NMO: Relapse Warning Signs and Care Planning

Living with a diagnosis of neuromyelitis optica means having two different kinds of plans: one for an unexpected change, and another for ordinary life between appointments. This guide is for people already diagnosed with NMO or neuromyelitis optica spectrum disorder, and the people who support them. It focuses on what to report, what to ask, and how to make care workable. It is not a test for diagnosing a relapse, a medication schedule, or a substitute for your specialist’s instructions. Keep your own emergency plan ahead of any general information here. If something serious is happening now, use urgent medical services rather than reading to the end.

Understand the purpose of your NMO care plan

NMO is an autoimmune disorder in which immune activity can injure the optic nerves and spinal cord. Many affected people have antibodies against aquaporin-4, often shortened to AQP4. Attacks can leave lasting difficulties, although the symptoms and recovery differ from one person to another. Medicines used to reduce future attacks have a different purpose from rehabilitation or treatments for existing pain, stiffness, or bladder problems. Understanding that distinction makes follow-up conversations easier: a treatment can be helping to prevent attacks even if an old symptom has not disappeared. Conversely, improvement in walking or pain does not by itself establish that preventive treatment is no longer needed. Your specialist can explain which parts of your current plan address inflammation, which address symptoms, and which support independence. Ask for those purposes to be written beside the names of your treatments so that you and your caregiver do not have to infer them from a prescription list. [1]

The symptoms worth recording include changes in eyesight or colour perception, pain around the eye, new weakness or numbness, muscle spasms, and changes in bladder or bowel function. Persistent vomiting or hiccups can also be part of NMO. Symptoms may develop over hours or days, and relapses can occur after a short or long period of stability. A previous quiet year is therefore not a reason to dismiss a new change. Describe what is different from your own usual function rather than comparing yourself with another patient. For example, “I normally read my phone with large text, but since this morning I cannot read it” gives the team more useful information than “my eyesight is bad.” A caregiver may notice a change in transfers, balance, or everyday tasks, but the person experiencing the symptoms should be included directly in the conversation wherever possible. [2]

Recognise a change without trying to diagnose it yourself

A suspected attack needs prompt clinical assessment. Other problems, including infection, fever, injury, pain, or medication effects, can worsen existing neurological symptoms and resemble an attack. Clinicians may call this a pseudo-attack, but that label is not something to assign at home. Having a temperature does not prove that a new neurological symptom is harmless, and feeling better briefly does not establish the cause. Specialist recommendations emphasise early attack treatment and, when needed, early escalation to treatments such as plasma exchange. Do not wait for symptoms to last a full day before asking for help. Research definitions that describe symptom duration are not instructions for delaying care. Tell the assessing team about both the neurological change and any possible infection, and follow their directions about where and how quickly to be examined. [3]

Changes in vision

Suddenly being unable to see from one or both eyes, or sudden severe eye pain, is an emergency. Less dramatic new visual changes still deserve urgent advice, particularly when you have an established neurological condition. Do not assume that every eye problem is optic neuritis: there are other causes of sight loss that also need timely assessment. Explain whether the problem started suddenly or developed gradually, whether one or both eyes seem affected, and whether there is pain. Avoid driving yourself when vision is affected. Arrange safe transport or call emergency services as appropriate. If you use glasses, a magnifier, or another aid, take it with you if doing so does not delay leaving. The practical aim is to help the clinician understand your usual sight and the new change, not to perform a series of home tests until you feel certain about the diagnosis. [4]

Breathing, swallowing, and bladder emergencies

Severe difficulty breathing, gasping, choking, being unable to speak normally because of breathlessness, sudden confusion, or a pale, blue, or grey change in skin or lips requires emergency help. Do not assume breathlessness is anxiety, fatigue, or an expected part of NMO. The immediate priority is assessment of breathing and circulation, not identifying the neurological explanation yourself. Use the emergency number for your location and clearly state the symptoms, your location, and that the person has NMO and receives any immune treatment. Do not drive yourself to emergency care. If another person is present, they can gather the medication list while you remain with the affected person. A specialist telephone line is useful for many questions, but it is not a replacement for an emergency response to severe breathing problems. [5]

