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Journal of Neurology and Clinical Neuroscience | Volume: 03
8th International Conference on
NEUROLOGICAL DISORDERS,
CENTRAL NERVOUS SYSTEM AND STROKE
&
International Conference on
NEUROLOGY AND NEUROSURGERY
December 04-05, Dubai, UAE
Joint event on J Neurol Clin Neurosci, Volume: 03
Notes:
Plasma exchange as a first line therapy in acute attacks of Neuromyelitis Optica
Spectrum Disorders
BL Kumawat
SMS Medical College, India
Background : Neuromyelitis Optica Spectrum Disorder
(NMOSD) is a demyelinating disorder of central nervous
system with deleterious effects. At present Intravenous
corticosteroids are used for the relapse as the first
line of treatment, but with only a class evidence III-IV.
Having an underlying humoral immune mechanism in
the pathogenesis of NMOSD and as it is rightly said that
“Time is Cord and Eyes”, delaying the time to start plasma
exchange (PLEX) awaiting favorable outcome in response
to corticosteroids is detrimental for the patient. Hence
PLEX may be a promising first line therapeutic approach in
the management of severe attacks of NMOSD.
Objective: To evaluate the efficacy of PLEX as the first line
of treatment for the acute attacks in patients with NMOSD,
that is being largely used as an add-on therapy for more
than 10 years and also to define the time opportunity
window for the starting of PLEX.
Materials and methods: After institutional ethical
committee clearance the study was conducted to analyse
the therapeutic efficacy and safety profile of PLEX as a first
line therapy in thirty patients diagnosed with NMOSD over
a period of thirty months. PLEX was performed using a
Hemonetics Mobile Collection Systemplus machine with
due written consent including the risks and benefits of the
treatment that is being proposed to the patient/relative in
their own language.
Results : A total of 30 patients were analysed, out of which
16 were females and rest males. Eighty five percent of the
patients were in the age group of 25 to 35 years. All the
patients had severe Expanded Disability Status Scale (EDSS)
scores at the baseline, and 73.33% showed significant
improvement following PLEX. The only predictor of good
outcome was the time to PLEX i.e. shorter delay better is
the outcome.
Conclusion: The study ascertained the importance of
early PLEX as a therapeutic intervention in severe attacks
of NMOSD irrespective of their Anti-Aquaporin 4 (AQP4)
antibody status.
Biography
BL Kumawat is currently working as a senior professor of neurology
at SMS Medical College and Hospital at Jaipur, Rajasthan, in India. He
studied DM Neurology in Medical College Jaipur. He has been awarded
twice for his outstanding work in the college. He also presented and
published his work many times in the international forums and journals.
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