Acute and Chronic Demyelinating Disorders

What are Demyelinating Disorders?
Demyelinating disorders are the disorders of the nervous system in which the protective covering of the nerve cells that is the myelin sheath is damaged. As a result of this damage, the conduction of signals is impaired in the affected nerves. This impairment in the conduction of signals by the nerves results in the deficiency of movement, sensation, cognition and a number of other functions depending on the nerves that are affected.

Classification of the Disorders
There are a number of demyelinating disorders which are usually classified into two kinds.

1. Demyelinating myelinoclastic disorders – In this case, the normal and healthy myelin sheath is damaged by a chemical, toxic or any autoimmune substances.
2. Demyelinating leukodystrophic disorders – In this case, the myelin itself is not normal and degenerates with the passage of time.

Causes of the Disorders
There are some of the acute and chronic demyelinating disorders which are caused due to genetic factors, some are caused by infectious agents and some are as a result of autoimmune reactions. Moreover, there are some of the demyelinating disorders, the causes of which are still not clear to medical science. There is a class of chemicals known as Organophosphates which are actually the active ingredients of some of the commercial insecticides which have been found demyelinate the nerves. Other than this, Neuroleptics can also be a contributing factor to demyelination.

Acute Demyelinating Disorders
There are a number of disorders arising as a result of the demyelination of the nerve cells but some of the acute and chronic demyelinating disorders are as listed below.

Guillain Barre Syndrome
Guillain Barre syndrome is the commonest acute demyelinating disorder of the peripheral nervous system . In this syndrome, the immune system of the body attacks the nerves and eventually destroying it completely. It starts off with weakening and tingling sensations in the extremities. The most severe part of the disorder is that it spreads very quickly which ultimately results in the paralysing the whole body which is why it is termed as one of the most acute and chronic demyelinating disorder. The patients need to be hospitalised immediately for receiving the effective treatment.

ADEM
ADEM is Acute Disseminated Encephalomyelitis or Acute Demyelinating Encephalomyelitis. It is a rare but a serious disease affecting the brain and spine. It is marked by a sudden widespread attack of inflammation on the brain and spine. The attack damages the myelin insulation resulting in the destruction of white matter.ADEM is associated with significant morbidity and death.

Transverse Myelitis
Transverse myelitis is another of the acute and chronic demyelinating disorder which causes inflammation on both the sides of any one section of the spinal cord. This neurological disorder erodes the insulating myelin from the nerve cells interrupting the flow of messages to various parts of the body. Pain and weakness are quite common in this disorder. In the severe cases, it can lead to paralysis of the whole body. The disease requires proper medications along with rehabilitative therapy for the proper recovery.

Our Services
The expert neuro team at the Dr.Vanchilingam hospital has sufficient expertise and all the necessary infrastructure to take a very good care of all the acute and chronic demyelinating disorders so that the patients are able to survive this extremely difficult situation of acute neurological disorders. The specialised infrastructure of Dr.Vanchilingam hospital includes the following for the treatment of these difficult neurological disorders.

• Plasma exchange: It involves the removal of the harmful antibodies from the blood of the affected individuals which is carried out using an automated blood cell separator for ensuring fluid balance along with the maintenance of a normal plasma volume. Our expert therapists take care that the plasma exchange is carried out in the most effective way.
• Intravenous immunoglobulins: In this therapy, our expert doctors inject a mixture of immunoglobulins or antibodies directly into the veins for an effective treatment of the acute and chronic demyelinating disorders. Previously, these were not available but now these IV Immunoglobulins are commercially available in the market and hence there is no need for preparing it.  
• RITUXIMAB: This is a new chimeric Monoclonal Antibody being used for Demyelinating Diseases. The drug has shown much promise for patients with severe disease. We have the expertise and experience in using this drug.

Our hospital aims at giving the perfect care which is not only efficient but also extremely effective so that positive results can certainly be achieved by adequately treating the patients to the best of our abilities. We leave no stone unturned when it comes to our patients with acute and chronic demyelinating disorders.  

Authored By Dr Somesh Vanchilingam - Neuro Specialist, Thanjavur