Neuromyelitis optica spectrum disorder (NMOSD) is an immune system demyelinating turmoil of the central nervous system (CNS) brought about by the authoritative of aquaporin‐4 (AQP4)‐immunoglobulin (IgG) to water channel protein at astrocyte foot measure. Normal indications of NMOSD incorporate cross over myelitis, optic neuritis, region postrema disorder, and brainstem condition. To lead efficient survey and meta‐analysis for the viability of therapeutic plasma exchange (TPE) for neuromyelitis optica range problem (NMOSD) with an intense assault. Deliberate audit was performed utilizing EMBASE and OVID/Medline information base. The qualified examinations must be the investigations of NMOSD patients treated with TPE during the intense stage. They should report treatment results utilizing either Expanded Disability Status Scale (EDSS) or visual acuity (VA) when the treatment. Pooled mean contrast (MD) was then determined by consolidating MDs of each examination utilizing the random‐effects model. The meta‐analysis exhibited an altogether diminished in EDSS after TPE treatment for NMOSD with an intense assault with the pooled MD of 0.83 (95% CI, 0.26–1.40; I2 69%) contrasting pretreatment with quick posttreatment and 2.13 (95% CI, 1.55–2.70; I2 31%) contrasting pretreatment with posttreatment at a half year to 1‐year follow‐up. Therefore, early forceful treatment after the underlying assaults is commonly viewed as a significant measure that could intensely impact the long‐term visualization of patients with NMOSD.

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