Demyelinating disease of the brain signs and treatment

Some nerve endings (in particular, the axons of the peripheral and central nervous system) are covered with a specific myelin sheath. This structure performs a number of important functions. In particular, myelin is responsible for the rate of transmission of electrical impulses along nerve fibers. In addition, the shell performs barrier and supporting functions, and is also responsible for nourishing the nerve endings.

Demyelinating disease of the brain is accompanied by one or another damage to the myelin sheath, which naturally affects the work of nerve cells. By the way, demyelinating diseases are a whole group of certain lesions of the nervous system, each of which has its own characteristics and is accompanied by a unique set of symptoms.

In fact, there are many diseases that are somehow related to the process of damage to myelin fibers. For example, Devik’s disease is considered quite specific, which is accompanied by inflammation and demyelination of the optic nerves and some segments of the spinal cord.

Chronic diseases include atrophic lateral sclerosis, which is most often manifested in adulthood. The list of diseases can be replenished with such pathologies as acute encephalomyelitis, Krabbe’s disease, periaxial encephalitis, as well as concentric sclerosis of Balo (more often at a young age), sclerosis Marburga and many others.

In fact, there are many diseases that are somehow related to the process of damage to myelin fibers. For example, Devik’s disease is considered quite specific, which is accompanied by inflammation and demyelination of the optic nerves and some segments of the spinal cord.

The classification of this ailment is based on highlighting the root cause of the disease:

  1. If myelin in the body is destroyed due to hereditary reasons, they speak of myelinlastia.
  2. If the membrane is produced and functions correctly, but then disappears due to the action of external factors, they speak of myelinopathy.

In addition, they identify the main diseases that are included in the concept of “demyelinating disease of the central nervous system”:

  1. The most common pathology of this kind – multiple sclerosis – affects all parts of the central nervous system. The characteristic symptoms are very diverse.
  2. Progressive multifocal leukoencephalopathy.
  3. Marburg’s disease.
  4. Acute disseminating encephalomyelitis.
  5. Devik’s disease.

The demyelinating process of the brain is a disease in which the sheath of the nerve fiber atrophies. At the same time, neural connections are destroyed, the conductor functions of the brain are disrupted.

It is customary to refer to the pathological processes of this type – multiple sclerosis, Alexander’s disease, encephalitis, polyradiculoneuritis, panencephalitis and other diseases.

The causes of demyelination are still not fully identified. Modern medicine makes it possible to identify three main catalysts that increase the risk of developing disorders.

It is believed that demyelination occurs as a result of:

  • Genetic factor – the disease develops against a background of hereditary diseases. Pathological disorders occur against the background of aminoaciduria, leukodystrophy, etc.
  • The acquired factor – myelin sheaths are damaged due to inflammatory diseases caused by infection in the blood. May be a consequence of vaccination.
    Less commonly, pathological changes cause injury, demyelination is observed even after removal of the tumor.
  • Against the background of diseases, a violation of the structure of nerve fibers, especially the myelin sheath, occurs as a result of acute transverse myelitis, diffuse and multiple sclerosis.
    Metabolic problems, a deficiency of vitamins of a certain group, myelinosis and other conditions are catalysts for damage.

For violations, the following symptoms are characteristic:

  • Increased and chronic fatigue.
  • Violations of fine motor skills – tremors, loss of sensation of limbs of the hands.
  • Problems in the work of internal organs – often the pelvic organs suffer. The patient has fecal incontinence, arbitrary urination.
  • Psycho-emotional disorders – a multi-focal brain lesion that has a demyelinating character, are often accompanied by problems in the patient’s mental state: forgetfulness, hallucinations, and a decrease in intellectual abilities.
    Until precise instrumental methods were used for diagnosing, there were cases when patients began to be treated for dementia and other psychological pathologies.
  • Neurological disorders – focal changes in the brain substance of a demyelinating nature are manifested in violations of the motor functions of the body and motility, paresis, epileptic seizures. Symptoms depend on which part of the brain is damaged.

