This website is intended for a European audience and is made available by Amgen.
This website is intended for a European audience and is made available by Amgen.
Dr. REFIK PUL: MS vs. NMOSD: Lessons learned
This video delves into the key differences between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), featuring insights from Dr. Refik Pul. It highlights the urgency of early diagnosis and treatment in NMOSD, the challenges in distinguishing it from MS, and the psychological impact of living with the condition. The discussion underscores the advancements in treatment options and the need for greater physician awareness and patient support systems.
[Dr. Refik Pul, Neurologist and Head of the MS Outpatient Clinic at Universitätsmedizin Essen, Essen, Germany]
In MS everything is, if you compare it with neuromyelitis optica spectrum disease, is everything a bit slower so you have time. But NMOSD is like a very fast destruction, and this makes a difference in treatment because if you don't treat the relapse very quickly then you have irreversible damage.
It is important for patients to understand these differences because time plays a big role for NMOSD patients. You must have heard, for example, in stroke ‘Time is brain’ and this is much more valid for neuromyelitis spectrum patients. In MS, you can wait. But NMOSD patients do not have the luxury to wait.
It is challenging to distinguish these two diseases because they are affecting similar regions sometimes, like the optic nerve or the spine. And sometimes you have a beginning in MS with spinal lesions, and MS patients can also have severe optic neuritis. And, you can't distinguish, you can't say, OK, just because of this, this is an NMOSD or it's MS. Some let's say diagnostic instruments can help you, but, but these are not available everywhere. So it is very important to seek for the antibodies very quickly.
The most important is to get very fast on a disease modifying treatment because NMOSD just needs one or two relapses that very severe disability can occur and then people can find themselves very quickly in a wheelchair or in a bed. So the first awareness of the patient should be that they should care for their self in having very early treatment. And then we can talk about other things like to care for themselves, like doing regular sports. What I learned in my experience is that the sporty patients, they are not suffering so much from disability than the unsporty ones. This is a very important thing and it also helps to improve their situation if they still continue, even if they are disabled, with sports.
The relapses of NMOSD patients are making patients afraid because it's not just a bit of tingling or a bit of weakness, it totally ends in disability like blindness or the leg can't be moved anymore. So I think that the patients are very afraid of relapses much more than MS patients. And you can feel it also if you are talking with the patients that that they are afraid that they don't want to get off, for example, if you do a change in the treatment, they are sticking on that what they have and they don't let switch you to other treatment because they are just afraid to. And, and I think that this psychology is in all of these NMOSD patients. Interestingly, this is different from MS, they don't have such an overlap with depressive symptoms, it's much lower. This I can tell at least from my own experience.
I hope that we can treat patients more effectively, having zero relapses. And I hope that it will be like in MS that we have 20 drugs and that we can use them all. Let's see what will happen.
As mentioned by Dr. Pul, while MS and NMOSD share some similar symptoms, they are distinct conditions that require different approaches to diagnosis and treatment. If you or someone you care about is experiencing any symptoms, it’s important to speak with a doctor to ensure the right diagnosis and care plan.
For more information on NMOSD and patient resources, visit: www.nmosd-in-focus.com.