Being unable to pass urine, especially with significant lower abdominal pain or swelling, needs medical attention straight away. Urinary retention can be dangerous and may occur for several reasons. Less obvious changes, such as repeatedly passing small amounts, a weak stream, difficulty starting, or unexpected leakage, also deserve discussion with a clinician. Leakage does not necessarily mean the bladder is emptying properly. In your care notes, distinguish a long-standing problem from a new change and record any existing catheter or bladder-management plan. Do not try to solve sudden retention by forcing yourself to drink large amounts or by changing bladder medicines independently. Tell the team about new back pain, weakness, numbness, fever, and medicines taken recently, because these details help them decide which assessments are needed. [6]

Swallowing problems should not be treated as a minor inconvenience. Coughing or choking during meals, a wet-sounding voice after drinking, food feeling stuck, or breathlessness after swallowing warrants urgent advice. If someone is actively choking or struggling to breathe, seek emergency help. A speech and language therapist can assess swallowing, and a dietitian may help protect nutrition and hydration. Food textures, drink thickness, positioning, and equipment should be chosen for the individual rather than copied from another person’s plan. Mention any difficulty swallowing saliva as well as food or liquids. Keep the current swallowing instructions where anyone helping with meals can find them. If symptoms change, ask for reassessment rather than assuming an old plan still fits. These precautions concern safe eating and drinking; they do not determine whether a neurological relapse is occurring. [7]

Make the first call easier

Prepare a short description that can be given without searching through months of messages. Start with the new symptom, the time it began, and what you can no longer do compared with your usual baseline. Then give the name of your neurological diagnosis, the specialist service, your current immune treatment, and any recent infection or medication change. If you are calling for someone else, say whether they are with you and able to speak. Keep the description factual: “new difficulty standing since lunchtime” is more useful than deciding it is definitely a relapse. Ask what to do next, where to go, and what to do if symptoms worsen while waiting. Write down the advice and the name or service of the person giving it. This is a communication template, not a scoring system that decides whether care is needed.

Create a simple contact sheet before you need it. Include the specialist team’s daytime number, the out-of-hours route, the local emergency number, and a trusted person who can help with transport or communication. Check whether a messaging service is monitored continuously or only during office hours. A message marked “sent” does not mean that a clinician has read it. Agree a fallback route for an unanswered call, and keep the sheet in an accessible format such as large print or a phone note that can be read aloud. Avoid storing your only copy inside an account that a caregiver cannot open during an emergency. Share only the information that the patient wants the caregiver to have, and confirm consent arrangements with the clinical service rather than assuming family members automatically have access.

Use appointments to connect tests with decisions

For each proposed test, ask what question it is intended to answer and how the result could change care. Ask whether you need to prepare, when to expect the result, who will explain it, and which clinician will receive a copy. This matters when care is split between a neurologist, eye service, primary-care clinician, and infusion centre. A result appearing in a portal is not the same as a completed clinical explanation. If a report contains unfamiliar terminology, request a plain-language explanation rather than interpreting an isolated abnormal value yourself. Keep your own list of outstanding results and the agreed follow-up date. Before leaving, clarify which concerns can wait for the next appointment and which should trigger earlier contact. Questions about cost, transport, or access are legitimate parts of treatment planning, not distractions from the medical discussion. [8]

Know which preventive medicine is being discussed

The following examples describe United States NMOSD labeling checked on 22 October 2026. They are not a ranking, a complete treatment menu, or a recommendation to switch. Indications, age limits, access rules, and monitoring can differ by country and can change over time. Ask your clinician to use the current local product information for your exact medicine and diagnosis. A drug may be approved for children with a different disease without being approved for children with NMOSD. Likewise, an approval for antibody-positive NMOSD does not automatically apply to antibody-negative disease or to MOG antibody-associated disease. Bring the exact generic and brand names to appointments, especially when several specialists prescribe medicines. The purpose of the questions below is to help you understand an agreed prescription, not to decide eligibility from a website.