Foci of demyelination in the cerebral cortex, in white and gray matter lead to the loss of important body functions. Depending on the location of the lesion, specific manifestations and disorders are observed.

The prognosis of the disease is unfavorable. Often, demyelination, resulting from secondary factors: surgery and or inflammation, develops into a chronic form. With the development of the disease, gradually progressive atrophy of muscle tissues, paralysis of the limbs and loss of the most important functions of the body are observed.

Single foci of demyelination in the white matter of the brain are prone to overgrowth. As a result, a gradually progressing disease can cause a condition in which the patient cannot swallow, speak, breathe on his own. The most severe manifestation of damage to the sheath of nerve fibers is a fatal outcome.

What is demyelination? The process develops as a result of the negative effects of antibody proteins on nerve tissue. This is accompanied by the development of an inflammatory reaction, damage to neurons, destruction of the myelin sheath and impaired transmission of nerve impulses.

The shells of nerve fibers are damaged by:

  1. Hereditary predisposition.
  2. Infectious viral diseases.
  3. Chronic foci of bacterial infection.
  4. Heavy metal poisoning, gasoline, solvent.
  5. Strong and prolonged stress.
  6. Excessive consumption of animal proteins and fats.
  7. Adverse environmental situation.

All these adverse conditions lead to the development of an autoimmune process, but the genetic role plays the largest role. Certain genes and their mutation lead to the production of abnormal antibodies that penetrate the barrier between blood and nerve tissue, which protects the brain from damage. As a result, the myelin protein is destroyed by the inflammatory process.

The second provoking factor is infectious diseases. The destruction of normal myelin occurs in a slightly different way. In the normal state, the immune system, after getting into the body of the infection, begins to produce antibodies to fight it. But sometimes the pathogen proteins are so similar to the proteins in the tissues of the human body that antibodies confuse them and, together with the bacteria, destroy their own cells.

In the initial stages of nerve fiber damage, when the inflammatory autoimmune process has just begun to develop, pathological changes can still be reversed. There is a chance of partial recovery of myelin, which will allow neurons to perform a certain part of their functions. But with the development of the disease, the nerve membranes are destroyed more and more, nerve fibers are exposed, and they lose the ability to transmit signals. It is impossible to get rid of nervous deficiency and restore the lost functions of the brain at this stage.

It is difficult to determine the type of demyelination based on symptoms only. Therefore, additional examinations are needed. Manifestations depend on the form of pathological changes.

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Multiple sclerosis

Foci of demyelination of the brain are most often found in multiple sclerosis. The disease is accompanied by autoimmunization, damage to nerve fibers, the breakdown of myelin sheaths and the replacement of damaged areas with connective tissue.

So far, it has not been possible to fully determine the causes of violations. It is believed that the brain is most affected by poor heredity, external conditions, infection with viruses and bacteria. The brain and spinal cord are usually affected.

Pathology may occur:

  • paresis and paralysis, increased tendon reflexes, muscle cramps;
  • imbalance and fine motor skills;
  • weakening of the facial muscles, swallowing reflex, speech function;
  • sensitivity change;
  • impotence, constipation, incontinence, or urinary retention;
  • decreased vision, narrowing of its fields, impaired brightness and color perception.

Marburg’s disease

This is the most dangerous form of brain damage. Pathology arises sharply and is accompanied by a rapid increase in symptoms. On the patient’s condition, this is reflected in the most negative way. A person can die in a matter of months.

The disease at first resembles an infection and is accompanied by fever, convulsions. With the destruction of myelin, motor functions, sensitivity and consciousness are disturbed. Characterized by the appearance of severe pain in the head and vomiting, increased intracranial pressure. With a malignant course, the brain stem is damaged, in which the nuclei of the cranial nerves are collected.

