Acute scattered encephalomyelitis symptoms. Acute scattered encephalomyelitis like a demyelinizing disease of the central nervous system

Infections are one of the most frequent causes of many diseases. Viruses and bacteria are so small that it is impossible to notice the danger of the hazard. In addition, sick people can distribute the infection long before any signs of disadvantaged in the body. But a considerable role is played by the response of the immune system for infection. In some cases, the latter causes much more negative consequences For a person, than viruses and bacteria. Such diseases include acute scattered encephalomyelitis.

What is encephalomyelitis

The head and spinal cord are the main leaders of all sides of the life of the body: dividing and updating cells, the process of metabolism, analyzing all types of information coming from outside. The main mechanism of communication nervous system With other organs and tissues there is an electrical signal. At the same time, all incoming information is sent to the center of nerve cells (neurons) for short refrigerations - dendrites. Response information is sent by a long process - axon.

Neuron - the main unit of the nervous system

The path of the nervous signal can be quite thorny. Very often, the brain does not independently transmit tasks to organs and muscles, but acts indirectly. Among the subordinates there is a spinal cord. Most electrical signals passes through it. The speed of information transfer in the body is high. The main mechanism is the presence of specific electrical insulation in neurons. In this role there is a leafy substance - myelin. Myelin shell is not solid and continuous. Between the covered areas are curtains. The latter are called Ranvier interceptions. Thanks to them electric impulse with high speed overcomes the length of nerve processes.

Interceptions of Ranvier provide high speed of the nervous impulse

Scattered encephalomyelitis is a specific disease of the nervous system, characterized by inflammation of myelin shell against the background of viral infection and the appearance of a plurality of negative features. In the pathological process in this case, all the components are involved: the spinal cord, brain, cranial and brain and peripheral nerves. Disease occurs as in childhoodand adults.

Synonym Disease: Demyelinizing Encephalomyelitis.

Classification

Scattered encephalomyelitis has a lot of accieveness:

Causes and factors of development

Scattered encephalomyelitis is directly associated with the infection of the body with a virus. Various diseases may act as the main starting factor:

The damage to the nervous system in these cases is necessarily preceded by the development of inflammation at the place of penetration of the virus into the body. Process in the skin, nasopharynk, putty sinuses, intestines - only the facade of the disease. Symptoms are the vertex of iceberg. The presence of a virus in the blood is hidden from the unarmed eye - Virushemia.

Nervous fabric is very sensitive to the effects of various pathological agents. Viruses in the course of vital activity are distinguished by many harmful substances. The infection can not only disturb the finely adjusted blood flow in the spine and brain. It penetrates the neurons themselves. These smallest forms of life are able to overcome a powerful hematostephalic barrier.

The latter is a specific structure similar to a high fence behind which the nervous tissue is hidden. In the role of the fence, special minor nerve cells protrude - neuroglia: astrocytes and oligodendrocytes. Their processes are so tightly covered by blood vessels that most of the blood components are not able to penetrate them. Similarly, the brain is protected from bacteria, viruses, toxins, as well as guard cells of immunity and their products - proteins and antibodies.

The combination of auxiliary cells of nervous tissue (neuroglia) is about 40% of the volume of the CNS

The destructive effect of the virus leads to the appearance in a powerful fence of large bars. Through them, both hostile particles themselves are rushed into the nervous fabric. immune cells. The first target on their way becomes a myelin shell of neurons. Pathological effects leads to the loss of electrical insulation of nerve cells. As a result, problems with the delivery of regulatory signals to the muscles appear, internal organs, skin Pokrov. In this case, the appearance of myelin varies significantly. In severe cases, the leaf-like shell resembles a solido.

The destruction of myelin leads to a loss of nervous impulse velocity

The location of the process determines which regulatory functions will suffer. In addition, most often inflammation damages myelin immediately in several places of the nervous system. Because of this characteristic feature, the disease has an adjective "scattered" in the title.

Video: Encephalomyelitis and its manifestations

Signs of scattered encephalomyelitis

Scattered encephalomyelitis causes the development of several groups of various signs. The first is a typical consequence of the inflammatory process and includes:

• fever;
• chills;
• lomotics in muscles and joints;
• marble drawing of the skin;
• pallor;
• general weakness;
• increased fatigue.

The second group of signs is universal for any disease of the nervous system, including multiple sclerosis:

The third totality of the signs will help not only establish the presence of inflammation in the nervous system, but also to determine the department of the spinal or brain, which has attacked the pathological process.

