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Demyelinating diseases of the CNS can be classified according to their pathogenesis into five non-exclusing categories: demyelination due to inflammatory processes, viral demyelination, demyelination caused by acquired metabolic derangements, hypoxic–ischaemic forms of demyelination and demyelination caused by focal compression. [3]
Demyelinating diseases are traditionally classified into two types: demyelinating myelinoclastic diseases and demyelinating leukodystrophic diseases. In the first group, a healthy and normal myelin is destroyed by toxic substances, chemicals, or autoimmune reactions.
Individuals with chronic inflammatory demyelinating polyneuropathy have evidence of activation of T cells in the systemic immune compartment; however, antigen specificity is still largely unknown. [21] [22] It was proposed more than 20 years ago that autoantibodies play a
Inflammatory demyelinating diseases (IDDs), sometimes called Idiopathic (IIDDs) due to the unknown etiology of some of them, are a heterogenous group of demyelinating diseases - conditions that cause damage to myelin, the protective sheath of nerve fibers - that occur against the background of an acute or chronic inflammatory process.
Even within a fascicle, demyelination does not affect nerves uniformly. For example, in the early stages, demyelination can be seen at the edge of fascicles near the periphery of the nerve, and in later stages the demyelination is diffusely seen within the entirety of a fasicle. [5] [16] Damage to the myelin sheath of nerves is a nerve injury.
This demyelination slows down or completely blocks the conduction of action potentials through the axon of the nerve cell (neurapraxia). [12] The most common cause is acute inflammatory demyelinating polyneuropathy AIDP, the most common form of Guillain–Barré syndrome [ 13 ] (although other causes include chronic inflammatory demyelinating ...
Patients with hereditary motor and sensory neuropathies are diagnosed through a physical evaluation that looks for muscle atrophy, weakness, and sensory responses. [3] In addition to this, electromyography and motor nerve conduction tests can help clinicians decide what type of motor and sensory neuropathy it is and how severe the disease is.
Some clusters of activated microglia, axonal transection and myelin degeneration are present. [7] [8] [9] Leaks in the blood–brain barrier appear and immune cells infiltrate, causing demyelination. [10] and axon destruction. [11] Multiple sclerosis differs from other idiopathic inflammatory demyelinating diseases in its confluent subpial ...