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A 28-year-old female presents with bilateral optic neuritis and transverse myelitis extending over 3 vertebral segments. MRI spine shows a long central cord lesion at C3-C6. Serum AQP4-IgG is positive. How does NMOSD differ from MS clinically, on MRI, and in CSF analysis? Does she need disease-modifying therapy, and which agents are now approved specifically for NMOSD (eculizumab, inebilizumab, satralizumab)?
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