J Clin Neurol.
2022 Mar;18(2):207-213. 10.3988/jcn.2022.18.2.207.
Results of a Survey on Diagnostic Procedures and Treatment Choices for Neuromyelitis Optica Spectrum Disorder in Korea: Beyond the Context of Current Clinical Guidelines
- Affiliations
-
- 1Department of Neurology, Korea University College of Medicine, Seoul, Korea
- 2Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea
- 3Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, College of Medicine, Cheonan, Korea
- 4Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 5Neuroscience Center, Samsung Medical Center, Seoul, Korea
- KMID: 2526872
- DOI: http://doi.org/10.3988/jcn.2022.18.2.207
Abstract
- Background and Purpose
Neuromyelitis optica spectrum disorder (NMOSD) is a rare demyelinating disease of the central nervous system (CNS). We investigated the medical behaviors of experts in Korea when they are diagnosing and treating NMOSD.
Methods
An anonymous questionnaire on the diagnosis and treatment of NMOSD was distributed to experts in CNS demyelinating diseases.
Results
Most respondents used the 2015 diagnostic criteria for NMOSD and applied a cerebrospinal fluid examination, magnetic resonance imaging (MRI) of the brain and spine, and anti-aquaporin-4 antibody testing to all suspected cases of NMOSD. All respondents prescribed steroid pulse therapy as an first-line therapy in the acute phase of NMOSD, and 67% prescribed azathioprine for maintenance therapy in NMOSD. However, details regarding monitoring, the tapering period of oral steroids, second-line therapy use in refractory cases, management during pregnancy, and schedule of follow-up MRI differed according to the circumstances of individual patients. We analyzed the differences in response rates between two groups of respondents according to the annual number of NMOSD patients that they treated. The group that had been treating ≥10 NMOSD patients annually preferred rituximab more often as the second-line therapy (p=0.011) and had more experience with rituximab treatment (p=0.015) compared with the group that had been treating <10 NMOSD patients.
Conclusions
This study has revealed that NMOSD experts in Korea principally follow the available treatment guidelines. However, the differences in specific clinical practices applied to uncertain cases that have been revealed will need to be investigated further in order to formulate suitable recommendations.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Postpartum Relapse of Neuromyelitis Optica Spectrum Disorder after a Long Period of Spontaneous Remission
- Neuromyelitis Optica Spectrum Disorder Presenting with Pseudoathetosis
- Differential Diagnosis between Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder
- Isolated Tongue Paralysis as Presentation of Seropositive Neuromyelitis Optica Spectrum Disorder
- Neuromyelitis Optica Spectrum Disorder Presented with Acute Memory Loss
