients, but there were noticeable pediatric cases too. It should be considered that LETM can be asymptomatic at first. Brain MRI abnormalities are almost prevalent. The disease is more prevalent in geographical areas like MS prevalence.

Keywords: Neuromyelitis Optica, Rituximab , Relapse Rate, Multiple Sclerosis, Cervical MRI