Descripción general
La neuromielitis óptica es un trastorno del sistema nervioso central que causa la inflamación de los nervios en los ojos y en la médula espinal.
La neuromielitis óptica también se llama trastorno del espectro de la neuromielitis óptica y enfermedad de Devic. Se produce cuando el sistema inmunitario del cuerpo reacciona ante a sus propias células. Esto sucede principalmente en el nervio óptico que conecta la retina del ojo con el cerebro y la médula espinal. Sin embargo, a veces sucede en el cerebro.
El trastorno puede surgir después de una infección o puede estar asociada a otra afección autoinmune. Los anticuerpos anómalos se adhieren a las proteínas del sistema nervioso central y causan daño.
La neuromielitis óptica generalmente se diagnostica erróneamente como esclerosis múltiple o como un tipo de esclerosis múltiple. Pero es una afección diferente.
La neuromielitis óptica puede causar ceguera en uno o ambos ojos, debilidad o parálisis en las piernas o brazos, y dolorosos espasmos. También puede causar pérdida de sensación, vómitos e hipo incontrolables, problemas de vejiga o intestinos debido al daño de la médula espinal. Los niños pueden presentar confusión, convulsiones o estado de coma.
Las recaídas son frecuentes. Prevenir los ataques recurrentes es clave para evitar la discapacidad. Los brotes de neuromielitis óptica pueden ser reversibles, pero pueden ser lo bastante graves como para causar pérdida permanente de la visión y problemas para caminar.
Síntomas
Symptoms of neuromyelitis optica are related to the inflammation that occurs in the nerves of the eye and spinal cord.
Vision changes caused by NMO are called optic neuritis. These may include:
- Blurred vision or loss of vision in one or both eyes.
- Not being able to see color.
- Eye pain.
Symptoms related to the spinal cord are called transverse myelitis. These may include:
- Stiffness, weakness or numbness in the legs and sometimes in the arms.
- Loss of feeling in the arms or legs.
- Not being able to empty the bladder or trouble managing bowel or bladder function.
- A tingling feeling or shooting pain in the neck, back or stomach.
Other symptoms of NMO may include:
- Hiccups.
- Nausea and vomiting.
Children can have confusion, seizures or coma. However, these symptoms in children are more common in a related condition known as myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).
Symptoms may get better and then worse again. When they get worse, it's known as a relapse. Relapses can happen after weeks, months or years. Over time, relapses can lead to total blindness or loss of feeling, known as paralysis.
Causas
Experts don't know exactly what causes neuromyelitis optica. In people who have the disease, the immune system attacks healthy tissues in the central nervous system. The central nervous system includes the spinal cord, brain and optic nerves that connect the retina of the eye with the brain. The attack occurs because altered antibodies bind to proteins in the central nervous system and cause damage.
This immune system reaction causes swelling, known as inflammation, and leads to the damage of nerve cells.
Factores de riesgo
Neuromyelitis optica is rare. Some factors that may raise the risk of getting NMO include:
- Sex assigned at birth. Women have NMO more often than do men.
- Age. Most often, NMO affects adults. The average age of diagnosis is 40. However, children and older adults also can have neuromyelitis optica.
- Race or ethnicity. People of Hispanic, Asian, or African or Afro-Caribbean descent have NMO at higher rates than do people who are white.
Some research suggests that not having enough vitamin D in the body, smoking and having few infections early in life also may raise the risk of neuromyelitis optica.
Dec. 13, 2024