Table: Focal signs of scattered encephalomyelitis

Fiber optic nerve	Neurons of the upper layers of large hemispheres	Brain neurons	Neurons of the cranial brain nerves	Cerebellum neurons	Neurons spinal cord	Spinal cord roots	Peripheral spinal cord nerves
sudden reversible blindness; cutting eye apples (Nistagm); partial loss of fields.	parish limbs; paralysis limbs; increased stress of paralyzed muscles.	blood violation of blood vessels; breath disorders.	swallowing disorders; speech disorders; changing voice timbre.	unstable gait; dizziness; problems with equilibrium.	parish limbs; paralysis limbs; impaired skin sensitivity; amyotrophy; urine delay; stool delay.	parish limbs; paralysis limbs; impaired skin sensitivity; reduced stress of paralyzed muscles; amyotrophy; urine delay; stool delay.	parish limbs; paralysis limbs; impaired skin sensitivity; reduced stress of paralyzed muscles; amyotrophy; urine delay; stool delay.

Photo Gallery: Encephalomyelitis Symptoms

Nistagm occurs during the damage to the glasses The damage to nerve cells at the level of the spinal cord leads to a decrease muscular mass Muscle paralysis of larynx creates serious problems with breathing and voice Paralysis of nerves leads to asymmetry The demyelinizing process is very often striking the visual nerves, which is due to visual fields.

Diagnostic methods

Recognize multiple encephalomyelitis - the task for an experienced neurologist specialist. In some cases, the help of an infectious system may be required. The following analyzes and instrumental methods help to establish the correct diagnosis:

• objective inspection - reveals general signs inflammatory disease (fever, pallor, frequent pulse);
• neurological examination - establishes disorders of the activity of the dorsal and brain (paresa, paralysis, violations of gait and coordination, vision disorders, hearing, speech, swallowing);
• ophthalmological inspection - the main way to establish a change in fields and visual acuity, as well as the defeat of the optic nerve disk on the eye day;
• the overall blood test - detects signs of inflammation (excess of white blood cells, high speed of erythrocyte erythrocytes to the bottom of the test tube);

  Lymphocytes - Basic Defenders of the Body of Viruses

• biochemical blood test - allows you to identify the causative agent of the disease, and it is possible to detect both antibodies against viruses and the infectious agent itself;
• polymerase chain reaction - with a high probability allows you to establish a source of the pathological process in the spine and brain;
• the study of the spinal fluid obtained through the puncture at the lumbar spine - allows you to establish the viral nature of the disease in the content of a large number of lymphocytes;
• electo-leather - the main method of studying the activity of neurons of the brain and their processes, the movement of the electrical signal is recorded in the form of a graph, the change in the appearance of which allows you to establish the degree of damage to nerve cells;
• magnetic resonance imaging is the main method used to identify pathological foci of the disease in the tissue of the spinal and brain, the resulting picture allows the severity of the demyelination of nerve cells, as well as to observe the effect of the treatment carried out.

  MRI - the main method of diagnosing scattered encephalomyelitis

Differential diagnosis is carried out with the following diseases:

Methods for the treatment of scattered encephalomyelitis

Therapy of the Demyelinizing Disease of the Spinal and Brain - Complex various methodsaimed at eliminating inflammation, eliminating its causes, as well as improved metabolism in nervous tissue. Treatment is carried out under the direction of a specialist in the profile department of the hospital. In severe cases, resuscitation may be required.

Medicate

To eliminate disease phenomena, the following are prescribed medications:

• Steroid hormones. It is they who possess the most powerful anti-inflammatory effect. Also these drugs are able to suppress the aggressive behavior of the immune system. These medicines include prednisone, methipred, dexamethasone, hydrocortisone.
• Antiviral drugs. Actively struggle with an infection that has already penetrated into nerve cells. To solve this problem, preparations containing interferon (interferon-alpha, interferon-beta, cycloferon) are best suited.
• Metabolic agents. Improve the metabolism in neurons and contribute to the formation of myelin shell (piracetam, flashes, mexidol, actovegin).
• Vitamins of Group V. help the formation and delivery of the nervous signals (pyridoxine, thiamine, riboflavin, cyanocobalamin).
• Vasoactive drugs. Improve blood circulation in brain vessels (Trental, Kuraltil).
• Dorganic medicines. Used to eliminate the inflammatory edema of the nervous tissue (diakarb, lazic, furosemide).
• Nonteroidal anti-inflammatory funds. Need to eliminate fever and other inflammatory phenomena (ibuprofen, nimesulide, paracetamol).
• Anticonvulsant drugs. Used to eliminate muscle seizures (relaignation, depair).

Photo Gallery: Preparations for the treatment of scattered encephalomyelitis

Cycloferon contains interferon protein with antiviral activity Actovegin improves metabolic processes in nervous tissue Milgamma - Complex vitamin Preparation Trental improves blood circulation in brain vessels Dapacarb prevents the accumulation of excess fluid in the nervous tissue
Naz - effective anesthetic and antipyretic drug Depaakin is used to prevent convulsion Prednisolone - Powerful anti-inflammatory drug

Physical church

Physiotherapy procedures favorably affect the activity of the nervous system. The following techniques are used:

Plasmapheresis has an effective effect. With special filters, blood is purified from antibodies - one of the factors for the development of the disease.

