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We thank Papp et al.1 for calling attention to neuromyelitis optica spectrum disorder (NMOSD) epidemiology. They reported lower NMOSD prevalence than previous studies.2,3 They explained the higher Olmsted County (United States) prevalence by statistical random chance,1 but failed to mention its almost 100% population coverage and the seroprevalence design (testing aquaporin-4 [AQP4]-IgG in >80% with CNS demyelinating disease), which markedly improved capture compared with their much larger population of 4.5 million.
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Author disclosures are available upon request (journal{at}neurology.org).
- © 2019 American Academy of Neurology
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