Edit concept Question Editor Create issue ticket

Spinal Demyelination

Demyelinating Disease of the Spinal Cord


Presentation

  • The prospective cohort comprised patients presenting to the neuroimmunology clinic for MS or other DD of 5-year-duration or less.[mdsabstracts.org]
  • Cord expansion may or may not be present; it was found in 47% in published series.[radiologykey.com]
  • Each section has been re-ordered to better present information and the Second Edition brings in many new authors and topics, more diagrams, illustrations, and tables to solidify concepts, and contains 18 entirely new chapters.[books.google.de]
  • Reactive astrogliosis was found to be present ( Figure 2c ). Axons seemed preserved ( Figure 2c ). Necrosis and cavitation in the spinal cord, involving both grey and white matter, typical for neuromyelitis optica (NMO), were not present.[nature.com]
  • Further, considering the acute onset and atypical clinical presentation, it seemed inappropriate to make a diagnosis of spinal cord demyelination, at least of a typical type.[dovepress.com]
Severe Clinical Course
  • Compared with patients who had MS, patients who had DNMO had a poor prognosis, higher age at onset, and a more sever clinical course. DNMO was most like to affect female patients. Corticosteroids are not helpful in DNMO, and the prognosis is poor.[radiologykey.com]
Neglect
  • This is an essential but neglected issue in modeling clinical trauma, where lesions are typically extensive.[grantome.com]
  • As dementia progresses, language ability may begin to deteriorate and the individual may neglect to care for himself appropriately.[britannica.com]
Clonus
  • The most common SMDs were tonic spasms (28), new-onset RLS (23), paroxysmal focal dystonia (9), spinal myoclonus (9), subjective fasciculations (9), spontaneous clonus (8), pseudoathetosis (7), spinal tremor (6), and hyperkeplexia (3).[mdsabstracts.org]
  • This pattern is almost pathognomonic of cord compression because of cervical spondylosis at the C5-C6 interspace. 12 Ankle clonus and Babinski's sign (pathologic extension of the great toe elicited by stroking the foot) in the feet may also be revealed[aafp.org]
Myoclonic Jerking
  • Subacute necrotizing encephalopathy, also called Leigh disease, is a lethal disorder of infancy marked by psychomotor delay, myoclonic jerks, paralyses of eye movements, and respiratory disorders .[britannica.com]

Workup

  • Diagnostic workup: History and physical examination MRI brain and spinal cord MRI of the optic nerves Visual and Auditory evoked potentials Somatosensory evoked potentials Lumbar puncture for CSF analysis Treatment: Disease modifying therapy: These therapy[pnpspecialists.com]
  • Therefore, a broad workup including infectious, immunologic, and metabolic tests, as well as a systematic follow-up Magnetic Resonance Imaging (MRI) is needed to establish an accurate diagnosis [5] .[sickkids.ca]
  • This approach results in increased operator time but should be recommended in the initial workup of patients who are presenting for the first time with neurologic syndromes that suggest a demyelinating disease when sensitivity in detection of brain lesions[ajnr.org]
Herpes Simplex Virus Type 2
  • Register Spinal Cord and Optic Nerve Demyelination in Experimental Herpes Simplex Virus Type 2 Infection - 24 Hours access EUR 36.00 GBP 28.00 USD 45.00 Rental This article is also available for rental through DeepDyve.[academic.oup.com]
Gliosis
  • The spinal cord lesions showed obvious loss of myelinated nerve fibers and fibrillary gliosis with minimal inflammatory cell infiltration.[springerlink.com]
  • With time, gliosis develops, and plaques reach a burned-out stage consisting of demyelinated axons traversing glial scar tissue (inactive plaque). Remaining oligodendrocytes attempt to make new myelin.[neuropathology-web.org]
  • Its imaging manifestations are worse than its clinical ones, possibly because early gliosis does not damage normal tissue. Hormone treatment has a poor effect on gliomas.[nrronline.org]

Treatment

  • This book will be of interest to students, medical professionals, and others interested in understanding the pathology and treatment of spinal degenerative disease.[books.google.com]
  • The last MRI, performed after the plasmapheresis treatment, documented progression of the spinal demyelination process. However, the patient became febrile. Immunosuppressive treatment was interrupted for a while.[nature.com]
  • Treatment was then discontinued and the patient remains under follow-up.[dovepress.com]
  • Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.[practo.com]

