NMOSD can affect children as young as 3 years and adults as old as 90 years. While MS is more prevalent among Caucasians, NMOSD disproportionately affects those of African descent. It is more common in women, particularly the relapsing form of NMOSD. 70% of NMOSD patients have relapses after their initial symptoms. The onset of NMOSD varies from childhood to adulthood, and the average age of onset is about 40 (about 10 years later than that of MS). In a more recent study published by Mealy et al.,1 of the cohort of 187 patients from three academic centers in the United States, there were 14 patients with onset as a minor, with only 5-8 being pre-menses in their development. Children with NMOSD are more likely to be NMO IgG seronegative.