Eculizumab and ravulizumab

The US Soliris label describes eculizumab as a complement inhibitor and includes NMOSD treatment in adults who are AQP4-antibody positive. Its serious meningococcal infection warning is central to the care plan. The label requires clinicians to address vaccination and, in specified circumstances, antibacterial prophylaxis, with treatment supplied through a US safety programme. Ask where your safety information is kept and what symptoms should prompt immediate assessment. Infusion-related reactions are another issue to discuss with the infusion team. If you receive plasma exchange or another treatment during an admission, make sure the hospital knows you receive eculizumab, because treatment interactions may affect the prescribed plan. Do not independently alter infusion timing or assume a hospital team has received the latest medication list from a different institution. [9]

The US Ultomiris label includes ravulizumab for adults with AQP4-antibody-positive NMOSD. It also carries a serious meningococcal infection warning and requires a clinician-led vaccination and prophylaxis assessment. The fact that ravulizumab and eculizumab act on complement does not make their schedules interchangeable. A switch, missed appointment, or treatment given during an acute admission needs instructions from the prescribing team. Ask who will reorganise an infusion if transport fails or you become unwell, and which service should be contacted before travelling to the infusion centre. Keep the current plan rather than an old printed calendar after a change. Do not infer your NMOSD eligibility from pediatric indications elsewhere in the same label: those may concern other conditions. The relevant indication and the individual prescription need to be read together. [10]

Inebilizumab and satralizumab

The current US Uplizna label includes inebilizumab for adults with AQP4-antibody-positive NMOSD. Before starting, the label calls for hepatitis B screening, tuberculosis assessment, and measurement of immunoglobulins. Infection assessment and infusion-reaction precautions are also part of care. Ask what your baseline results mean, who will review subsequent blood tests, and how to report infections between appointments. An immunoglobulin measurement is not simply a box to tick: your team interprets it alongside your history and treatment. Tell them about recurrent or unusual infections, even if another clinician treated them. If a future infusion is approaching and you feel unwell, contact the service for instructions rather than arriving without warning or deciding on your own to skip it. Information for the medicine’s other approved conditions should not be substituted for its NMOSD instructions. [11]

The US Enspryng label includes satralizumab for adults with AQP4-antibody-positive NMOSD. It identifies screening for hepatitis B and tuberculosis, baseline liver testing, and ongoing checks including liver enzymes and neutrophils. Vaccination timing and possible infection also need discussion. Ask for a written monitoring calendar and a clear route for obtaining advice before a planned injection when you suspect an infection. If self-injection is part of your prescription, training should cover the actual device, safe handling, and what to do if a dose is missed or there is a problem with the product. This article does not provide a catch-up schedule. A caregiver who helps should receive the same practical training, with your agreement. Keep the manufacturer’s current patient instructions alongside the plan supplied by your team rather than relying on memory. [12]

Build infection precautions around the actual treatment

For people receiving complement inhibitors, meningococcal vaccination reduces risk but does not eliminate it. CDC guidance also notes that substantial risk can remain despite both vaccination and preventive antibiotics. That is why a safety plan needs symptom recognition and immediate access to assessment as well as vaccine records. Ask which vaccines and boosters apply to you, who will arrange them, and whether prophylaxis is indicated. The answers depend on the medicine, prior vaccinations, timing, current recommendations, and clinical circumstances. There is no single schedule in this article for every person with NMO. Do not delay or stop prescribed neurological treatment on your own while trying to complete a vaccine list. Instead, make sure the specialist and vaccination provider coordinate the plan and that both know the exact treatment you receive. [13]

