What kind of disease is white matter demyelination?

Demyelination occurs when the myelin sheath of the axons of the cerebrospinal cord is lost. There are two categories: myelin destruction; Disorders of myelination. Spinal inflammatory demyelinating diseases are currently considered to be immune-mediated diseases, and their clinical features are:

The patients were children and young adults;

Acute onset, common history of cold, fever, infection, rash, vaccination, cold, childbirth or surgery 1 month before the illness;

A thorough neurological examination often reveals evidence of other central nervous system involvement in addition to spinal cord symptoms and signs;

cerebrospinal fluid examination is positive for oligoclonal bands;

Electrophysiology and MRI can detect some subclinical lesions in the brain; MRI reveals abnormal signals of white matter in the brain. Some myelittic demyelinating lesions present:"Pseudoneoplasia"Manifestations, the MRI shows a mild mass effect, mild edema around it, and there may be patchy hemorrhagic signals, which can easily be misdiagnosed as spinal cord tumors. At present, the effect of internal medicine drugs** is not good.

Therefore, neurosurgical intervention is inevitable and necessary.

Demyelinating myelitis is usually acute multiple sclerosis (MS) spinal type, and the clinical presentation is similar to that of postinfectious myelitis, but the progression is slow, and the disease usually peaks within 1 to 3 weeks. The prodromal infection may be subtle, usually incomplete transverse lesions, with weakness or paralysis of one or both lower extremities, with numbness, the level of sensory impairment is inconspicuous or two-plane, and urinary and fecal disorders are present. Evoked potentials and MRI may reveal lesions elsewhere in the CNS.

Demyelination refers to the damage to the myelin sheath that occurs after the formation of myelination, and demyelinating diseases are a group of diseases characterized by the loss of nerve myelin and relatively mild involvement of neuronal cell bodies and axons, including hereditary and acquired. Hereditary demyelinating diseases mainly refer to leukodystrophy, which is more common in children. Acquired demyelinating diseases are further divided into two categories: central and peripheral.

The most representative peripheral demyelinating diseases are acute and chronic inflammatory demyelinating polyneuropathy. Central demyelinating diseases include multiple sclerosis and acute disseminated encephalomyelitis.

In atrophy, it refers to the delay in the conduction of the myelin sheath. Just like electric wires, the wires inside the damaged skin are abnormally discharged, resulting in poor contact and loss of working power. So, what's the deal with white matter demyelination?

In the demyelination of the white matter, the normal myelin that has matured is destroyed, i.e., the white matter demyelination disease. It mainly includes:

Multiple sclerosis, progressive multifocal leukoencephalopathy, acute sporadic encephalomyelitis, subacute sclerosing panencephalitis, pontine myelinolysis, corpus callosum degeneration, subcortical arteriosclerotic encephalopathy and concentric circle sclerosis, etc.

White matter demyelination disease refers to areas of myelination that vary in size on the inner surface of the central nervous system. This actually includes three conditions: the first is demyelination due to axonal damage; The second is that the formation of myelination is defective and cannot complete normal development, that is, the so-called leukodystrophy, which is mostly a genetic defect and is only seen in children.

The third is when the myelin sheath is damaged and the axons are not damaged or less damaged. Pathological changes are divided into acute and chronic.

Demyelinating lesions are acute onset or subacute damage to the nerve center of the disease, the peak incidence is two to three weeks, if the first delay of the damaged nerve secondary ischemic degeneration will occur, multiple sclerosis occurs, the onset of severe disease can invade the spinal cord anterior horn cells and brainstem nerve nuclei and cerebral motor cortex pyramidal cells are life-threatening, mostly caused by abnormal genetic immunity or viral infection. The early symptoms of the patient are very mild and not obvious, easy to ignore, and the clinical symptoms occasionally include trance, restlessness, dizziness, depression, anxiety, obsessive-compulsive, insomnia, claustrophobia, headache, abnormal vision or brain discomfort, as well as mild local numbness, muscle weakness, etc., which are not appropriate and prone to delayed nerve redamage.

After the edema of the white matter will lead to the loss of myelin, also known as the white matter demyelination disease or demyelinating encephalopathy, demyelinating encephalopathy has primary, secondary, ** and late type and ** many, the primary demyelination is mostly formed during pregnancy or childhood, and there is a difference in severity, the degree of nerve damage is related. Severe patients are more likely to have postpartum cerebral palsy, mild damage and damage to non-functional brain tissue areas can occur at any age, and mild patients often develop neurological disorders or dizziness, headache, depression, anxiety, insomnia, forgetfulness and cerebrospinal syndrome after the age of 50 before MRI (cervical spondylosis and lumbar spondylosis occur after muscle spasm and stretching of the spine due to cranial nerve function involvement). However, the magnetic resonance report will mostly report pathologies such as cavity infarction to the lesion, so many patients have neck and low back pain symptoms After cervical and lumbar spine surgery, the symptoms not only cannot be relieved, but also more neurological symptoms occur (such as aggravation of limb numbness, spasms, dizziness, headache, depression, anxiety, etc.), so this phenomenon is called secondary nerve injury.

With the unclear diagnosis of the disease and the delay in diagnosis and treatment, many patients will eventually suffer from chronic ischemia and delayed spinal cord nerve redamage, resulting in spastic insufficiency and paralysis. Therefore, the diagnosis and treatment of white matter demyelinating diseases need to consider many aspects, find and estimate the source of the disease, correctly make the microcirculation of the affected nerves get sufficient blood supply, nutrition and excitation activation, and regenerate and repair the affected nerves, so as to essentially alleviate the symptoms and prevent the disease from continuing to deteriorate and achieve the best recovery state.

Beijing Deshengmen Hospital of Traditional Chinese Medicine-Wen Jihuan-Deputy Chief Physician-Department of Encephalopathy-What is white matter demyelinating lesion?

Demyelinating changes in white matter ischemia, also known as demyelinating brain disease, are mainly caused by damage to the autonomic nerves of the white matter of the brain, and make the regulatory disorders unable to regulate themselves independently, and the diversity of pathological changes that occur by nourishing the tissues in the innervation area. As we age, the body's immunity decreases, so some of the body's arteriosclerosis will occur, which can also cause white matter ischemic demyelinating disease.

White matter refers to the nerve fibers in the white matter area of the brain, where nerve fibers gather inside the brain. The nerve fibers are wrapped in a layer of clotted myelin sheath, and the blood supply to the white matter area is relatively weak, which is easy to cause ischemia, so the myelin cells are the first to be damaged, resulting in dysfunction of the nerve fibers. Emotional, cognitive, memory and other functions will change.

Flaccid hemiplegia. The main manifestations of the obstruction are the abnormality of the distal side of the body and the decrease in the feeling of rubber gloves and cotton socks. Tenderness in muscles throughout the body. Bilateral facial nerve palsies are the most common.

Neurological disorders within the brain.

Demyelination of the white matter is also a type of demyelinating disease, which is a neurological disease.

The nerves of the human brain themselves have a nutritional effect, and due to the degeneration of some brain tissues, the function of the corresponding areas decreases, resulting in demyelination-like changes in the white matter of the brain.

White matter demyelination disease is mainly caused by damage to the white matter autonomic nerves of the brain, so that its regulatory disorders are unable to regulate itself autonomously and various pathological changes occur in the tissues of the nutrient-dominated area.

The main manifestations in the early stage can be that the early symptoms of some patients can be insignificant, and they are prone to delayed nerve damage, and in severe cases, they can invade the entire center and cause neurological damage and paralysis.

Most patients are genetically abnormal, and are infected by specific disease viruses that lead to demyelination of the white matter.