The patient's blood is cleaned of harmful impurities, and then returns to the body

Encephalomyelitis is a serious illness requiring the attention of a specialist. Self-treatment or the use of folk agents is not only inefficient, but can aggravate the situation.

Complications and forecast

The bright manifestations of the disease are observed within 10-14 days, after which, as a rule, decrease. For the entire recovery process takes several months. In sixty-seven percent cases, negative features are completely eliminated, the work of the nervous system is restored. However, there is a possibility that some disorders will remain forever.

In addition, if there is a special predisposition, encephalomyelitis can move into an irreversible demyelinating process - multiple sclerosis. In case of severe disease, the following complications are possible:

The virus that caused damage to the myelin shell of neurons in a woman during pregnancy can provide a variety of, including extremely negative impact on the fruit. Herpes virus, rubella can lead to the formation of heavy anatomical deviations, spontaneous miscarriage in the early periods and stillbirth.

Life expectancy is determined by the nature of the disease and the degree of severity neurological violations. From these same circumstances, the ability to endure and give birth to a child.

Prevention

The main method of prophylaxis of encephalomyelitis is vaccination against causative agents of infectious diseases. Chickenpox, rubella, flu - diseases fraught with many heavy complications. The formation of immunity against such pathologies is one of the most important achievements of modern medicine.

Vaccine forms acquired immunity against infections

The inflammatory defeat of the CNS, which is presumably autoimmune, is called acute scattered encephalomyelitis. It is manifested in the form of a complication of a recently suffered infectious disease or may develop due to immunization. Treatment of the disease occurs under the supervision of the doctor.

The concept of pathology

Acute scattered encephalomyelitis is a rather dangerous illness, in which the head and spinal cord are affected. In case of non-timely started treatment and with difficult cases, a fatal outcome is possible.

They believe that children are most susceptible to pathology. Average age, in which the disease has a disease in this category - 8 years. It can begin in infancy (3 months), and most often meets up to 10 years. In the mature and old age, the disease begins, respectively, at 33.9 and 62.3 years.

Select primary and secondary forms of the disease. At the first, it appears as a result of a viral infection. Secondary acute encephalomyelitis develops due to the emergence of complications after various ailments of viral nature or after vaccination.

Classification

For the area that is affected by the ailment, the following varieties of encephalomyelitis are distinguished:

1. Disseminated myelitis. In this case, the work of the spinal cord is violated.
2. Opticoisitis and optical and monozefalomyelitis. It is characterized by a similar pathogenesis, while lesions of both the head and spinal cord are also observed, as well as the defeat of the visual nerves.
3. Polyncephalomyelitis. With this disease, the work of the nerve nuclei of the skulls located in the brain trunk is also affected, the spinal cord is also affected (its gray substance).
4. Encephalomyelopolyradiculiaurite. One of the most common similar pathologies. In this case, there are violations of almost all components of the nervous system.

The most often diagnosed acute scattered encephalomyelitis. In this case, various parts of the head and spinal cord are affected. Pregnancy with acute scattered encephalomyelitis flows as usual.

There is no single classification of this disease. In general, the following varieties are distinguished:

• stem encephalitis;
• cerebellit;
• optomelitis;
• neuritis optic nerve;
• acute transverse myelitis;
• acute hemorrhagic leuoenetsephalitis.

With the first species are observed the following signs:

• violation of respiratory acts;
• neuritis facial nerve;
• violation of the process of swallowing.

Malgic encephalomyelitis is also distinguished. It develops after vaccination or submitted illness of viral origin. At the same time, the following symptoms are manifested:

• muscle pain;
• disorders of the gastrointestinal tract;
• frequent mood change;
• depression;
• the appearance of pain syndromes in the articulated areas;
• fast fatigue after low loads;
• chronic fatigue.

The reasons

To date, they are not fully understood. It is still unknown, due to what reasons the body begins to produce proteins aimed at combating the nervous system.

The progression of the ailment is noted on the following of them:

• colds;
• allergy;
• reduction;
• introduction of certain types of vaccines;
• viral infectionsFirst of all, such that cause various rashes on the skin: rubella, windmill, herpes;
• heart injuries.

Signs

The disease begins rapidly. The symptoms of acute scattered encephalomyelitis are divided into communal and focal. The following are the following:

• reduction of intelligence;
• weakening of memory;
• violation of consciousness;
• epilepsy attacks.

With their absence, the diagnosis of "acute scattered encephalomyelitis" is dubious.

Focal symptoms are manifested in the form of multiple brain lesions. They are mainly combined in the form of the following:

• eye violations;
• extrapyramidal;
• cerebellum;
• pyramidal.

Only on these signs to put the correct diagnosis can only a highly qualified doctor.

The two categories described above the symptoms of acute scattered encephalomyelitis are manifested for 7-14 days, after which the clinical picture becomes less pronounced. Against the background of the occurrence of the disease, disorders may appear in the peripheral nervous system. There may be such a state as polyneuropathy.