Devik’s disease

In this case, damage to the optic nerves and spinal cord occurs. The acute development of the pathological process leads to complete blindness. Due to the fact that the disease affects the spinal cord, a person suffers from paresis, paralysis, disorders of the functions of the pelvic organs, and sensitivity disorders.

The essence of pathology

Neurons have a specific shape that distinguishes them from all other types of cells. They have very long processes, some of which are covered with a myelin sheath, which makes it possible to transmit nerve impulses and makes this process faster. If myelin is destroyed, the process will either not be able to communicate with other neurons at all through electrophysiological impulses, or this process will be extremely difficult.

Subsequently, the structure of the human body will suffer, the innervation of which is associated with a damaged nerve. This means that the disappearance of the myelin sheath can have a variety of symptoms and consequences. Patients with similar diagnoses, but with different localization of the pathological focus, can live a different amount of time, the prognosis depends on the importance of the affected structure.

A very important role in the destruction of the membrane is played by the immune system, which suddenly attacks the living structures of the body.

Some causes of this disease of the central nervous system do not depend on lifestyle (for example, heredity), while others are associated with the neglect of a person to their own health.

Most likely, the demyelinating process of the brain occurs under the influence of several factors simultaneously.

The development of this ailment can be associated with the influence of such factors:

  1. Defects of hereditary information associated with the formation of the myelin sheath.
  2. Harmful habits that cause poisoning of neurons by smoke, narcotic compounds, alcohol.
  3. Prolonged exposure to stress.
  4. Viruses (rubella, herpetic diseases, measles)
  5. Neuroinfections affecting nerve cells.
  6. Hepatitis Vaccination.
  7. Autoimmune disease, against the background of which the destruction of the myelin sheath is carried out.
  8. Metabolic failure.
  9. A paraneoplastic process that develops due to the growth of neoplasms.
  10. Intoxication with any potent harmful substances (including those that are used in everyday life – paints, acetone, drying oil), as well as toxic metabolic products.

Most people do not know what it is, what demyelination of the brain is. However, demyelinating diseases of the nervous system occur in both children and adults. It is interesting that the frequency of their occurrence is related to geographical location and race: the largest number of patients with this diagnosis belongs to Caucasians and is observed in Europe and America.

A very important role in the destruction of the membrane is played by the immune system, which suddenly attacks the living structures of the body.

In many cases, this is due to the fact that immunity reacts very violently to infectious pathogens located in the brain, and at the same time to the structural components of the central nervous system; a so-called autoimmune reaction develops. But there are other, non-infectious causes of such failures.

Demyelinating diseases of the nervous system

Diseases of the nervous system (ICD-10 according to the international classification), which are combined in a similar way to defeat myelin, are caused by several causes – from allergic to viral agents. This group of pathologies is characterized by the fact that demyelinating diseases of the central nervous system often affect able-bodied men and women, who subsequently come to disability.

  • multiple sclerosis;
  • multifocal leukoencephalopathy;
  • acute encephalomyelitis.

Multiple sclerosis

What is multiple sclerosis, recently often found out by young people from 15 to 40 years. A feature of this disease is the simultaneous defeat of several parts of the central nervous system at once, which leads to different symptoms in patients. The disease alternates with periods of remission and exacerbation. The basis of multiple sclerosis is the occurrence of foci of myelin destruction in the spinal cord and brain, which are called plaques. Their sizes are small, but sometimes large joints are formed. Often such a pathology leads to Marburg disease or atherosclerosis.

The disease refers to a viral infection of the nervous system, which develops in the immunodeficiency state of the patient. Pathology progresses rapidly and can lead to death of the patient within a year. Often the cause of multifocal leukoencephalopathy is a reactivated virus that enters the body in childhood and is latent in the kidneys or tissues.