Prognosis

  • Compared with patients who had MS, patients who had DNMO had a poor prognosis, higher age at onset, and a more sever clinical course. DNMO was most like to affect female patients. Corticosteroids are not helpful in DNMO, and the prognosis is poor.[radiologykey.com]
  • Lumbar puncture may be helpful in establishing the diagnosis, as oligoclonal bands are found in more than 80% of patients. 4 Prognosis is directly related to the MS subtype: primary progressive, progressive relapsing, relapsing remitting, and secondary[jaocr.org]
  • Prognosis 94% recover 20/40 or better at 5 years out in the ONTT. 20/200 or worse visual outcome occurred in 3% of patients at 5 years out in the ONTT.[eyewiki.aao.org]
  • Clinicopathologic findings and prognosis of chronic inflammatory demyelinating polyneuropathy. Neurology. 1999;52:498-503. Lewis RA. Multifocal motor neuropathy and Lewis Sumner syndrome: two distinct entities. Muscle Nerve. 1999;22:1738-39. Nevo Y.[rarediseases.org]

Etiology

  • It is of unknown etiology, but is more common in people of African and Asian origin [4] .[sickkids.ca]
  • However, transverse myelitis encompasses multiple diverse etiologies. Acute idiopathic transverse myelitis is a diagnosis of exclusion once viral and autoimmune causative factors are eliminated.[jaocr.org]
  • This brief guide will help the general ophthalmologist to understand: Optic neuritis is a clinical diagnosis, thus MRI of the orbit with gadolinium looking for optic nerve enhancement, blood testing for inflammatory or infectious etiologies, and lumbar[eyewiki.aao.org]
  • […] sensory level and bilateral signs and symptoms; (3) proof of inflammation within the spinal cord by MR imaging or CSF examination; (4) symptoms from onset to reach maximal deficit between few hours and 21 days; and (5) exclusion of extra-axial compressive etiology[radiologykey.com]
  • An infectious etiology has been suggested by the following evidence: The distribution of MS is very non-uniform. Temperate climates have a higher incidence than warm climates, but the disease is uncommon in Japan.[dartmouth.edu]

Epidemiology

  • Pathogenesis and epidemiology of multiple sclerosis. . Accessed June 9, 2017. See more Expert Answers .[mayoclinic.org]
  • (Epidemiology)", "What Causes MS" PubMed Health: "Myelin Sheath" UpToDate: "Clinical Course and Classification of Multiple Sclerosis.[onhealth.com]
  • Epidemiologic studies suggest that MS is often acquired in childhood or adolescence. Moving from a high-risk to a low-risk area after the age of 15 does not appear to reduce one's chances of developing MS.[dartmouth.edu]
Sex distribution
Age distribution

Pathophysiology

  • The study will also continue to provide basic information on the biophysical organization of myelinated axon, and on the more general phenomenon of demyelination pathophysiology in the mammalian nervous system.[grantome.com]
  • Some likely mechanisms for the pathophysiological damage are as follows.[dovepress.com]
  • This is important because it would suggest demyelination is a pathophysiological process of non-traumatic spinal cord injury and that targeting myelin for repair may lead to the recovery of function.[scienceinthecity.com]
  • Nobutoshi Kawamura, Ryo Yamasaki, Tomomi Yonekawa, Takuya Matsushita, Susumu Kusunoki, Shigemi Nagayama, Yasuo Fukuda, Hidenori Ogata, Dai Matsuse, Hiroyuki Murai, Jun-ichi Kira 雑誌名 Neurology 巻 : 81 ページ : 714-722 DOI 関連する報告書 査読あり [学会発表] Elucidation of pathophysiology[kaken.nii.ac.jp]
  • A review of the pathophysiology of cervical spondylotic myelopathy with insights for potential novel mechanisms drawn from traumatic spinal cord injury. Spine. 1998;23:2730–7. 3. Wilkinson M.[aafp.org]

Prevention

  • Research underway // Treatment can manage symptoms, but there isn’t much we can do yet to prevent demyelination from happening.[health.clevelandclinic.org]
  • James Sejvar of the US Centers for Disease Control and Prevention who was not involved in the study told The Washington Post .[the-scientist.com]
  • Caregivers may help move your limbs when you can’t to prevent clots. Later, you’ll get physical therapy to help you use your limbs again. HTLV-I Associated Myelopathy (HAM) This condition results from a virus called HTLV-1.[webmd.com]
  • Preceding infection can also disrupt the normal process of prevention of self-immunity by removing regulatory cells that would otherwise have prevented inappropriate autoimmune responses.[clinicaladvisor.com]
  • Treatment There is no cure for demyelinating diseases or to prevent their progression, but early treatment can help to minimize the effects of attacks, manage symptoms and modify disease course.[news-medical.net]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!