Acute disseminated encephalomyelitis
Contents:
Description:
Acute disseminated encephalomyelitis belongs to autoimmune demyelinating diseases of a nervous system.
Symptoms of Acute disseminated encephalitis:
The disease sharply begins, often imitating a respiratory infection. Body temperature, sometimes considerably increases. There are a headache, a febricula, psychomotor excitement, paresthesias. All-brain symptoms can be expressed. Usually meningeal signs come to light. On their background in 2-3 days the focal symptoms indicating localization of defeat in a hemisphere or a brainstem and also in a spinal cord join. Spinal symptoms are shown couple - and tetraparesis, usually central character, however sometimes observes the phenomena of peripheral paresis. Often there are disorders of sensitivity on conduction type and disturbances of functions of pelvic bodies. Broun-Sekar's syndrome is possible. At preferential localization in a brainstem bulbar paresis develops, signs of damage of the taking-away and facial nerves sometimes join it. Optic nerves as retrobulbar neuritis also are involved in process. There is a hemiparesis. Cerebellar frustration are available often in the form of a nystagmus and a dynamic ataxy.
In liquor at acute disseminated encephalomyelitis small increase in protein content, a lymphocytic pleocytosis is found (20-100*106/l). During the acute period of a disease in blood the moderate leukocytosis, increase in SOE are noted.
Current and forecast. Disseminated encephalomyelitis proceeds as an acute disease with bystry increase of symptoms and their further regress. In certain cases the disease develops subacutely when symptoms increase within several weeks.
The forecast is favorable. Usually there comes the absolute recovery, however sometimes there are paresis, disorders of sensitivity, decrease in sight. Also the heavy course of acute disseminated encephalomyelitis meets consciousness disturbance, the expressed bulbar frustration and a lethal outcome.
Reasons of Acute disseminated encephalitis:
The opinion on an infectious origin of this disease dominates. Most often the disease develops against the background of the postponed respiratory infection or against the background of purulent sinusitis, otitis. It was not succeeded to identify the exact activator yet. However in a disease pathogeny the leading role is played by the allergic reactions leading to demyelinating process in a head and spinal cord.
The basis of pathomorphologic process is made by the perivascular multiple centers of demyelination with participation of a microglia. Localization of process is various: white matter of big parencephalons, brainstem, spinal cord. Periaksialny demyelinating process is found also in spinal roots and nerves of extremities.
Treatment of Acute disseminated encephalitis:
Symptomatic. During the acute period the desensibilizing, dehydrating drugs are shown. Appoint AKTG (to 80 PIECES a day) or corticosteroids, immunoglobulins. At the expressed bulbar disturbances hold resuscitation events. Use глиатилин, Dibazolum in small doses, group B vitamins, nootropic, neurotyre-tread drugs.
