A cross sectional study was conducted to assess patients with NMOSD. The data was obtained from the newly established NMO database using the 2015 international consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Demographics, clinical and radiological characteristics, and serological markers including serum anti-Aquaporin-4 IgG were extracted. 

As of September 2018, 32 patients were identified with NMOSD; of which 26 (81.3%) were women. The mean age and mean age of onset of the cohort were 35.6 ±11.9 and 28.9 ±9.8 years respectively. The mean disease duration was 6.9 ±6.6 years. 56.3% were seropositive to anti-aquaporin-4 IgG. Most of the patient (50%) presented initially with optic neuritis, followed by myelitis (37.5%) while 6.3% and 3.1% presented with brainstem and area postrema syndromes, respectively. Longitudinally extensive transverse myelitis was present in 78.1% while oligoclonal bands in CSF was positive in 31.3% of patients. Plasamphoresis was administered to 23 (71.9%) patients due to poor response to systemic corticosteroids. The mean EDSS score was 3.7 ±2.2 at last follow-up visit. The most commonly used disease modifying therapies were Rituximab (59%), followed by Azathioprine (30.8%) and mycophenolate mofetil (10.3%). 

This is the first report of patients with NMOSD in Kuwait. There was a strong female predominance.The clinical features in our cohort are similar to reported studies from Western countries , yet we have seen lower EDSS score , which could be the result of early use of Rituximab. Longer follow-up data is needed to assess natural history and prognosis.