Meningococcal illness can begin with symptoms resembling a flu-like infection and worsen rapidly. Fever, headache, a stiff neck, confusion, sensitivity to light, and vomiting are possible features; bloodstream infection can cause chills, severe aches, rapid breathing, and cold hands or feet. A dark rash may occur later, so waiting for a rash is unsafe. If these symptoms occur, seek immediate medical attention and state prominently if you take a complement inhibitor. Do not dismiss the symptoms because vaccination is up to date. Keep the medicine’s safety card or equivalent information available, but do not delay seeking help while looking for it. A caregiver can help by communicating the medicine name to emergency staff. The objective is rapid assessment, not a home diagnosis of meningitis or a decision that an illness is “only a virus.” [14]

Keep medicine changes and practical barriers visible

Steroids may be part of an attack-treatment plan or another prescribed regimen, but stopping instructions depend on the course and the person. Some people need a gradual reduction, and stopping suddenly can be harmful. Ask for an unambiguous written plan if your dose changes over time, including what to do if vomiting or another problem prevents you taking it. Do not restart leftover steroids for a suspected relapse or copy a previous course. Long-term steroid use can affect bones, blood sugar, blood pressure, mood, infection risk, and eye health; the relevant monitoring should be individualised. Tell the team about troublesome sleep or mood changes rather than quietly abandoning treatment. If several clinicians are involved, ensure each can see the current regimen and which clinician is responsible for reviewing it. [15]

Missed treatment is not always a matter of forgetting. Painful injections, unreadable labels, cost, fear of side effects, transport problems, work commitments, or uncertainty about the purpose of a medicine can all get in the way. Tell your team which barrier is actually happening. NICE guidance on medicines adherence emphasises discussing concerns and practical difficulties without blame. A reminder alarm may help with forgetting but cannot fix an unaffordable prescription or a device you cannot use safely. Ask whether an accessible label, training session, pharmacy review, transport arrangement, or different practical support is possible. If you have already missed treatment, report what happened and ask for specific instructions. Do not double a dose or invent a catch-up schedule. An honest account gives the clinician a safer basis for advice than a medication list that appears perfect but does not reflect daily life. [16]

Rehabilitation should solve the tasks that matter to you

Make vision support specific

If vision loss makes ordinary tasks difficult, ask about low-vision rehabilitation rather than waiting until every medical treatment has finished. Support may include magnification, improved lighting, higher-contrast displays, larger text, read-aloud technology, and training in using remaining vision. The best combination depends on the task and your particular visual difficulty. A phone setting that helps with reading messages may not solve problems navigating steps or identifying medicines. Take examples to the appointment: a bill you cannot read, a screen you struggle to use, or a description of an unsafe route at home. Ask for a demonstration and an opportunity to practise before choosing equipment. Rehabilitation does not imply that a new visual change can be ignored; sudden changes still need medical assessment. It helps make current daily activities more manageable while clinical care continues. [17]

Occupational therapy considers how illness affects personal care, household tasks, work, leisure, seating, and the home environment. For NMO care planning, choose a small number of concrete goals rather than a vague request to become more independent. Examples might be preparing breakfast while seated, using the shower safely, accessing a computer, or getting a child ready for school with less help. Describe the task from beginning to end, including where fatigue, pain, vision, or hand function causes difficulty. The therapist can assess the person and the environment together. A recommendation is more useful when it includes who will obtain equipment, whether someone will teach its use, and how the arrangement will be reviewed. Independence can mean choosing when to accept help, not necessarily completing every task without another person. [18]

Physiotherapy can support movement, strength, and function after illness or disability. Ask for advice that reflects your current abilities, symptoms, and home setting rather than adopting a demanding programme from social media. A useful plan explains the purpose of each activity, how to perform it safely, what support or equipment is needed, and when to stop and seek advice. Tell the therapist about falls, near-falls, changes in sensation, pain, and fatigue, even if you feel embarrassed about them. If getting to appointments is difficult, ask what local options exist, which may include remote advice or home-based services depending on eligibility. Progress should be assessed against meaningful goals such as a safer transfer or a manageable journey through the house. Exercise is not a substitute for assessment of new weakness or another suspected neurological change. [19]