Various symptoms can manifest themselves depending on which brain department is amazed.

The initial signs may appear during the infectious disease that serves as the cause of encephalomyelitis, during asthenia and increasing body temperature. These include:

• the feeling of tingling in the legs - it is rare quite rarely;

• violations in the work of the GCT;
• increased arousal, sometimes replacing lethargy;
• rubber, pain and sore throat;
• drowsiness;
• it is possible to increase body temperature, although not necessarily;
• headache;
• general malaise.

If the brain is affected, then the following signs of the disease can be observed:

• appearance convulsive syndromesimilar to an epileptic seizure;
• parires limbs;
• paralysis;
• violations of speech.

With the damage to the spinal cord roots, the following symptoms are observed:

• pain syndromespreading along spinal column, resembling clinical manifestations lumbago;
• the functioning of the abodes of the small pelvis is deteriorating: urination delay, intestinal emptying, or reverse pattern in the form of incontinence may occur;
• freamed pain and temperature sensitivity of the body;
• the trophic changes in the epidermis appear.

With the defeat of the visual nerve, the following symptoms are observed:

• there is pain in the eyeboard, which gradually increases, especially when performing sharp movements by the agencies of vision;
• before the eyes, "Pelon" is formed;
• worsen eyesight.

The main differences between acute scattered encephalomyelitis and multiple sclerosis are as follows:

• unlike the last autoimmune response to MIELIN antigens do not have chronic flow and limited to one exacerbation;
• the structure of foci in both diseases is the same, however, the inflammatory dynamics and swelling are more pronounced with the ailment under consideration, the oligodendrocytes are less affected.

Diagnostics

To identify the disease are carried out with acute multiple encephalomyelite MRI using contrast. Features of the illness are easily detected by a doctor in the picture or screen. In Flair and T2 modes, asymmetric hyper-trienidistic foci, having a bad outlines, both in white and in the gray matter of the brain, and in the second they may not be expressed. They may be small (up to 0.5 cm), large (more than 2 cm) and medium (having intermediate values). Sometimes large drain foci with perifocal swelling, which cause the displacement of the surrounding structures. Spectative bugs can also be involved. In large areas of inflammation, hemorrhages are observed. The contrast agent in the foci accumulates with different intensity. They can be detected in the spinal cord in a small amount of cases not exceeding 30%. After identifying the disease and conducting its treatment, patients recommended a re-conduction of MRI in six months. A decrease in demyelinization sites or their complete disappearance indicates the correct formulation of the diagnosis and on the exclusion of multiple sclerosis.

In addition, the diagnosis can be performed using a lumba puncture. In this case, the patient lays down on the side with the implementation local anesthesia. Between the lumbar vertices, a needle is introduced for the fence of a small number of spinal fluid, which is analyzed. If there is a disease in it, a large number of lymphocytes will be found.

Additionally, perimetry, ophthalmoscopy, an oculist consultation can be appointed.

Be sure to form a diagnosis should be taken into account the presence in the clinical picture of signs of general-selling syndrome or encephalopathy. The latter includes the patient's complaints for nausea, vomiting, headaches, while there are violations in behavior and consciousness - from stunning and drowsiness up to the development of coma of varying degrees.

Options for the course of the disease

Currently, three such are distinguished:

• monophasic;
• return;
• multiphase.

In the first case, a single episode of the neurological violation occurs and there is no resolution in the future.

With a return option, the same symptoms or even increase their rise 3 months after the start of the first attack or 30 days after the end of the corticosteroid reception.

The multiphase flow is characterized by the fact that later the same period of time appear new complaints and symptoms.

Objectives of therapeutic treatment

The patient must first of all know that acute scattered encephalomyelitis is curable. But in order to achieve this, it is necessary to carry out appropriate treatment, which should be directed to:

• identification and treatment of infections, which prevents it in transformation into multiple sclerosis, every six months must be checked for their presence, making control immunograms;
• control of the organism's immune state for the selection of optimal antiviral therapy;
• the maximum possible restoration of the work of brain sections affected by inflammation by stimulation of remilization;
• the elimination of aggressive behavior of immunity to the CNS with the normalization of the response of the first to enter foreign microorganisms into the body.

Treatment of encephalomyelitis

Basic therapy is carried out by anti-inflammatory steroid preparations. Can be used medium or high doses "Prednisolone" depending on the condition of the patient, with their gradual decline.

Corticosteroid therapy is carried out for 2-5 weeks. For warning side Effects Assign intravenous administration Immunoglobulins. Remove immune antibodies and immune complexes from the body can with plasmapheresis, which is carried out in difficult cases.

The treatment of acute scattered encephalomyelitis is aimed at eliminating the causes of the disease. For this, antiviral agents belonging to the interferon group are prescribed.

Sometimes antibiotics may be assigned in the bacterial etiology of the disease:

• "Cefzol";
• "Gentamicin";
• "Ampioks".

