Demyelinating diseases
Find a neuro specialistWhen a condition or illness damages or destroys your myelin, it’s a type of demyelinating disease. Myelin, also called your myelin sheath, wraps around your nerve cells in your brain and spinal cord to offer protection and support.
When your myelin is damaged, your nerve signals slow down or stop altogether. This is called demyelination. If you have a demyelinating disease, your nerve signals don’t work as they should. This may lead to symptoms such as muscle weakness or vision loss.
The most common type of demyelinating disease is multiple sclerosis (MS). There’s no cure for a demyelinating disease, so early treatment is important to manage symptoms.
What is demyelination?
Image shows the process of demyelination, the loss of myelin and abnormal axon function due to a type of demyelinating disease.
Myelin wraps around the axon of your nerve fibers in your central and peripheral nervous systems. Axons connect your nerve fibers so they can communicate with each other. This network of nerves is also called “white matter” since the myelin sheath gives the tissue a white color.
The insulation from myelin helps support the axon function of the nerve cells (neurons) – the exchange of information and communication (electrical impulses) to other neurons within and outside of the nervous system.
When demyelination occurs, your myelin is damaged. Scar tissue forms in its place, disrupting the proper flow of nerve signals.
There are three types of demyelination:
- Inflammatory demyelination: Your body’s immune system mistakenly attacks myelin and myelin-forming cells. This is the most common type of demyelination.
- Viral demyelination: Myelin is damaged due to a viral infection.
- Hypoxic-ischemic demyelination: A lack of oxygen in the brain damages your myelin.
Demyelination vs. dysmyelination
Dysmyelination can be confused for demyelination since they both affect your myelin. Dysmyelination happens when your body can’t form myelin normally. It’s a hereditary mutation – something you’re born with – that causes the formation of malformed or defective myelin.
Types of demyelinating diseases
Common types of demyelinating diseases can be categorized by the nervous system they’re impacting. It can be in the central nervous system (brain and spinal cord) or your peripheral nervous system (nerves outside of your brain and spinal cord).
Demyelinating diseases that affect your central nervous system include:
- Multiple sclerosis (MS)
- Acute disseminated encephalomyelitis (ADEM)
- Transverse myelitis (TM)
- Neuromyelitis optica spectrum disorder (NMOSD)
- Leukodystrophy
- Central pontine myelinolysis (CPM)
Demyelinating diseases that affect your peripheral nervous system:
- Guillain-Barre Syndrome (GBS)
- Chronic inflammatory demyelinating polyneuropathy (CIDP)
- Charcot-Marie-Tooth disease (CMT)
What causes demyelination?
Research on demyelinating illnesses is ongoing. Sometimes the cause is unknown. Known causes include:
- Inflammation from an autoimmune condition
- A viral or bacterial infection
- Loss of oxygen to the brain
- Vitamin deficiencies
Demyelinating disease symptoms
Symptoms vary by the type of demyelinating disease. You may have symptoms in only one part of your body, or you may experience several symptoms at the same time.
It’s common to experience symptoms in your muscles with a demyelinating disease. These include:
- Muscle weakness
- Numbness or tingling in your muscles
- Stiff muscles
Other symptoms of demyelinating disease include:
- Blurred vision
- Balance and walking difficulties
- Slurred speech
- Fatigue
- Trouble chewing or swallowing
- Depression or anxiety
- Irregular eye movements
- Confusion
- Bladder or bowel issues
Some types of demyelinating diseases have symptoms that improve over time, while others gradually worsen or could be fatal. It’s common for those with MS to have episodic symptoms, with improvement between episodes.
Diagnosing a demyelinating disease
First, your doctor will review your medical history, perform a physical exam and discuss any potential demyelinating disease symptoms. If a demyelinating disease is suspected, you’ll be referred to a neurologist, who will perform a neurological exam using the latest leading-edge tools.
Depending on your unique situation, several other tests may be recommended. These tests, including imaging and nerve tests, can rule out other possible conditions and diagnose a type of demyelinating disease. Additional testing may include:
- Blood tests
- An MRI
- A CT scan
- Electromyography (EMG) test
- Lumbar puncture (also known as a spinal tap)
Demyelinating disease treatment
A demyelinating disease is a lifelong condition since there is no way to repair nerve damage. You’ll need to manage your symptoms with regular visits with your care team. The outlook depends on several factors, including the extent of the damage to your nerve cells, your symptoms and how quickly you started treatment.
Your doctor will work with you to create a personalized demyelination disease treatment plan. Your treatment plan will focus on managing the condition or illness that caused your type of demyelinating disease. Your doctor will also help you manage any symptoms.
Common treatments for demyelinating diseases include medications and physical therapy.
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