Protect skin when mobility or sensation is limited

People who spend long periods in bed or a chair, or cannot reposition independently, may need a pressure-damage prevention plan. Ask a clinician to assess your individual risk and recommend suitable positioning, equipment, and skin checks. A universal turning timetable is not appropriate for everyone. Areas of persistent colour change, warmth, pain, blistering, or skin breakdown should be reported promptly. Changes can look different on darker skin, so colour alone is not the only observation. If you need help checking an area, agree who will assist and protect privacy. Cushions and mattresses should be selected for the person rather than assumed effective because they are advertised as supportive. Include skin care in discharge planning, especially if mobility has changed, and ask how replacement equipment or an urgent review will be arranged. [20]

Manage fatigue without dismissing new symptoms

Pacing is a way to use available energy more deliberately, not a promise that fatigue will disappear. A neurological rehabilitation team can help you look at the pattern of activity and rest across a day. Break a demanding task into stages, plan recovery time, and distinguish what is essential from what can be shared or postponed. For example, preparing ingredients while seated may make cooking more manageable than doing the whole meal in one uninterrupted effort. Keep room for something enjoyable rather than spending every available bit of energy on chores. A short activity diary can show whether appointments, travel, concentration, or physical work are particularly draining. Use it as a discussion aid, not a test you must pass. The plan should fit your actual circumstances and be adjusted with professional guidance if it is not working. [21]

Persistent tiredness can have more than one cause. Sleep problems, mood difficulties, other illnesses, and medicines can contribute, so it should not automatically be attributed to NMO. Tell a clinician when fatigue changes, interferes with daily life, or comes with other symptoms such as weight loss or disturbed breathing during sleep. Describe the practical effect: falling asleep during conversations is different from muscles tiring during an activity. A clinician may consider tests or a medication review according to your symptoms. Keep new weakness, visual symptoms, or other neurological changes separate in your account rather than hiding them under the single word “fatigue.” General sleep routines may help some people, but they do not replace assessment of an unexplained change. Care planning works better when the problem is described precisely enough for the appropriate service to help. [22]

Give pain, bowel care, and medication access their own plans

Nerve pain may need a different treatment approach from an ordinary headache or muscle ache. Medicines used for nerve pain are sometimes also used for depression or epilepsy; receiving one does not necessarily mean you have either condition. Ask what symptom the medicine is intended to help, how benefit will be reviewed, and which side effects should be reported. Drowsiness, dizziness, or blurred vision can affect driving and other tasks requiring alertness. Tell the prescriber if pain relief comes at the cost of being too sleepy to function. Do not adjust the medicine independently. A useful record includes where the pain is, what it feels like, how long it lasts, and what it prevents you doing. This information helps distinguish an ineffective treatment from one that helps partially but still needs review. [23]

A bowel plan should be discussed openly, especially if constipation or accidents are limiting your activities. General constipation care may involve appropriate food and fluid intake, activity within your abilities, toilet routines, and prescribed or recommended medicines. Neurological bowel problems may need a more individual plan, so do not assume that simply adding fibre will solve everything. Tell the clinician what you currently take, including non-prescription products, and whether a medicine change preceded the problem. Ask which symptoms should trigger urgent advice and who will review an unsuccessful plan. Practical access matters too: safe transfers, enough time, privacy, and help when needed should be considered alongside treatment. Avoid repeatedly adding laxatives or stopping other medicines without advice. The aim is a reliable routine that protects comfort and participation, not embarrassment-driven trial and error. [24]