For the treatment of acute scattered encephalomyelitis, accompanied by rheumatism, prescribe biotillinotherapy.

Symptomatic therapy is necessarily carried out. Hemodynamics, artificial ventilation of the lungs, resuscitation activities can be recovered.

To prevent brain edema injected the following drugs:

• "Furosemid";
• "Magnesia";
• "Diakarb".

How to eat when diagnosed "acute scattered encephalomyelitis"? Pronounced dysphagia must be accompanied by power through the probe.

With urine delay in bladder Catheter insert. If the intestinal paresis is observed, then there are enemas. In the presence of cramps, anti-wilful agents are prescribed.

Anticholinesterase funds are prescribed for the treatment of neurological disorders: "Prezero", "Galanamin", vitamins of group B and C.

During reconvalues, absorbing drugs are used: "Cerebrolysin", "Lidase".

Treatment of scattered encephalomyelitis may be accompanied by a reception of nootropic drugs:

• "Nootropyl";
• "Ginkgo biloba".

Doctors can also assign neuroprotectors: "Mexidol", "Semax".

Motor activity is restored by the implementation of the FFC and massage. Also carry out transcranial magnetic stimulation.

Upon exacerbation of the disease, treatment is carried out in stationary conditions. At the same time, potent drugs are prescribed.

Folk remedies

They can be used, but not during the exacerbation. They are mainly used at the recovery stage in order to maintain the work of the nervous system. The following recipes are used:

1. Mordovnik Chairolar. Take 3 tbsp. l. Fruits, 250 ml boiling water are poured, are placed in a thermos, in which they insist for 12 hours. Dropped by infusion during the day with small portions. Treatment is carried out within two months.
2. Mummy. 5 g is dissolved in 100 ml of water. Take three times a day for 1 h. 1 hour before meals three times a day.
3. Leek with honey. The bulb is cleaned and crushed with a grater. Pressing juice, after which it is mixed with honey. It is consumed three times a day for 1 t. L. For a month.

The main method of treatment they should not be. Apply from the permission of the attending physician.

The main differences in the course of the disease in children and adults

Preceding vaccination or transferred infection Most often causes acute scattered encephalomyelitis in children. At the beginning of the development of the illness, they often have a fever, which in adults is missing. For children is characterized by encephalopathy syndrome flowing in a rough form. In adults, it is manifested in a mild or moderate form with possible advent hallucinations and nonsense.

In children, it is often observed signs of meningoencephalitis with the emergence of ataxia; In adults there are motor and sensory deficiencies, the root syndrome may be observed.

When conducting MRI, the centers in children are located in the spinal cord, trunk, cerebellum, the crust and region of basal nuclei, perivventicular foci are rare. In adults, the latter often are observed, a protein increases, Plequitosis.

Children recovery process pass fast enough. At the same time, adults have a long period of hospitalization with the same recovery.

Mortality in children is located in the region of 5%, in adults - in the region of 8-25%. Little patients have the most favorable outcome of the disease. For adults, a rude residual deficit is often characteristic.

The disease can be characterized by a severe course, resulting in bulbar disorders that can lead to a fatal outcome.

In the form of the consequences of acute scattered encephalomyelitis, residual neurological deficit, leading to deeply disabled, can manifest. Age-related changes They are a risk factor for repeated exacerbations and conversion of the disease into multiple sclerosis.

Some patients acquire persistent symptoms manifested in the form sensory disorders, violations of vision and parares.

Prevention

To prevent the development of the disease, it is necessary to adhere to enough simple rules:

• avoid physical overload during the course of the ailment;

• refuse harmful habits and vaccinations;
• avoid overheating and supercooling the body during vaccination.

Forecast

Acute period Diseases occurs within 1.5-2 weeks. In most cases, the prognosis is favorable. Up to 90% of patients undergo a monophasal flow option. The main part of patients (70-90%) symptoms are subject to regression for six months after the onset of the disease, which is associated with periodization processes.

The forecast is worsening during return and multiphase flow versions. At the same time, the sharp form of the disease goes into chronic, multiple sclerosis begins to develop.

Finally

Acute scattered encephalomyelitis is characterized by violation of the activity of the spine and brain. At the same time, patients may experience various symptoms depending on the affected departments and age. The diagnosis mainly includes the implementation of the MRI of these organs. Treatment during the exacerbation period is carried out in the hospital, includes the reception of corticosteroids and, depending on the accompanying ages - other means. In coordination with the doctor for recovery, phytotherapy can be applied in the complex. More favorable forecast - for the monophasic version of the course of the disease and for children, although in adults at a timely revealed disease and proper holding Treatment - the forecast is good.

Our body is an amazing system, the functions of its systems and organs are closely intertwined between themselves, and any violation in their activities may cause serious diseases. So in certain cases those strength human bodywhich are designed to protect it from aggressive attacks, show their activity against their own tissues. In this case, the doctors talk about autoimmune reactions. Pretty serious disease This type is multiple encephalomyelitis, whose symptoms will consider on this page www.set, as well as treatment, causes of occurrence as well possible consequences Such a disease for human health.

