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The document develops and validates evidence-based guideline statements to improve NMOSD care in Brazil. It combines the Delphi method with the GRADE framework to assess recommendations for treatment strategies across multiple clinical scenarios. The process evaluates general management and diagnosis, acute and preventive therapies, and special populations.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/2025-brazilian-guidelines-for-the-management-of-neuromyelitis-optica-spectrum-disorder-in-adults-and-children/435981/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/2025-brazilian-guidelines-for-the-management-of-neuromyelitis-optica-spectrum-disorder-in-adults-and-children/435981.png","ImageObject",300,407,{"name":92,"@type":93},"Emma Wilson","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What methods were used to develop the NMOSD management guidelines?","Question",{"text":113,"@type":114},"The guidelines combine the Delphi process with the GRADE approach to validate evidence-based statements for NMOSD treatment.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which clinical areas do the recommendations cover?",{"text":118,"@type":114},"They include general management and diagnosis, acute and preventive treatments, and therapeutic approaches in special groups such as pediatric patients and pregnant women.",{"name":120,"@type":111,"acceptedAnswer":121},"How was consensus achieved for the guideline statements?",{"text":122,"@type":114},"Consensus was reached through three voting rounds covering all proposed statements. After revisions, the final remaining statement was resubmitted and achieved consensus in the third round.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},435981,1790790175,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},3848291630094,"https://eur-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Article published online: 2025-11-10  \nBrazilian Academy of Neurology 1  \n2025 Brazilian guidelines for the management of neuromyelitis optica spectrum disorder in adults and children  \nSamira Luisa dos Apóstolos-Pereira 1 Alfredo Damasceno2 Ana Claudia Piccolo3  \nMaria Fernanda Mendes4 Maria Lúcia Brito5 Regina Alvarenga6 Bruna Klein da Costa7,8 Douglas Kazutochi Sato9,10 Doralina Guimarães Brum 11 Elisa Mello 12 Felipe von Glehn 13 Giordani Passos 14,15 Guilherme Diogo 16 Herval Soares Neto 17,18 Lis Campos 19,20 Manuela Fragomeni21 Milena de Sales Pitombeira22 Rafael Paterno23 Raquel Vassão24 Renata Barbosa Paolilo25 Tarso Adoni 1 Thiago Fukuda26 Vanessa Daccach27  \nJefferson Becker7 Claudia Cristina Ferreira Vasconcelos6  \n1 Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Serviço de Neurologia, São Paulo SP, Brazil.  \n2 Universidade Estadual de Campinas, Campinas SP, Brazil.  \n3 Universidade Municipal de São Caetano do Sul, São Paulo SP, Brazil.  \n4 Santa Casa de São Paulo, Faculdade de Ciências Médicas, Disciplina de Neurologia, São Paulo SP, Brazil.  \n5 Hospital da Restauração, Recife PE, Brazil.  \n6 Universidade Federal do Estado do Rio de Janeiro, Pós-Graduação Stricto Sensu em Neurologia, Rio de Janeiro RJ, Brazil.  \n7 Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre RS, Brazil.  \n8 Santa Casa de Porto Alegre, Hospital da Criança Santo Antônio, Porto Alegre RS, Brazil.  \n9 Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brazil.  \n10 Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil.  \n11 Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu SP, Brazil.  \n12 Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo SP, Brazil.  \n13 Universidade de Brasília, Brasília DF, Brazil.  \n14 Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto Alegre RS, Brazil.  \n15 Hospital Mãe de Deus, Porto Alegre RS, Brazil.  \nArq. Neuro-Psiquiatr. 2025;83(11):s00451812471 .  \nAddress for correspondence Samira Luisa dos Apóstolos Pereira (email: [samira.apostolos@hc.fm. usp.br](samira.apostolos@hc.fm. usp.br))  \n16 Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo SP, Brazil.  \n17 Hospital do Servidor Público Estadual de São Paulo, São Paulo SP, Brazil.  \n18 Hospital Israelita Albert Einstein, São Paulo SP, Brazil.  \n19 Universidade Federal de Sergipe, Aracajú SE, Brazil.  \n20 Universidade Tiradentes, Aracajú SE, Brazil.  \n21 Hospital da Criança de Brasília, Brasília DF, Brazil.  \n22 Hospital Geral de Fortaleza, Divisão de Neurologia, Fortaleza CE, Brazil.  \n23 Irmandade da Santa Casa de São Paulo, Serviço de Neurologia, São Paulo SP, Brazil.  \n24 Santa Casa de Belo Horizonte, Clínica Neurológica, Belo Horizonte MG, Brazil.  \n25 Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, São Paulo SP, Brazil.  \n26 Universidade Federal da Bahia, Hospital Universitário Professor Edgar Santos, Salvador BA, Brazil.  \n27 Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Ribeirão Preto SP, Brazil.  \nAbstract Background Neuromyelitis optica spectrum disorder (NMOSD) is a debilitating  \nrecurrent inflammatory disease of the central nervous system. Establishing management guidelines is essential to optimize patient care in Brazil.  \nObjective To combine the Delphi and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approaches to validate evidence-based guideline statements for NMOSD treatment.  \nreceived July 1, 2025  \nreceived in its final form September 16, 2025 accepted  \nSeptember 19, 2025  \nDOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1812471 . ISSN 0004-282X.  \nEditor-in-Chief: Ayrton Roberto Massaro.  \nAssociate Editor: Lívia Almeida Dutra.  \n© 2025 . The Author(s) .  \nThis is ","cbCaisqcLQRK5a0K","https://ap.wps.com/l/cbCaisqcLQRK5a0K","pdf",4890545,21,"English","# Abstract\n## Background\n## Objective\n## Methods\n## Results\n## Conclusion","[{\"question\":\"What methods were used to develop the NMOSD management guidelines?\",\"answer\":\"The guidelines combine the Delphi process with the GRADE approach to validate evidence-based statements for NMOSD treatment.\"},{\"question\":\"Which clinical areas do the recommendations cover?\",\"answer\":\"They include general management and diagnosis, acute and preventive treatments, and therapeutic approaches in special groups such as pediatric patients and pregnant women.\"},{\"question\":\"How was consensus achieved for the guideline statements?\",\"answer\":\"Consensus was reached through three voting rounds covering all proposed statements. After revisions, the final remaining statement was resubmitted and achieved consensus in the third round.\"}]","2025 Brazilian guidelines for the management of neuromyelitis optica spectrum disorder in adults and children | PDF",1790676251,53]