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CONy 2021 | Is AQP4-IgG NMOSD an exclusively relapsing disease?

Nikolaos Grigoriadis, MD, PhD, Aristotle University of Thessaloniki, Thessaloniki, Greece, discusses whether aquaporin 4 IgG-associated (AQP4-IgG) neuromyelitis optica spectrum disorders (NMOSD) is an exclusively relapsing disease. Dr Grigoriadis first describes a recent and unusual case of a patient with AQP4-IgG NMOSD that might follow a primary progressive course. Nevertheless, for the time being, there is clear evidence that AQP4-IgG NMOSD is a relapsing disorder where patients experience relapses and remission. However, it might be the case that relapses occur quickly after the other giving the impression that there is an ongoing progression. Although there is no consensus on this question, this debate unfolds a novel and interesting opportunity to discuss how progression is defined. Future research should identify the mechanism through which the underlying pathology makes NMOSD a relapsing disorder, whereas, in multiple sclerosis, progressive disease can also be present. This interview was conducted during the virtual 2021 World Congress on Controversies in Neurology (CONy) meeting.