If tablets are difficult to swallow, ask a pharmacist or prescriber about the exact product. Do not crush pills, open capsules, or change the formulation without advice, because this can affect how the medicine works. Difficulty with food or drinks as well as tablets needs swallowing assessment; ordinary pill-swallowing tricks may be unsafe in that situation. Explain whether the barrier is swallowing, poor vision, weak hands, packaging, or confusion about the schedule. These require different solutions. A liquid is not automatically interchangeable with a tablet, and a caregiver should not estimate an equivalent amount. Ask for clear instructions and an accessible label if a change is prescribed. Keep the medication list updated when a formulation changes so that future appointments and hospital admissions reflect what is actually being used. [25]

Include emotional health and caregiver capacity

Living with a long-term disease can affect mood, confidence, relationships, and the ability to make plans. Depression is treatable and is not something you must accept as an unavoidable part of having a physical condition. Persistent low mood, loss of interest, difficulty concentrating, or changes in sleep and appetite deserve a conversation with a healthcare professional. Explain how you are functioning rather than feeling you must use a particular diagnostic word. Treatment may include talking therapy, medication, or a combination, chosen with consideration of your existing care. Make sure the mental-health clinician knows your medicines and neurological treatment. Support for emotional health should sit alongside physical care, not replace investigation of new physical symptoms. You can ask for help even if you are still working, caring for others, or appearing outwardly well. [26]

Caregivers need a workable plan of their own. Helping with washing, transport, medicines, appointments, or emotional support can affect sleep, employment, and relationships. Discuss which tasks are manageable and which require training or additional help. In England, an adult providing unpaid care can ask the local council for a carer’s assessment; this is separate from the needs assessment of the person receiving care. Other countries have different routes, so ask the local health or social-care team what support exists. Useful outcomes may include safer handling advice, respite, help with practical tasks, or information about available services. Do not wait until a caregiver is exhausted before identifying a backup. The person with NMO should still be involved in decisions about who helps, what information is shared, and which routines they want to preserve. [27]

Plan pregnancy and travel with the right specialists

Pregnancy planning should involve the NMO team early. Specialist recommendations advise planning during a stable phase and discussing the risks of both disease activity and treatment changes, including the period after birth. Do not discontinue immunotherapy independently because you want to become pregnant. [3]

A medication review before pregnancy should include prescriptions, non-prescription products, supplements, and medicines used only occasionally. Decisions about continuing, changing, or stopping treatment should be made with the clinicians responsible for your care. Pregnancy safety cannot be inferred from whether a medicine is “natural,” familiar, or available without a prescription. If pregnancy is unexpected, contact the relevant clinicians promptly rather than making abrupt changes yourself. Ask for a coordinated plan covering neurological follow-up, maternity care, and medicine questions so that advice from different services is reconciled. Breastfeeding intentions should also be raised early, since the answer depends on the particular treatment and circumstances. Keep a written record of agreed changes and who is responsible for them. This is especially useful when appointments occur in different hospitals or when care transfers between teams. [28]

Before international travel, discuss your itinerary with a clinician who understands your treatment and with a travel-health service when appropriate. CDC advises people with weakened immune systems to seek preparation well before departure, ideally at least four to six weeks. Vaccines may be less effective during some treatments, and live vaccines may be unsuitable depending on the degree and type of immune suppression. Bring your vaccination record and the exact medication list rather than asking for a standard travel package. Discuss food and water precautions, infection prevention, and what to do if you become ill away from home. Take enough prescribed medicine for the trip and foreseeable delays, following the product’s storage instructions. If you develop illness after returning, tell the clinician where you travelled rather than assuming it is unrelated. [29]

The destination’s ability to provide appropriate care matters as much as the journey. Identify a suitable hospital, understand insurance coverage for existing conditions, and check whether emergency treatment or medical evacuation is covered. A remote itinerary may need reconsideration if urgent specialist care would be difficult to obtain. CDC travel guidance stresses that recommendations for immunocompromised travellers should be tailored, because different treatments produce different risks. Keep essential medicines in carry-on luggage where permitted and avoid depending on an unfamiliar supply abroad. If a medicine needs special storage, obtain a realistic transport plan rather than improvising on the day. Share the itinerary with your care team when it could affect treatment attendance. Travel planning is not a reason to change an infusion or injection interval without the prescriber’s agreement. [30]