Such a notch, as a scattered encephalomyelitis is an inflammatory defeat of the head, as well as a spinal cord. Such a state is provoked by the aggression of human immunity in relation to its own nervous system. Such an atypical doctor's immune response is called demyelinization. Where does the scattered encephalomy, the reasons for his appearance are taken? Let's talk about it in more detail.

Causes of scattered encephalomyelitis

It is believed that multiple encephalomyelitis develops for several reasons that can be combined with each other. Such a notch often arises due to the hereditary features of the immune system or due to the hereditary features of the nervous system proteins, which make their structure similar to the structure of proteins of various microbes, viral particles and fungi.

Also, the development of scattered encephalomyelitis can be provoked by the depletion of the immune system and of various types of stressful effects, for example, mental stress, operational interventions, injuries, ORVI, herpes, etc.

In certain cases, this disease starts due to the infection of the organism with a microbe, whose proteins are similar in its structure with the proteins of the nervous system. Also, such a pathological condition may occur on the background inflammatory processes (microbial either autoimmune), in cases where proteins destroyed by immunity give as an autoimmune crossover with some proteins of the nervous system.

Symptoms of scattered encephalomyelitis

The main target of immunity with scattered encephalomy is myelin, which is a protein of nerve fibers. Aggressive immunity factors see such proteins as alien, and try to destroy them. As a result, the patient formed the foci of inflammation inside the substance of the head, as well as the spinal cord (the so-called demyelinization foci).

The affected areas lose the ability to perform their functions. For example, when defeating the brain departments responsible for the movement of the hand, this limb begins to weaken. If pathological processes damage the visual bark either speed \u200b\u200bnerveThey become the cause of vision disorder and other violations.

The destruction of the brain sections can lead to numbness, as well as to a decrease in the sensitivity of different parts of the body, sometimes in patients, on the contrary, the sensitivity of some departments of the body increases. Pathological processes often cause weakness of muscles and limbs, the cause of paralysis, the pares, hemipab, paraper, and a monopabe. Also, scattered encephalomyelitis is able to provoke convulsions, spasticity, equilibrium disorders and feelings of coordination, dizziness and precision. Many patients complain about hearing problems, vision and smell, they may also have changes in psyche. A frequent manifestation of the disease is also disturbed pelvic functions.

Negative manifestations in most cases make themselves felt suddenly, for example, after transferred diseases, physical stresses (surgical interventions or supercooling), mental stresses and nervous exhaustion. Yes, it's good to know about it. Yes, just a sense of this not much. The disease does not leave anywhere ... Therefore, it's time to talk about how multiple encephalomyelitis is corrected, the treatment will help consider.

Treatment of scattered encephalomyelitis

Therapy of scattered encephalomyelitis is aimed at eliminating immunity aggression to the cells of the nervous system, while the doctors are trying to preserve the normalistic protective reactions of the organism. The treatment is also designed to restore the activities of the affected brain departments. Patients need to constantly monitor the activities of immunity and adjust it as needed, moreover, it is also necessary to take measures to diagnose and treat all sorts of infectious lesions.

To stop inflammatory processes, the doctor uses most often steroid hormones or intravenous immunoglobulins. To prevent relapses, measures are taken to identify the reasons for the development of scattered encephalomyelitis and, for their correction, eliminate infections and carry out immunocorrorizing treatment.

To restore conductive paths of the nervous system, antioxidants and nootropic drugs are taken. Also, patients are shown motor rehabilitation to eliminate paralysis and spasticity, and to restore the functions of the affected muscles.
It is perfectly treated and cured of the disease. But it is necessary to take care of your health even before you get sick. To such diseases, as considered by us, this also applies. There are no pushing factors - and health will not weaken ... Because those who are not accepted for themselves for themselves to know that there are such a disease with such a disease as a scattered encephalomyelitis, the consequences of this can periodically spoil and subsequent life.

The consequences of scattered encephalomyelitis

As practice shows, with timely diagnosis and adequate treatment, it is quite possible to achieve complete recovery with multiple encephalomyelitis. Some patients may have residual symptoms, and the diseases can often be viewed on MRI throughout life. Sometimes a disease can relap on another neurological picture, which is most often classified by doctors, as the development of multiple sclerosis. In addition, in some cases, pathological processes can develop again, in the absence of old foci on MRI, which makes it possible to conclude about the recurrent scattered encephalomyelite.

Acute scattered encephalomyelitis (Orhem., Odem.) It is an inflammatory demyelinizing disease of the CNS, which is believed to be due to the reaction of hypersensitivity of T cells. This is one of many syndromes that can develop after vaccination or microbial infection, and has a latent period (1-2 weeks). Typical manifestations of this demyelinizing lesion on MRI is the preferential involvement of the white substance of the perivativericular localization. Although, although to a lesser extent, a gray matter of basal ganglia and spinal cord may be affected.

