NMOSD or Neuromyelitis Optica Spectrum Disorder, also known as Decic syndrome or opticomyelitis, is a chronic brain and spinal cord disorder that causes inflammation of the optic nerve. The rarity of this disorder can be gauged from the fact that it affects only 1-10 per 100,000 individuals. This makes it more important to be aware of its signs and symptoms, nutrition options, and medicines.

Signs and symptoms

Blurry vision
The primary symptom of NMOSD is inflammation of the optic nerve. This is also termed optic neuritis or myelitis. The inflammation can lead to pain in the eyes followed by acuity or loss of clear vision. NMOSD is typically unilateral, as it usually affects only one eye. It can affect both eyes as the disease progresses.

Poor bowel movements
Since NMOSD also affects the spinal cord, it can cause spinal inflammation. This cardinal syndrome is also known as transverse myelitis as it affects all sensory, motor, and autonomic functions. This can lead to problems with bowel movements.

Weakness in limbs
Most sensory nerves originate from the spinal cord. Hence, when a patient suffers from transverse myelitis or inflamed spinal cord, it leads to weakness in the limbs. Individuals may also experience pain in their spine and limbs. The pain may diminish in the earlier stages, and the individual’s deep tendon reflexes may exaggerate. As the disorder progresses, the person may have a stiff neck and get headaches.

The signs and symptoms mentioned above can also be a result of any other disorder. For instance, in the earlier course of this disorder, the symptoms look similar to multiple sclerosis. However, the difference is, a person suffering from NMOSD may have severe optic neuritis and myelitis. As these early signs and symptoms become severe, the person may experience vision loss or paralysis. However, the same improve with standard treatment.

While NMOSD can be treated with medication, certain changes in the food regime are required as well. These foods not only complement the treatment but also helps reduce risk. Read on to know more.

Foods to eat and avoid
Nutrition plays a crucial role in managing NMOSD symptoms. While these may not classify as an NMOSD treatment option, eating and avoiding certain foods can certainly provide relief.

Foods to eat

Food rich in vitamin D
It is found that people with low vitamin D levels are at a greater risk of suffering from NMOSD. It can lead to having lower bone density, which can make it difficult to manage NMOSD. Food rich in vitamin D includes fatty fish like tuna, mackerel, and salmon, low-fat cheese, yogurt, beef liver, orange juice, and some dairy products.

Food rich in PUFA
PUFA or polyunsaturated fatty acids play an important role in managing NMOSD. PUFA such as omega-3 and omega-6 fatty acids can help decrease inflammation in the brain and spinal cord. This may provide relief from pain in the limbs and bowel movements. Some foods rich in PUFA include walnuts, sunflower seeds, sesame seeds, peanut butter, flaxseeds, poppy seeds, avocado, and safflower.

Gluten-free food
Poor bowel movements are one of the signs of NMOSD. Hence, it is important to include foods that get easily processed by the digestive system. Gluten is a type of compound that binds the grain structure. However, gluten can take a long to digest and cause bloating. Hence, it is important to switch to gluten-free food options like legumes, dairy products, eggs, fruits, and vegetables.

Antioxidant-rich foods
Free radicals are one of the other factors that increase the risk of inflammation in the body. Foods such as green tea and berries are rich in antioxidants that can eliminate these free radicals in the body, helping reduce inflammation.

Foods to avoid

Processed foods
Most processed and packaged foods contain preservatives and other additives that can make it difficult to manage symptoms caused due to inflammation in the brain and spinal cord. It is recommended to eat freshly cooked food or packaged foods that do not contain preservatives.

Foods containing saturated fats
Saturated fats are not easily processed by the body and remain in the digestive system for a longer period. This can increase the risk of suffering from bloating, which further burdens an already weakened bowel system. Some foods rich in saturated fats include cakes, biscuits, fatty cuts of meat, sausages, bacon, and cured meats.

Eat less salt
Salt contains sodium, which retains water in the body. Eating excess salt not only increases the risk of hypertension but also causes pain due to inflammation. Hence, it is recommended to cut down on salt or replace it with spices and herbs to enhance flavor.

It is important to discuss with a doctor before making any changes in daily nutrition like eating and avoiding foods that may aggravate some other underlying health conditions.

Treating NMOSD
While it is important to be aware of symptoms and foods, certain NMOSD treatment options can help provide better relief from the same. Following are some medications and other procedures that can be considered as NMOSD treatment options:

Plasma therapy
This is typically considered as the first line of treatment for NMOSD. The procedure involves removing some blood from the patient’s body and separating plasma mechanically. The blood is then mixed with some other replacement solution that is transfused back into the body. Plasma therapy can help manage pain in the muscles due to inflammation in the spinal cord.

Corticosteroids
This treatment option of NMOSD is a form of anti-inflammatory medicine that is used for managing inflammation in the spinal cord and the brain. This can suppress some symptoms such as pain in limbs and even provide relief from poor bowel movements.

Other medications
Immunosuppressants like Azathioprine, mycophenolate mofetil, and Rituximab are used alongside low doses of intravenous corticosteroids as NMOID treatment options. Medications such as Uplinza and Enspryng have also been approved by the FDA as another NMOSD treatment option in an adult with AQP4 antibody.