Demyelinating disorders: Pathology review
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Demyelinating disorders: Pathology review
Pathology
Central and peripheral nervous system disorders
Amyotrophic lateral sclerosis
Neurofibromatosis
Sturge-Weber syndrome
Tuberous sclerosis
von Hippel-Lindau disease
Central nervous system disorders
Brain herniation
Broca aphasia
Kluver-Bucy syndrome
Wernicke aphasia
Wernicke-Korsakoff syndrome
Acoustic neuroma (schwannoma)
Adult brain tumors
Pediatric brain tumors
Pituitary adenoma
Ischemic stroke
Transient ischemic attack
Brain abscess
Cavernous sinus thrombosis
Creutzfeldt-Jakob disease
Encephalitis
Epidural abscess
Meningitis
Neonatal meningitis
Aqueductal stenosis
Cerebral palsy
Chiari malformation
Dandy-Walker malformation
Septo-optic dysplasia
Spina bifida
Spinocerebellar ataxia (NORD)
Syringomyelia
Tethered spinal cord syndrome
Alzheimer disease
Creutzfeldt-Jakob disease
Delirium
Frontotemporal dementia
Lewy body dementia
Normal pressure hydrocephalus
Vascular dementia
Acute disseminated encephalomyelitis
Central pontine myelinolysis
JC virus (Progressive multifocal leukoencephalopathy)
Multiple sclerosis
Transverse myelitis
Cavernous sinus thrombosis
Cluster headache
Idiopathic intracranial hypertension
Migraine
Tension headache
Trigeminal neuralgia
Arteriovenous malformation
Epidural hematoma
Intracerebral hemorrhage
Saccular aneurysm
Subarachnoid hemorrhage
Subdural hematoma
Essential tremor
Huntington disease
Opsoclonus myoclonus syndrome (NORD)
Parkinson disease
Restless legs syndrome
Torticollis
Early infantile epileptic encephalopathy (NORD)
Epilepsy
Febrile seizure
Brown-Sequard Syndrome
Cauda equina syndrome
Friedreich ataxia
Neurogenic bladder
Syringomyelia
Treponema pallidum (Syphilis)
Vitamin B12 deficiency
Concussion and traumatic brain injury
Peripheral nervous system disorders
Poliovirus
Spinal muscular atrophy
Charcot-Marie-Tooth disease
Guillain-Barre syndrome
Bell palsy
Trigeminal neuralgia
Carpal tunnel syndrome
Erb-Duchenne palsy
Klumpke paralysis
Sciatica
Thoracic outlet syndrome
Ulnar claw
Winged scapula
Lambert-Eaton myasthenic syndrome
Myasthenia gravis
Nervous system pathology review
Adult brain tumors: Pathology review
Central nervous system infections: Pathology review
Cerebral vascular disease: Pathology review
Congenital neurological disorders: Pathology review
Dementia: Pathology review
Demyelinating disorders: Pathology review
Headaches: Pathology review
Movement disorders: Pathology review
Neurocutaneous disorders: Pathology review
Neuromuscular junction disorders: Pathology review
Pediatric brain tumors: Pathology review
Seizures: Pathology review
Spinal cord disorders: Pathology review
Traumatic brain injury: Pathology review
Assessments
Demyelinating disorders: Pathology review
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Transcript
Content Reviewers
At the neurology department, a 23 year old male, named Charles, is brought by his parents because of weakness in his feet that started 2 days ago and worsened over time. During clinical examination, the deep tendon reflexes in his lower extremities are decreased but sensation is intact. Past medical history reveals a case of gastroenteritis about three weeks ago. Next to Charles, there’s a 26 year old female, named Maria, that came in because of an episode of blurring in her left eye and pain during eye movement. She had a similar episode a few months ago that lasted about a week and resolved without any treatment. She also describes an episode where she felt an electric shock-like sensation through her body after having a hot shower.
Alright, so both of them have a demyelinating disorder. This occurs when myelin, the protective sheath that surrounds the axons of neurons, is destroyed. Now, myelin is produced by oligodendrocytes in the central nervous system, or CNS, which includes the brain and the spinal cord, while in the peripheral nervous system, or PNS, which includes all of the neurons that extend beyond the brain and the spinal cord, it is produced by Schwann cells. Myelin helps the neurons to quickly send electrical impulses. As a result, the destruction of myelin, or demyelination, makes communication between neurons difficult, ultimately leading to all sorts of sensory, motor, and cognitive problems. Okay, now demyelinating disorders can be classified into two groups. The first one includes disorders that affect the myelin in the CNS, such as multiple sclerosis, acute disseminated encephalomyelitis, progressive multifocal encephalopathy and central pontine myelinolysis. The second group includes diseases that affect the myelin in the PNS, like Guillain-Barre syndrome and Charcot-Marie-Tooth. Now, other less high yield demyelinating disorders include Krabbe disease, metachromatic leukodystrophy and adrenoleukodystrophy.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Adams and Victor's Principles of Neurology 11th Edition" McGraw-Hill Education / Medical (2019)
- "Multiple Sclerosis and Demyelinating Diseases" Lippincott Williams & Wilkins (2006)
- "Multiple sclerosis is primarily a neurodegenerative disease" Journal of Neural Transmission (2013)
- "Acute disseminated encephalomyelitis" Seminars in Pediatric Infectious Diseases (2003)
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