Devic's neuromyelitis optica (NMO) is a serious neurological disorder, which is often misdiagnosed as multiple sclerosis (MS). This autoimmune, inflammatory disease typically presents with optic neuritis and transverse myelitis. NMO is a generally rare disease with poor outcome and only a very limited number of cases have been described during pregnancy.
We report a case of neuromyelitis optica in a Gravida 3 Para 0 at 20 weeks gestation, in which pregnancy had an adverse effect on the disease course.
Our case highlights the importance of differentiating between NMO and MS. We review the current literature concerning the two disease entities in pregnancy. Prognosis and Management of both disorders vary significantly. Symptomatic therapy for NMO is based on long term immunosuppression and the limited data in pregnancy suggest a significant risk of exacerbation in pregnancy. Conclusive diagnosis, pre-pregnancy counseling and specific multidisciplinary team antenatal care are essential to manage a pregnancy in an affected mother appropriately.
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