Overview of Neuroimmunology

(Multiple Sclerosis and Related Disorders)

Neuroimmunology focuses on diagnosis and treating patients with neurologic disorders caused by inflammation and autoimmunity (body’s immune system starts attacking your own body) in the nervous system (essentially your body’s command center). 


Our team of highly skilled specialists is able to diagnose and treat a number of conditions that fall into this field. 


Types of conditions

  • Demyelinating Diseases: A demyelinating (dee-my-uh-luh-nay-ting) disease is a condition that causes damage to the protective covering that surrounds nerve fibers in your brain, the nerves leading to the eyes (optic nerves) and your spinal cord. Nerves send electrical signals that help you feel sensations such as touch, taste, see and feel. They also help with movement.  When nerve fibers are damaged, these signals slow down or even stop, causing neurological problems.
 
  • Multiple Sclerosis (MS): The most common demyelinating disease. Signs and symptoms can vary, but may include movement or vision problems, tingling or body pain, and bowel and bladder dysfunction.
 
  • Acute Disseminated Encephalomyelitis (ADEM): A rare neurological condition that typically follows a viral infection. Signs and symptoms may include trouble swallowing, weakness in the arms and legs, confusion, drowsiness or even coma. 
 
  • Neuromyelitis Optica Spectrum Disorders (NMOSD): A rare neurological condition that often affects the optic nerves (responsible for transmitting visual information) and spinal cord (runs in the center of your spine). Signs and symptoms are wide but there is a spectrum of neurologic, ophthalmic, systemic, and psychiatric features. 
 
  • Myelin Oligodendrocyte Glycoprotein-Associated Disorders (MOGAD): Is a relatively new disease in the field of neuroimmunology and the diagnosis and treatment are still emerging. Symptoms can overlap between MS, ADEM and NMOSD. Patients are treated similarly as in other demyelinating syndromes. 
 
  • Pediatric Acquired Demyelinating Diseases: This is an umbrella term and represents a myriad of demyelinating diseases that occur in childhood. This includes and is not limited to certain conditions such as MS, ADEM, NMOSD, MOGAD, vitamin deficiencies, optic neuritis (attack of the optic nerves) and transverse myelitis (attack of the spinal cord). 
 
  • Autoimmune Encephalitis: Group of conditions that occur when our body’s immune system creates antibodies that mistakenly attack our healthy brain cells causing inflammation to the brain. It generally occurs sporadically and in some cases it can occur with cancer (known as paraneoplastic syndrome). Symptoms include impaired memory and cognition, abnormal movements, seizures, and problems with walking, balance, speech, and vision. Types of autoimmune encephalitis includes Anti-NMDAR receptor encephalitis, Hashimoto’s encephalopathy, LG11/CASPR2-antibody encephalitis, Limbic encephalitis and Rasmussen’s encephalitis.
 
  • Neuromyelitis Optica (NMO): Is a disorder that mainly affects the eye nerves and spinal cord. It sometimes occurs after an infection, and can often be misdiagnosed as multiple sclerosis. Neuromyelitis optica can cause blindness, weakness or paralysis in the legs or arms, painful spasms, loss of sensation, uncontrollable vomiting and hiccups, and bladder or bowel dysfunction from spinal cord damage.
 
  • Myasthenia Gravis: Myasthenia gravis is caused by a breakdown in the normal communication between your nerves and muscles. It’s characterized by weakness and rapid fatigue of any of the muscles under your voluntary control. There's no cure for myasthenia gravis, but treatment can help relieve symptoms, which can include weakness of arm or leg muscles, double vision, drooping eyelids and difficulty with speech, chewing, swallowing and breathing.
 
  • Other conditions: There are other conditions that fall under the umbrella of neuroimmunology that are not considered demyelinating diseases.


Tests

To help diagnose a neuroimmunological condition or infection, your doctor may order a number of tests, including:
 
  • Blood test: This test draws blood and may be used to help distinguish certain conditions from each other. 
 
  • Eye exam: An eye exam may be conducted to check for swelling or other problems near the optic nerve.
 
  • Computerized tomography (CT) scan: A CT scan uses X-rays to create detailed images of the inside of the body.
 
  • Magnetic resonance imaging (MRI): An MRI is a safe and painless test that uses radio waves and magnets to create a detailed view of the inside of the body.
 
  • Lumbar puncture (also called a “spinal tap”): This procedure is used to take a sample of cerebrospinal fluid, the fluid that surrounds your brain and spinal cord.
 
  • Stimuli response test: You may undergo a test to learn how well your brain responds to stimuli such as sounds, sights or touch.


Treatments

Before deciding on a course of treatment for you, we'll take into account your specific diagnosis and other factors to come up with an option that best fits your individual needs. We use a multi-disciplinary approach, which means bringing in experts from various fields and divisions to come up with a plan of treatment.

Generally, treatment for a neuroimmunological condition may include any of the following:
 
  • Medication: Treatment varies depending on the severity of the disease. This includes corticosteroids and long term drug modifying therapy.
 
  • Physical and occupational therapy: Physical therapy can also help manage movement problems often associated with multiple sclerosis.
 
  • Speech therapy: Led by certified speech language pathologists, services are available for patients who are having difficulty communicating verbally, concentrating and expressing thoughts, or swallowing.
 
  • Respiratory therapy
 
  • Nutrition counseling
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