Epidemiology

Usually strength scattered encephalomyelitis It occurs in children or adolescents (usually under 15 years old). However, the literature describes the occurrence of Odem in any age groups . In some studies, seasonal peaks of morbidity per winter and spring are noted, which is well consistent with Odem's infectious theory. Less than 5% of all Codem registered cases occurred after vaccination. Unlike many other demyelinizing diseases (for example, multiple sclerosis or girl's disease) was not revealed greater predisposition in women, and even on the contrary, men are slightly prevailing.

Clinical picture

Usually proceeds as a monophazic disease, while individual cerebral lesions may be on different stages development. In 10% of cases, recurrence develops during the first three months. In contrast to multiple sclerosis, symptoms have more systemic, and include fever, headaches, oppression of the level of consciousness up to coma, cramps and neurological deficit in the form of hemipreps, damage to the cranial and brain nerves, motor disorders, changes in behavior in the form of depression, nonsense or psychosis.

Pathology

Acute scattered encephalomyelitis (Orhem, Odem) occurs as a result of cross-immune response to antigens of the virus provoking aukoimmune defeat central nervous system. In half confirmed cases are detected IgG antibodies Anti-MOG (myelin-oligodendroglyocyte glycoprotein). Pathological sign is limited perivenular inflammation (in English literature - sleekelination sleeves (Sleeves of Demyelination)), which is also characteristic feature sclerosis. However, multiple sclerosis is usually a drain zone of fully demyelinized areas infiltrated by macrophages and reactive astrocytes.

Markers

• spinal brain fluid
  • pleocytosis
  • it is possible to increase the main protein of myelin
• anti-Mog Antibodies

Diagnostics

The manifestations vary from small point to tumor-like lesions having a less pronounced mass effect, which are expected at the same size of the lesion, and localizing both infrates and in the supratenterial white substance of the brain. Unlike multiple sclerosis, defeat morale body Not typically for scattered encephalomyelitis. The lesions are usually bilateral, but at the same time asymmetrical. Defeat of the cortex of the brain, subcortic gray substance (especially thalamus and barrels) is found but not often, and if there is, it allows to differentiate the defeat from multiple sclerosis. In addition to the damage to the gray matter, antibodies can be formed to basal ganglions, causing more diffuse lesions. The involvement of the spinngo of the brain is found only in third cases and is manifested in the form of drain intramedullary lesions of various sizes and the degree of contrast gain.

CT scan

The lesions represent non-timbbled density areas in white substances that may have a ring-shaped contrasting gain.

Magnetic resonance imaging

MRI is more sensitive than CT and demonstrates the features of the demyelinizing process:

• T2.: manifests itself with subcortic areas of an increased signal surrounded by peripocal edema; Perhaps the involvement of the Talamus and the brain stem
• T1 with paramagnetics: point or ring-shaped contrast gain (it is possible to gain in the form of an open ring); No strengthening does not exclude the diagnosis
• Mot.: It is possible to limit diffusion on the periphery; The central part of the lesion (which also has a high signal on T2 and a low signal on T1 suspended images), has neither diffusion limitations (in contrast to the brain abscess), nor the absence of a signal expected at cysts, due to the increase in the content of intracellular water in zone of demyelination.

Magnification transfer can be preparing in the delimitation of Ortem and PC.

Differential diagnosis

• susaca Syndrome (Retinochleocerebral Vasculopathy)
• multiple sclerosis
  • option Marburg
• acute hemorrhagic leuoenetsephalitis (Hurst's disease)

Last updated: 05/17/2017

Literature

1. Morimatsu M. Recurrent Adem or MS? J Intern Med. 43 (8): 647-8. J Intern Med.
2. Honkaniemi J, DastiDar P, Kähärä v, Haapasalo H. Delayed Mr Imaging Changes in Acute Disseminated Encephalomyelitis. AJNR. American Journal of Neuroradiology. 22 (6): 1117-24. PubMed.
3. Inglese M, Salvi F, Iannucci G, Mancardi GL, Mascalchi M, Filippi M. Magnetization Transfer and Diffusion Tensor Mr Imaging of Acute Disseminated Encephalomyelitis. AJNR. American Journal of Neuroradiology. 23 (2): 267-72. PubMed.
4. PubMed.
5. Garg Rk. Acute Disseminated Encephalomyelitis. Postgraduate Medical Journal. 79 (927): 11-7. PubMed.
6. Hynson JL, Kornberg AJ, Coleman LT, SHIELD L, Harvey As, Kean MJ. Clinical and Neuroradiologic Features of Acute Disseminated Encephalomyelitis in Children. Neurology. 56 (10): 1308-12. PubMed.
7. Wong Am, Simon Em, Zimmerman Ra, Wang HS, Toh CH, NG SH. Acute Necrotizing Encephalopathy of Childhood: Correlation of Mr Findings and Clinical Outcome. AJNR. American Journal of Neuroradiology. 27 (9): 1919-23.

