1 / 17

Demyelinating Diseases

Demyelinating Diseases. Central nervous syetem : Multiple sclerosis(MS) Neuromyelitis optica(NMO) Peripheral nervous syetem : Acute inflammatory demyelinating polyneuropathy (AIDP).

sagira
Download Presentation

Demyelinating Diseases

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Demyelinating Diseases Central nervous syetem: Multiple sclerosis(MS) Neuromyelitis optica(NMO) Peripheral nervous syetem: Acute inflammatory demyelinating polyneuropathy (AIDP)

  2. Multiple Sclerosis Ⅰ.Definition MS is an auto-immune disease.It is characterized by multifocaldemyelination in the white matter of the central nervous system.

  3. Ⅱ.Etiology and pathogenesis 1.Viral infection and auto-immune reaction. 2.Genetic factor: inherited predisposition. 3.Environmental factor.

  4. Ⅲ .Pathology 1.Multiple demyelination in the white matter of the central nervous system. 2.Site:round the lateral ventricle ; optic nerve ;brain stem ;spinal cord ;cerebellum 3.Phase (1)acute phase: (2)chronic phase

  5. Ⅳ.Clinical Features 1.General condition: onset: acute or subacute age:10-50 precipitating factor characteristic of duration:alternative recurrent-remit

  6. 2.symptom

  7. 2.symptom

  8. 2.symptom

  9. 3.Characteristic signs (1) internuclear ophthalmoplegia(INO) (2) nystagmus

  10. 4.Clinical type Alternative recurrent-remit type Secondary progressive type Primary progressive type Progressive recurrent type Benign type

  11. Ⅴ.Investigation 1.CSF (1)Routine and biological examination cell: normal or slightly high, <15 protein:slightly high (2)IgG:characteristic a.CSF-IgG index: [CSF-IgG/S-IgG]/[CSF-ALB/S-ALB]>0.7 b.oligoclonal bands of IgG(OB):95%

  12. 2.Brain evoked potential(BEP)VEP,BAEP,SEP. detect subclinical lesions 3.CT:multiple low density lesion white matter 4.MRI:the most sensitive means a.multifocal long T1 and long T2 signals b.paraventricle,half-oval area,brain stem,cerebellum,spinal cord,corpus callosum c.Enlarged ventricle

  13. 2.Brain evoked potential(BEP)VEP,BAEP,SEP. detect subclinical lesions 3.CT:multiple low density lesion white matter 4.MRI:the most sensitive means a.multifocal long T1 and long T2 signals b.paraventricle,half-oval area,brain stem,cerebellum,spinal cord,corpus callosum c.Enlarged ventricle

  14. Ⅵ.Diagnosis

  15. Ⅶ.Differential Diagnosis 1.Acute disseminated encephalomyelitis(ADEM) 2.Cervical spondylosis 3.Tropical spastic paraplegia(TSP) 4.Brain arteritis 5.Vasodeformity 6.Multiple infarction 7.Cerebral lymphoma 8.SLE,Lyme,etal

  16. Ⅷ.Treatment 1.Corticosteroid and adrenocorticotropic hormone(ACTH) 2.β-IFN 3.Immunoglobin 4.Immunosuppressive therapy: azathioprine;cyclophosphamide; methotrexate;cyclosporine A 5.Plasma exchange(PE) 6.Symptomatic treatment:baclofen

  17. Neuromyelitis Optica(NMO) 1.pathology:demyelination;necrosis 2.Clinical features (1)Acute transverse myelitis: incomplete and asymmetric (2)Optic neuritis 3.investigation: (1)CSF:cell:1/3>50 (2)MRI:long T1 and long T2,>3 segments (3)Oligoclonal band is rare 4.treatment:methylprednisone

More Related