Neuroinflammation Flashcards
what are common causes of neuroinflammation
multiple sclerosis
transverse myelitis
acute disseminating encephalomyelitis (ADEM)
autoimmune encephalitis
neuromyelitis optica spectrum disorder
describe transverse myelitis
inflammation in the spinal cord only
present with a subacute onset of paraparesis, pain and loss of sensation up to the level that marks the inflammation
MRI is important when diagnosing as it may also be caused by external compressive lesions
pathophysiology of acute disseminating encephalomyelitis
acute severe inflammation of the brain, spinal cord or both
lesions are similar in shape and location to MS, round/ovoid in shape but much larger than MS
common symptoms of ADEM
focal brain and spinal cord symptoms that correspond to the site
can also have symptoms that indicate pressure/oedema is building up in the brain (headache, vomiting, fever, seizures, coma, or delirium)
what is autoimmune encephalitis
immune-mediated brain disease, associated with specific autoantibodies to neuronal surface antibodies
can be limbic or encephalitis associated with NMDA receptor antibodies
what are common symptoms of limbic encephalitis
memory impairment (elderly patients can often be misdiagnosed with dementia)
emotional and behavioural disturbance
seizures (fast brief movements of arm and face)
what is the pathophysiology of NMDA associated encephalitis
can be a paraneoplastic disorder
synaptic cleft proteins are targeted
progressive symptoms (often requiring ITU support and coma)
can recover with treatment
what is molecular mimicry in paraneoplastic neurological disorder
infiltration of immune cells leads to ectopic expression of neuronal proteins, this causes the development of specific autoimmune to brain protein
describe neuromyelitis optica spectrum disorder presentation
present with painful, blurred loss of vision in an episode of optic neuritis
can be present with paraparesis or quadriparesis
intractable hiccups and vomiting
what is the mechanism of action for NMO
cause inflammation of the brainstem and in area postrema
associated with antibodies to two cell types, aquaporin-4, and myelin oligodendrocyte glycoprotein (MOG)
what is the mechanism of aquaporin-4
important for water homeostasis across the blood-brain barrier
what does loss of aquaporin-4 lead to
impaired astrocyte function and complement-dependent cytotoxicity
what is the mechanism of oligodendrocyte antibodies
bystander immune damage to oligodendrocytes disrupts the blood-brain barrier which causes oedema and osmotic damage
