What types of demyelinating disease affect the central nervous system, and what can you do about them?

Answer From Jerry W. Swanson, M.D.

A demyelinating disease is any condition that results in damage to the protective covering (myelin sheath) that surrounds nerve fibers in your brain, optic nerves and spinal cord. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

Multiple sclerosis

Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system. In this disorder, your immune system attacks the myelin sheath or the cells that produce and maintain it.

This causes inflammation and injury to the sheath and ultimately to the nerve fibers that it surrounds. The process can result in multiple areas of scarring (sclerosis).

Other causes

Other types of demyelinating disease and their causes include:

  • Optic neuritis — inflammation of the optic nerve in one or both eyes
  • Neuromyelitis optica (Devic's disease) — inflammation and demyelination of the central nervous system, especially of the optic nerve and spinal cord
  • Transverse myelitis — inflammation of the spinal cord
  • Acute disseminated encephalomyelitis — inflammation of the brain and spinal cord
  • Adrenoleukodystrophy and adrenomyeloneuropathy — rare, inherited metabolic disorders

MS and other demyelinating diseases most commonly result in vision loss, muscle weakness, muscle stiffness and spasms, loss of coordination, change in sensation, pain, and changes in bladder and bowel function.

Treatment

No cures exist for demyelinating diseases and their progression, and symptoms are different for everyone. Getting treatment early is important. Treatment focuses on:

  • Minimizing the effects of the attacks
  • Modifying the course of the disease
  • Managing the symptoms

A variety of drug therapies are recommended depending on your specific disorder. Strategies to treat symptoms include physical therapy, muscle relaxing drugs, and medications to reduce pain and fatigue. Talk with your doctor about the best course of treatment for your specific disorder.

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May 05, 2020 See more Expert Answers