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Presenting an up-to-date review of the literature of PLEX in NMO.<jats:italic>Methods<\/jats:italic>. We summarize the rationale of PLEX in relation with the physiology of NMO, the main technical aspects, and the available studies.<jats:italic>Results<\/jats:italic>. PLEX in severe attacks from myelitis or optic neuritis are associated with a better outcome, depending on PLEX delay (\u201ctime is cord and eyes\u201d). NMO-IgG status has no influence. Finally, we build up an original concept linking the inner dynamic of the lesion, the timing of PLEX onset and the expected clinical results.<jats:italic>Conclusion<\/jats:italic>. PLEX is a safe and efficient add-on therapy in NMO, in synergy with steroids. Large therapeutic trials are required to definitely assess the procedure and define the time opportunity window.<\/jats:p>","DOI":"10.1155\/2012\/787630","type":"journal-article","created":{"date-parts":[[2012,2,12]],"date-time":"2012-02-12T21:01:28Z","timestamp":1329080488000},"page":"1-9","source":"Crossref","is-referenced-by-count":41,"title":["Plasma Exchange in Severe Attacks of Neuromyelitis Optica"],"prefix":"10.1155","volume":"2012","author":[{"given":"Mickael","family":"Bonnan","sequence":"first","affiliation":[{"name":"Service de Neurologie, Hopital F. 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