Prognosis of Devic’s Disease

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Just like multiple sclerosis, Devic’s disease eventually leads to worsening of the symptoms which can include permanent loss of sight and paralysis in at least one leg. The prognosis of the condition, however, is very different in people with the so-called monophasic Devic’s disease who have only one or two attacks and people who experience relapses. But most people have the latter form of the disorder which is unfortunately, fatal for many patients.

The majority of patients with monophasic Devic’s disease recover completely without any lasting consequences. Unfortunately, the attacks in monophasic Devic’s disease are usually more severe than in the relapsing form of the conditions and can lead to permanent vision disturbances, while the majority of patients also have at least some degree of weakness in at least one limb. Many also experience occasional urinary incontinence. About one fifth, however, loses sight permanently, while about 30 percent of people with monophasic Devic’s disease develop paralysis in one or both legs. Physical therapy and other rehabilitation therapies help the patients regain independence to at least certain degree. The five-year survival rate of people with monophasic Devic’s disease is about 90 percent.

Patients with relapsing form of the disorder usually experience less severe attacks, however, further damage which is caused to myelin during subsequent attacks eliminates any advantages in the long term. The frequency of relapses varies greatly from one patient to another as the remission period can last from several months to several years. However, the statistics show that more than 50 percent of people with relapsing Devic’s disease will experience another attack within one year, while about 90 percent of patients will have at least one subsequent attack within five years.

The relapsing form of the disorder is characterized by gradual worsening of symptoms. As already mentioned earlier, every attack causes further damage to myelin in spinal cord or/and optical nerve and within a period of five years, at least 50 percent of patients develop paralysis or/and lose their sight. In addition to visual and physical disability, the relapses also increase the risk of respiratory failure which can be fatal. In the mid-20th century, respiratory failure was the most common cause of death in Devic’s disease patients, while the five-year survival rate was below 70 percent.

The severity of Devic’s disease complications and death rate declined dramatically by the end of the 20th century due to improvements in treatments which, however, do not offer a cure. Corticosteroid medications and immunosuppressant therapy which are used to prevent relapses, unfortunately, only reduce their severity and frequency but do not prevent the attacks. As a result, most Devic’s disease patients with the relapsing form of condition will eventually lose sight or/and physical mobility. Many eventually also develop breathing problems and need artificial ventilation. Some experts suggest that people with relapsing form of Devic’s disease may benefit from long term corticosteroid or immunosuppressive therapy, however, the others disagree claiming that they may have the opposite effect. In addition, both therapies can cause serious side effects.