Neuromyelitis optica (Devic’s disease). The combination of a severe myelopathy with recurrent optic neuritis is highly suggestive of Devic’s disease. Myelitis is usually more severe than in multiple sclerosis and demyelinating lesions are usually confined to the optic nerves and spinal cord. Brain MRI is therefore likely to be normal, as in this patient. Spinal cord lesions are usually elongated, extending over three or more segments and cavitation may occur. While there may be a …