Multiple encephalomyelitis is a disease in which a variety of inflammatory processes occur in the spinal cord and brain. Pathology is characterized by lesions scattered throughout the nervous tissue. The name itself (encephalitis and myelitis) indicates the severity of the disease, and the prognosis of the patient’s recovery depends on the activity of the process, the adequacy and timeliness of treatment, the initial state of the body. The outcome of acute encephalomyelitis can be both recovery and disability or even death of the patient.

Multiple sclerosis

The disease refers to a viral infection of the nervous system, which develops in the immunodeficiency state of the patient. Pathology progresses rapidly and can lead to death of the patient within a year. Often the cause of multifocal leukoencephalopathy is a reactivated virus that enters the body in childhood and is latent in the kidneys or tissues.

The main causes of demyelinating disease

Any demyelinating disease of the central nervous system can occur for various reasons. The most famous among them:

  1. Malfunctions in the metabolism. This is typical for diseases such as diabetes mellitus, thyroid disease.
  2. Paraneoplastic processes, which are the first manifestation of a malignant tumor.
  3. Intoxication with chemical components: narcotic, psychotropic, alcoholic, paint and varnish and others.
  4. The reaction of immunity to proteins that are in the composition of myelin.

Numerous studies in recent years confirm that demyelinating diseases of the brain can develop due to the negative effects of the environment, poor heredity, malnutrition, prolonged stress or bacterial infection. An important role in the spread of pathology is played by infectious diseases: herpes, measles, rubella, Epstein-Barr virus.

It is not always possible to find out the reason for the appearance of such a process. Nevertheless, in modern medicine, it is common to identify several major risk factors. For example, quite often such a disease develops against a background of hereditary diseases, including aminoaciduria, leukodystrophy, Alexander’s disease, etc.

Demielisation can have an acquired character. In some cases, damage to the myelin sheath occurs against the background of infectious inflammatory diseases, less often after the introduction of vaccines. Diseases such as diffuse and multiple sclerosis, acute transverse myelitis can also cause demyelination of nerve fibers.

Among the main reasons as a result of which demyelination of the brain begins to develop in the body, it is customary to attribute:

  1. The reaction of the human immune system to the protein that myelin is made of. As a result of irreversible processes that occur in the body, such a protein begins to be perceived by the immune system as a foreign one. Cells begin to attack it and gradually destroy it. This reason is the most dangerous. This mechanism can be triggered by the ingestion of an infection or features of the human immunity, which are hereditary. These include multiple sclerosis, multiple encephalomyelitis, etc.
  2. The demyelinating process may begin in response to the presence of a neuroinfection that specifically affects myelin.
  1. Violation of metabolic processes in the body. As a result, myelin begins to suffer from a deficiency of the substances it needs and gradually breaks down. This is possible in patients who have a history of diabetes and problems associated with the functioning of the thyroid gland.
  2. The effect on the body of toxins and chemicals, including: alcohol, psychotropic drugs, acetone, body waste products.
  3. Paraneoplastic processes that occur as a complication of cancer.

As a result of scientific research, it was possible to establish that heredity and adverse environmental conditions play a special role in the defeat of myelin (the sheath of nerve fibers). There is also information about the relationship between the likelihood of this disease with the geographical location of a person, where foci of demyelination are noted.

There are two types of brain demyelination:

  1. Myeloklastia – characterized by a hereditary predisposition to rapid destruction of the membrane of the substance myelin.
  2. Myelinopathy is a process of destruction of the myelin sheath, which has other causes.

symptomatology

Symptoms depend on the type of disease and where the foci of brain demyelination are located.

In particular, multiple sclerosis is characterized by the following set of symptoms:

  1. Change in the ratio of the intensity of tendon and some skin reflexes, paresis, muscle cramps.
  2. Change in the characteristics of vision (distortion of the field, clarity, contrast, the appearance of cattle).
  3. Changes in the degree of sensitivity of various analyzers.
  4. Signs of impaired functioning of the brain stem and nerves anatomically associated with the brain (bulbar syndrome, facial muscle dysfunction, nystagmus).
  5. Pelvic dysfunction (impotence, constipation, urinary incontinence).
  6. Changes of a neuropsychological nature (decreased intelligence, depressive states, euphoria).

