Autoimmune neurological disorders ms, tm

neuro ahmed sallam

1. Autoimmune Neurological Disorders Ahmed sallam

2. Index Multiple Sclerosis Transverse Myelitis Optic Neuritis Neuromyelitis Optica Acute disseminated encephalomyelitis Neurosarcoidosis

3. Multiple Sclerosis recurrent cell-mediated autoimmune attack on the myelin sheath of the CNS. Affection mainly of white matter. Remission and relapse Precipitative factors as pregnancy, labour , infection, surgery Patchy distribution.

4. Clinical features Common presentations of MS Optic neuritis ……….. Optic nerve Relapsing and remitting sensory symptoms Subacute painless spinal cord lesion Acute brainstem syndrome 6th cranial nerve palsy

5. Other symptoms Afferent pupillary defect and optic atrophy (previous optic neuritis) Lhermitte’s symptom (tingling in spine or limbs on neck flexion) Progressive non-compressive paraparesis Partial Brown–Séquard syndrome Internuclear ophthalmoplegia with ataxia Trigeminal neuralgia ……..

6. Transverse myelitis Acute inflammatory disorder affecting the spinal cord with cord swelling and loss of function. Causes include : Para-infectious autoimmune inflammatory response. Systemic inflammatory disorders, e.g. SLE, Sjögren’s , sarcoidosis. Neuromyelitis optica.

7. Neuromyelitis optica Inflammatory relapsing demyelinating disorder, previously thought to be a variant of MS . It is characterized by longitudinally extensive transverse myelitis (>3 segments ) and bilateral or recurrent optic neuritis .

8. Acute disseminated encephalomyelitis (ADEM) is usually postinfectious , following infections such as measles , mycoplasma , mumps , and occasionally following 1–2weeks after immunization. There is a monophasic illness with multifocal brain, brainstem and often spinal cord inflammatory lesions in white matter, with demyelination. ADEM is caused by an immune-mediated host response to infection and occurs principally in children and young adults.

9. Neurosarcoidosis Neurosarcoidosis, with or without systemic sarcoid, causes chronic meningoencephalitis, cord lesions, cranial nerve palsies – particularly bilateral VII th nerve lesions, polyneuropathy and myopathy

10. Behçet’s disease Recurrent oral and/or genital ulceration, inflammatory ocular disease and neurological syndromes. Brainstem and cord lesions, aseptic meningitis, encephalitis and cerebral venous thrombosis

11. Thank you