Scattered encephalomyelitis is a rare neurological disease that arises as a result of autoimmune violations. Scattered encephalomyelitis develops against the background of viral and infectious diseases leaking with high temperatures. With timely handling medical institution The disease is well amenable to therapy, without the development of complications in the future.

In the Yusupov Hospital perform diagnostics of any complexity. In case of suspected scattered encephalomyelitis, the patient will be examined in the shortest possible time. The earlier the diagnosis is set, the faster it will be started effective treatment. In the Yusupov Hospital use modern equipment.

Scattered Encephalomyelita syndrome

The immune system of a person is aimed at protecting the body from the harmful effect of alien objects (viruses, bacteria, etc.). Elements of the immune system (lymphocytes, leukocytes, macrophages, antibodies) begin to fight pathogenic objects, trying to destroy them. In autoimmune states, the elements of the immune system begin to attack including healthy cells of the body.

Scattered encephalomyelitis refers to autoimmune diseaseswhich occurs pathological processes in the brain. The immune system destroys the myelin shells of neurons, thereby disrupts the work of the cerebral cells.

The launch mechanism for the development of scattered encephalomyelitis is a viral or infectious disease with an increase in body temperature above 38c. Quite often the cause of the development of scattered encephalomy is becoming the infections of the upper respiratory tract. Also encephalomyelitis are able to call:

• herpes virus,
• virus Epstein-Barr,
• cytomegalovirus,
• chickenpox,
• measles,
• pair
• rubella,
• various bacteria.

Scattered encephalomyelitis is more common in childhood, since the immune system of the child is still immature. Sometimes scattered encephalomyelitis occurs after vaccination using a weakened living bacterium, which is also an anomalous reaction of the immune system.

Scattered Encephalomyelitis: Symptoms

First signs neurological pathology Appear one or a few weeks after the first episode of temperature increase. Scattered encephalomyelitis begins as a normal cold with high temperature, fragile in the body. Next arise headaches that are difficult to stop using medicines. After a short period of time, a more pronounced neurological picture is developing:

• confusion of consciousness
• numbness in hand and legs,
• convulsions
• epileptic seizures,
• speech disorders
• shots in the eyes
• swallowing
• drowsiness,
• hallucinations
• breathing disorder
• coma.

For scattered encephalomyelitis, a rapid increase in symptoms is characterized, so it is important not to postpone the visit to the doctor. The Yusupov Hospital works around the clock without days off, there will be help here at any time.

Scattered encephalomyelitis with cerebelchkova attack

Scattered encephalomyelitis affects various parts of the brain. Indimacy clinical picture It will depend on the degree of defeat of one or another site. Often, scattered encephalomyelitis affects the cerebellum, causing a cerebellum ataxia. Pathology is manifested by a violation of coordination of movements of various muscle groups. The clumsiness in movements and discoordination are accompanied by intermittent speech, violation of the coherence of eye movements. The gait is disturbed, involuntary movements of the limbs may occur.

Scattered Encephalomyelitis: Diagnostics

The clinical picture of scattered encephalomyelitis is very similar to scarmed sclerosis. After laboratory and tool methods Diagnostics The diagnosis "scattered encephalomyelitis" is established fairly accurately. To determine the disease, the cerebrospinal fluid is investigated using a lumbar puncture and conduct MRI.

Analysis of the cerebrospinal fluid will show an increase in protein levels and lymphocytes. On MRI will be clearly visible areas of the lesion of the white matter of the brain. White substance - These are nervous fibers that cover the Melinic shell. With scattered encephalomyelitis, the shell is destroyed by forming foci of lesion of various sizes. Visualization of the disease in the images of MRI helps to reliably diagnose.

Scattered Encephalomyelitis: Treatment

For the treatment of scattered encephalomyelitis use medical therapy. The disease is well treatable. The timely start of therapy is the guarantee of rapid recovery and information to a minimum of residual phenomena. For treatment, the following means are used:

• corticosteroids
• plasmapheresis
• antibiotics
• preparations of supporting therapy.

Corticosteroids greatly accelerate the process of recovery during multiple encephalomyelitis. If they do not give the desired result, the plasmapheressee is immediately prescribed. Antibiotics use if scattered encephalomyelitis develops on the background bacterial infection. To normalize the patient's condition, measures are used to reduce the temperature, preparations are used, restoring metabolic processes in the brain (nootropics), and the general fasteners (vitamins, amino acids, etc.).

In the Yusupov hospital, patients get a full range of medical services. The best neurologists of Russia, doctors of science, which have extensive experience in the treatment of neurological diseases (including scattered encephalomyelitis). The patient can receive treatment in a comfortable hospital, where he will be held around the clock qualified assistance. You can make an appointment and get advice from experts by phone.