Marburg’s disease (disseminated encephalomyelitis) is a transient, deadly disease that can kill a person in a few months. There is a classification according to which this ailment is attributed to the form of multiple sclerosis. It resembles an infectious disease in which the following symptoms appear:

  1. A rapidly developing demyelinating pathology affects the brain stem and the nerves associated with it.
  2. Intracranial pressure rises.
  3. Disturbed motor function and sensitivity.
  4. Often there is a headache, accompanied by vomiting.
  5. Convulsions appear.

Devik’s disease is called a process of demyelination, which covers mainly the optic nerves, as well as the substance of the spinal cord. The disease is considered more dangerous for adults and less dangerous for children, especially if you start treatment with hormonal medicines on time. The manifestations of this pathology are as follows:

  1. Vision problems leading to complete blindness.
  2. Paralysis.
  3. Pelvic dysfunction.

Another pathology, progressive multifocal leukoencephalopathy, is characterized by a combination of immune shifts caused by external factors and the appearance of demyelinated foci. You can suspect such an ailment by the following signs:

  1. Decreased visual ability.
  2. Decreased intelligence.
  3. Loss of coordination.
  4. Convulsions.
  5. Paresis.

As you understand, such problems greatly reduce the quality of life.

Symptoms depend on the type of disease and where the foci of brain demyelination are located.

As you understand, such problems greatly reduce the quality of life.

Symptoms of Multiple Sclerosis

Chronic multiple sclerosis is a demyelinating disease of the brain in which the body treats its tissues as foreign. Immunity with antibodies begins to fight them. A demyelinating process occurs during which the nerve fibers are exposed, and the patient has the initial symptoms: the occurrence of urinary retention, impaired gait or vision.

Later, a partial recovery of the myelin sheath occurs, and the first signs of the disease disappear. The patient thinks that the problems went away on their own and do not seek medical help. This is the insidiousness of multiple sclerosis or another demyelinating disease of the central nervous system.

The most common signs of the initial stage of multiple sclerosis are the following conditions:

  • numbness of limbs;
  • amyotrophy of the muscles of the hands;
  • imbalance;
  • double vision and blurred vision;
  • violation of coordination of movements;
  • blurred speech;
  • cognitive impairment;
  • sharply arising paralysis of the limbs.

Therapies

If there is a slightest suspicion of such a disease, it is worthwhile to see a doctor. Naturally, there are many methods of diagnosis, but a kind of “gold standard” is magnetic resonance tomography of the head. The results of MRI help the doctor to determine the localization of the demyelination process, as well as the stage of the development of the disease, the features of its course and the rate of progression.

Further studies will be required, in particular, blood and cerebrospinal fluid tests, etc. These tests provide an opportunity to find out the cause of the development of the disease, which is extremely important for drawing up an effective treatment regimen.

The treatment of such complex ailments involves two main approaches: containment of pathological phenomena in the central nervous system and the fight against autoimmune processes (pathogenetic therapy) and mitigation of symptoms.

Interferon

The first direction of treatment involves the appointment of drugs containing interferon. Impact on immunity involves the elimination of those immune complexes and antibodies that are in the blood of the patient.

Drugs can be administered intravenously, subcutaneously, and if they are taken for a long time, the risk of sudden progression is really reduced.

Plasma exchange

Another way to eliminate myelin-hazardous antibodies is to filter cerebrospinal fluid. During each of eight consecutive procedures, about 150 mg of cerebrospinal fluid is driven through special filters. For the same purpose, plasmapheresis is used – to remove antibodies circulating in the patient’s vessels and sent to the brain.

