Devic's neuromyelitis optica (NMO) may have a monophasic or relapsing course. The prognosis is worse for a patient with the relapsing course.
Factors seen in patients who develop a relapsing course:
(1) age > 30 years at onset
(2) female gender
(3) less severe motor impairment associated with the myelitis
(4) longer interval between the first and second episode (> 6 months)
Factors associated with a poor prognosis (severe disability or death) in a patient with the relapsing course:
(1) residual disability after the initial episode
(2) longer interval between the first and second episode (> 6 months)
(3) frequent relapses during the first 2 years of the disease
(4) coexistence with an autoimmune disease
(5) severe involvement of the cervical spinal cord
