Demyelinating disorders are conditions that affect the coating around nerve cells in the brain and spinal cord. This coating, called myelin, helps nerve cells send messages to other parts of the body. When myelin is damaged or destroyed, it can lead to problems with movement, vision, thinking and other functions. There are several different demyelinating disorders, each with its own set of symptoms.
Type of demyelinating disorder
Transverse Myelitis
Acute Flaccid Myelitis (AFM)
Neuromyelitis Optica (NMO)
Acute Disseminated Encephalomyelitis (ADEM)
Multiple sclerosis (MS)
What is it?
A neurological disease that causes inflammation and damage to the spinal cord. It interrupts the messages from your brain that control your muscles.
A rare and serious illness that affects the nervous system, specifically the spinal cord. AFM affects mainly children and young adults.
An autoimmune condition in which the body attacks its own myelin. Also known as Devic’s disease, it is a rare neurological disorder that affects the brain, spinal cord and optic nerves.
A rare neurological disorder characterized by a brief but widespread attack of inflammation in the brain and spinal cord.
Causes
The most common causes are infections and autoimmune disorders.
The cause of AFM is unknown, but it may be caused by a virus or other environmental factors. Some cases have been linked to infections such as polio and West Nile virus, while others may be due to exposure to environmental toxins. There is also some evidence that it may be caused by autoimmune disorders.
The cause of NMO is unknown, but there is some evidence that it may be caused by a virus or by exposure to certain chemicals.
The cause of ADEM is unknown, but it may be triggered by a viral infection or, less often, a bacterial infection. ADEM can also occur after a vaccination. It is not contagious from person to person but it can be spread through contact with body fluids from someone who already has it— for example, a blood transfusion from an infected donor.
Symptoms
- Sudden weakness or paralysis in the arms or legs
- Loss of bladder or bowel control
- Loss of feeling or sensation in your arms or legs
- Tingling or numbness in your arms or legs
- Pain in your lower back or hips
- Difficulty breathing
The symptoms of AFM can be very similar to those of polio. The symptoms usually start suddenly, and may include:
- Weakness or paralysis in the arms and legs
- Loss of muscle tone
- Drooping eyelids or facial muscles
- Slurred speech
The symptoms of NMO can vary depending on the child’s age and stage of development. In very young children, the main symptom may be difficulty walking. In older children, the main symptoms may be vision problems or numbness in the limbs.
Early symptoms include:
- Fatigue
- Fever
- Headache
- Nausea and vomiting
- Confusion
- Irritability
Over time, as the disorder damages white matter in the brain, patients with acute disseminated encephalomyelitis can develop:
- Vision loss
- Difficulties with speech and/or slurred speech
- Muscle weakness and difficulty with coordination
- Amnesia
- Changes in personality
- Seizures
Treatments for demyelinating disorders
There is currently no definitive cure for demyelinating disorders, so treatment focuses on relieving symptoms and helping the person to regain as much function as possible. Some people with demyelinating disorders may need lifelong care and monitoring. This may include regular check-ups with a neurologist, physical therapist
and other specialists. It is important to work closely with your healthcare team to develop a treatment plan that works best for your child and your family. While treatment can vary based on the type of demyelinating disorder and specific symptoms, common treatment options include a combination of the following:
- Physical therapy
- Occupational therapy
- Speech therapy
- Medication
- Bracing or splinting
- Nutritional support
- Steroid therapy
- IVIG
- Rehabilitation
- Surgery
- Breathing assistance
- Equipment