Turn the next review into a usable plan

Shared decisions work best when the clinical evidence and your priorities are both visible. Tell the team what matters most now: preventing further sight loss, managing transport to treatment, returning to a particular activity, planning a family, or reducing the burden of appointments. Ask about the expected benefits, harms, uncertainties, and practical implications of the options actually available to you. You can request accessible information, an interpreter, or involvement of a chosen support person. There is no requirement to absorb every detail in one conversation. Ask to hear the explanation again or to receive a written summary. Before leaving, repeat the plan in your own words so that misunderstandings can be corrected. A clear decision includes the follow-up arrangements and what would prompt reconsideration, not just the name of a medicine. [31]

Keep one current care summary rather than a collection of conflicting lists. Useful headings are diagnosis and antibody information supplied by the specialist, medicines and their purposes, allergies, important previous treatment reactions, current daily support needs, and upcoming appointments. Add a short list of changes since the last visit and the questions you want answered first. Include non-prescription medicines and supplements in the medication section. Date the summary and update it after a confirmed change; do not quietly replace clinical instructions with your own interpretation. A paper copy, accessible digital version, or both can help different services work from the same information. The summary is yours to use as a communication aid, not a substitute for medical records. Ask the team to correct anything that is unclear or inaccurate. [32]

For example, a useful review goal might be: “I want to get from the bedroom to the bathroom safely at night, and I need to know who to contact if my leg strength changes.” That single statement separates an everyday rehabilitation need from a possible urgent change. Another might be: “I understand why I receive treatment, but transport is making appointments unreliable.” It invites a practical solution without concealing missed care. Choose the questions that match your life rather than trying to complete every topic in this guide at once. Start with safety, the current treatment plan, and the difficulty that is limiting you most. Then agree the next step, the person responsible, and how you will know whether it has happened.

For background terminology, see our general overview of neuromyelitis optica. Our guide to transverse myelitis and spinal cord symptoms provides related reading. These articles do not replace your individual assessment or the official clinical sources below. The most useful care plan is one that you can find, understand, and act on when circumstances change, while leaving diagnosis and treatment decisions with the appropriate clinical team.

Sources

1. NINDS: Neuromyelitis optica spectrum disorder
2. NHS: Neuromyelitis optica
3. NEMOS: Attack therapy and long-term management recommendations
4. NHS: Vision loss and urgent symptoms
5. NHS: Shortness of breath
6. NIDDK: Symptoms and causes of urinary retention
7. NHS: Swallowing problems
8. NIA: Questions to ask during a checkup
9. DailyMed: Current US Soliris prescribing information
10. DailyMed: Current US Ultomiris prescribing information
11. DailyMed: Current US Uplizna prescribing information
12. DailyMed: Current US Enspryng prescribing information
13. CDC: Complement inhibitors and meningococcal disease risk
14. CDC: Meningococcal disease symptoms
15. NHS: Steroids and stopping safely
16. NICE: Medicines adherence recommendations
17. National Eye Institute: Low vision
18. Oxford University Hospitals: Neurological occupational therapy
19. NHS: Physiotherapy
20. CNTW NHS: Pressure ulcer prevention information
21. Torbay and South Devon NHS: Pacing with a neurological condition
22. NHS: Tiredness and fatigue
23. NHS: Nerve pain treatment
24. NIDDK: Constipation treatment
25. NHS: Problems swallowing pills
26. NIMH: Chronic disease and depression
27. NHS: Carer assessments
28. Ashford and St Peters NHS: Medicines in pregnancy
29. CDC: Travel with a weakened immune system
30. CDC Yellow Book: Immunocompromised travelers
31. NICE: Shared decision making recommendations
32. NIA: Talking with your doctor worksheets