Devic's Disease
Diagnosis

An early diagnosis of Devic's disease is critical for the management of this condition and for quality of life.

Your child's doctor will start by conducting a thorough physical examination, asking about any symptoms your child is experiencing, including when they started and how they've eased or progressed over time. Your child's doctor will also record a full medical history, including information about your immediate and extended family's medical history.

In many ways, Devic's disease closely resembles multiple sclerosis (MS) and may be misdiagnosed in the early stages. There are some key differences between the two conditions that a neurologist can recognize. Generally, attacks of Devic's disease tend to be more frequent and severe than in MS. Also, Devic's disease affects only the optic nerves and spinal cord, while MS affects the brain as well.

Magnetic Resonance Imagining (MRI)

Your child will have a magnetic resonance imaging (MRI) of the brain to look for lesions or areas of damage that may indicate MS or other disorders. In most cases, children with Devic's disease will have a normal brain MRI, while those with MS will show evidence of damage or lesions. Your child will also have an MRI of the spinal cord. Children with Devic's disease will show significant inflammation of the spinal cord, whereas those with MS will have less severe inflammation. An MRI scan is a non-invasive procedure that uses powerful magnets and radio waves to construct clear, detailed pictures of brain and spinal cord tissues.

Other Tests

Your child may have a recently developed blood test that checks for NMO antibodies, which helps establish a definite diagnosis of Devic's disease.

Your child also will have a lumbar puncture or spinal tap to determine if there are abnormalities in the cerebrospinal fluid (CSF). The CSF is the fluid that bathes, cushions and protects the brain and spinal cord. It flows through the skull and spine in the subarachnoid space, which is the area inside the arachnoid membrane. Typically, in Devic's disease, CSF lacks the elevation of antibodies detected in children with MS.

An eye exam by an ophtalmologist who will look for optic nerve damage may also be recommended. In addition, an evoked potentials test, which records electrical activity in the brain when nerves are stimulated, may also be conducted.

A diagnosis of Devic's disease is based upon an evaluation of your child's symptoms, along with the results of the physical exam and tests.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Pediatric Brain Center

Multiple Sclerosis Center
1825 Fourth St., Fifth Floor, 5A
San Francisco, CA 94158
Phone: (415) 353-3939
Fax: (415) 353-3543
Appointment information