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 (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 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.
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.
June 30, 2017
See more Expert Answers
- Overview of demyelinating disorders. Merck Manual Professional Version. http://www.merckmanuals.com/professional/neurologic_disorders/demyelinating_disorders/overview_of_demyelinating_disorders.html. Accessed June 7, 2017.
- Hardy TA, et al. Atypical inflammatory demyelinating syndromes of the CNS. Lancet Neurology. 2016;15:967.
- Related conditions. National Multiple Sclerosis Society. http://www.nationalmssociety.org/What-is-MS/Related-Conditions. Accessed June 7, 2017.
- Signs and symptoms consistent with demyelinating disease. National Multiple Sclerosis Society. http://www.nationalmssociety.org/For-Professionals/Clinical-Care/Diagnosing-MS/Signs-and-Symptoms-Consistent-with-Demyelinating-D. Accessed June 7, 2017.
- Longo DL, et al., eds. Multiple sclerosis and other demyelinating diseases. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2016. http://accessmedicine.mhmedical.com. Accessed June 8, 2017.
- Olek MJ, et al. Pathogenesis and epidemiology of multiple sclerosis. https://www.uptodate.com/home. Accessed June 9, 2017.