Does NMO Qualify for Disability?

Neuromyelitis optica (NMO) or Devic disease is an autoimmune disease of the central nervous system. NMO primarily affects the myelin sheath (a layer of cells that insulates the nerves and supporting cells in the nervous system). Therefore, the disease targets the spinal cord, optic nerves, and brainstem. The damage to the optic nerves causes swelling and inflammation that cause pain and loss of vision. However, damage to the spinal cord causes weakness or paralysis in the legs or arms, loss of sensation, and problems with bladder and bowel function. Moreover, damage to the brainstem can lead to prolonged hiccups, nausea, vomiting, vertigo, or respiratory failure.

NMO is a relapsing-remitting disease. During a relapse, the new damage to optic nerves and/or spinal cord can cause additional disability.

Unlike multiple sclerosis, NMO isn’t a progressive disease. Hence, preventing relapse is crucial to prevent further disabilities.

There are two types of NMO:

1. Relapsing form: It is the most common type of NMO and mainly affects women over men. It has periodic flare-ups with some respite in between.
2. Monophasic form: It involves a single attack that lasts for 1-2 months. Both men and women are equally affected by this form.

The most prevalent symptoms in a patient with NMO are:

• Blurred vision
• Lack of color vision and complete blindness
• Weakness or numbness in the arms and legs
• Paralysis of the arms and legs
• Difficulty controlling the bladder or bowels
• Uncontrollable vomiting and hiccups

Due to the above symptoms, the patients must undergo severe physical and emotional distress. Other impacts include:

• Frustration at having to concentrate and plan everything in advance
• Physical and emotional dependence on others
• Degrading self-confidence
• Need to develop other senses, such as hearing, memory, touch, and vibrations
• Negative effect on their daily activities, mood, ability to walk, enjoyment of life, and relationships
• Restrictions on employment or education
• Bladder problems cause embarrassment, humiliation, decreased self-confidence, and reduction in social activities

Living becomes difficult with NMO because the disability worsens over time. Some of the complications of NMO include:

• Visual impairment or blindness
• Paralysis or weakness of one or more limb
• Stiffness or muscle spasms
• Loss of bowel or bladder control
• Depression
• Fatigue

Some people may require ventilators for breathing purposes. People with NMO should seek support from friends, family, and support groups to deal with the trauma. A person with major disabilities may also require support from neurologists (who specialize in NMO), occupational therapists, physical therapists, and social services professionals.