Devic's disease, also known as Devic's syndrome, is a rare neurological disease characterized by damage to the myelin sheath that covers the optic nerve and spinal cord. It is similar to multiple sclerosis except that with Devic's disease, there is no brain involvement, and magnetic resonance imaging (MRI) of the brain usually looks normal in Devic's patients. Diagnosis and treatment for this condition are usually supervised by a neurologist, a physician who specializes in care of the brain and spinal cord.
This condition can manifest in several ways. In some patients, the optic nerve and spinal cord are attacked at the same time by the immune system, leading to a set of symptoms experienced together. In others, the attacks are separated and patients experience either vision problems or spinal cord problems, but not both at the same time. Inflammatory flareups associated with Devic's disease are much more severe than those associated with multiple sclerosis.
When the disease attacks the optic nerve, it causes neuromyelitis optica. The patient can lose vision in one or both eyes due to the damage to the optic nerve and may experience other visual disturbances. Attacks on the spinal cord lead to transverse myelitis. This can cause paralysis, incontinence, numbness, weakness, and other symptoms, depending on the area of the spinal cord involved. In both cases, as the inflammation resolves, the patient will start to feel better.
In monophasic Devic's disease, a patient experiences a single inflammatory event, usually with a viral infection preceding the flareup. Patients with the relapsing form will experience multiple Devic's disease attacks. They can strike unpredictably after the first flareup and may be of varying intensity.
When a patient reports to a physician with symptoms of Devic's disease, diagnostic testing can be performed to rule out multiple sclerosis and other neurological conditions. A spinal tap may be performed to test the cerebrospinal fluid around the spinal cord for signs of inflammation, while medical imaging can be used to explore the brain and optic nerve. There are medications available to treat this disease and ongoing research is aimed at producing more effective treatments.
Devic's disease is incurable and degenerative. With each attack, more of the myelin that protects the optic nerve and spinal cord will be damaged, creating long term problems for the patient. During flareups, patients may find it difficult to work and engage in other activities because of pain and visual disturbances.