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Neuromyelitis optica (NMO) is an inflammatory disorder restricted to the spinal cord and optic nerves. Contrary to multiple sclerosis (MS), relapses of NMO are often strikingly severe and most NMO patients present stepwise neurological impairments. NMO treatments are aimed to prevent the relapses with the administration of various promising immunosuppressive drugs. However, relapse treatment is still a tricky problem. Since the largely used steroid treatment usually fails to control severe attacks, specific add-on treatments have to be considered in order to limit the stepwise increase of residual impairment. Given that a strong humoral response characterizes NMO physiology, one might assume plasma exchange (PLEX) to be particularly well adapted in severe NMO relapses.

Plasma Exchange in Severe Attacks Associated with Neuromyelitis Optica Spectrum Disorder