RT Book, Section
A1 Ropper, Allan H.
A1 Samuels, Martin A.
A1 Klein, Joshua P.
A1 Prasad, Sashank
SR Print(0)
ID 1162596445
T1 Multiple Sclerosis and Other Inflammatory Demyelinating Diseases
T2 Adams and Victor's Principles of Neurology, 11e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9780071842617
LK accessmedicine.mhmedical.com/content.aspx?aid=1162596445
RD 2024/04/19
AB In  the  language  of  neurology,  the  term  demyelinating  disease  has  acquired  a  special  meaning.  To  define  these  diseases  precisely  is  difficult,  for  the  simple  reason  that  there  is  probably  no  disease  in  which  myelin  destruction  is  the  exclusive  pathologic  change.  The  generally  accepted  pathologic  criteria  of  a  demyelinating  disease  are  (1)  destruction  of  the  myelin  sheaths  of  nerve  fibers  with  relative  sparing  of  the  other  elements  of  nervous  tissue,  that  is,  of  axons,  nerve  cells,  and  supporting  structures,  which  are  less  affected;  (2)  infiltration  of  inflammatory  cells,  particularly  in  a  perivenous  distribution;  (3)  lesions  that  are  primarily  in  white  matter,  either  in  multiple  small  disseminated  foci  or  in  larger  foci  spreading  from  one  or  more  centers.  In  most  of  the  demyelinating  diseases,  it  has  been  known  since  the  early  descriptions  that  there  is  some  degree  of  neuronal  and  axonal  degeneration,  but  it  is  the  preferential  effect  on  myelin  that  defines  this  group  of  disorder.  The  most  common  and  important  inflammatory  demyelinating  disease  is  multiple  sclerosis  (MS).