Hormones

Hormone treatment also helps to remove aggressive biochemical compounds from the blood that destroy the membrane of neurons. If autoimmunization is pronounced, it is advisable to use cytostatics.

Nootropics

Symptomatic treatment involves the use of nootropic medicines that protect the nervous system from the pathological effects of the disease. These drugs are taken for a long time, but they do not have an adverse effect on the body.

Nootropics not only stimulate thinking and optimize the basic mental processes, but also prevent the death of neurons and associated cells from oxygen deficiency. Under their influence, venous circulation and timely outflow of blood from the brain improves, and the sensitivity of the brain structures to toxic substances decreases.

Despite the many positive effects, nootropics still have contraindications: they can not be taken with sickle cell anemia, drug addiction, neurosis, cerebrovascular insufficiency and some other conditions.

Muscle relaxants

With these pathologies, a situation may arise when neurons with a destroyed membrane cease to send signals to relax the muscles, and they are in constant tension. To resolve this problem, muscle relaxants are prescribed.

To reduce the intensity of inflammation and inhibit the violent reaction of the body to its own inflamed tissues, anti-inflammatory drugs are needed. Under their influence, the vasculature in the central nervous system ceases to be so permeable to autoantibodies and immune complexes.

Folk methods

Treatment using traditional, non-traditional methods can only be auxiliary. Such diseases cannot be overcome with the help of herbs, home procedures. But some ways to strengthen the immune system may be appropriate. In this case, any recipes used should be discussed with your doctor.

Conclusion

Such pathological changes in the central nervous system can provoke many factors, but a person must remember that in some cases it can prevent the development of a dangerous ailment. For example, avoiding hypothermia and communication with people infected with the infection, you can reduce the risk of developing violent immune reactions that can lead to the destruction of the structures of your own body. Being engaged in hardening of the body and elementary physical exercises, it is possible to increase resistance to very many negative influences at times.

The destruction of the myelin sheath of nerve cells (neurons) of the central nervous system or peripheral nervous system is called demyelination. Demyelinating diseases occur as a manifestation of genetic disorders or autoimmune diseases.

The treatment of demyelinating diseases is complex, depending on the stage of the disease and the individual characteristics of the body. It is completely impossible to cure them, with exacerbation and progress of the disease, drug therapy is prescribed. At the Yusupov hospital, the patient can undergo physiotherapeutic procedures, massages, and practice gymnastics with the hospital’s specialists.

Is there an effective treatment?

Unfortunately, today there are no tools that can quickly and finally save the patient from such an illness. Nevertheless, every year there are more and more drugs that are prescribed to patients with a diagnosis of demyelinating disease of the brain. Treatment, of course, depends on the type and stage of development of the disease.

Quite effective drugs are beta-interferons, which quite well block the further progression of the disease and the risk of disability. According to statistics, such a course of treatment at 30% reduces the likelihood of occurrence of certain complications.

Depending on the characteristics of the course of the disease, therapy also includes taking muscle relaxants, anti-inflammatory drugs (usually corticosteroids), as well as cytostatics. Nootropic drugs, amino acid complexes and neuroprotective drugs have a positive effect on the brain.

Approximately such treatment requires demyelinating disease of the brain. The prognosis for patients depends on the variety and form of the disease, as well as the rate of its progression and the quality of the care given to a person. And do not forget that the development of new drugs is still underway.

Quite effective drugs are beta-interferons, which quite well block the further progression of the disease and the risk of disability. According to statistics, such a course of treatment at 30% reduces the likelihood of occurrence of certain complications.

For the normal interaction of neurons (nerve cells) with each other and with other structures of the body, it is very important not only their internal content, but also the membrane containing the substance myelin. Its components are lipids and proteins.

If such a “wrapper” of neurons is destroyed for any reason, transmission of nerve impulses is impossible. A demyelinating disease of the brain can lead to such consequences, which can greatly affect the consciousness and even human vitality.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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