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Myelin is a soft, white, fatty material that protect cell membranes. Acute demyelination is rapid stripping of the protective myelin sheaths that cover the nerves. This differs from chronic diseases which slowly erode myelin over time, causing progressive symptoms. Multiple sclerosis (MS) is an example of a chronic demyelinating disease, while Guillain-Barré is an acute condition. Such diseases can be challenging to treat, depending on the underlying cause, and patients may need physical therapy and other interventions to retain function in the wake of myelin injuries.
Patients can develop acute demyelination for a number of reasons. One potential cause is an acute and rapid immune reaction, where the body mistakenly identifies proteins found in myelin as invaders and starts attacking them. This can be seen with Guillain-Barré, also known as acute inflammatory demyelinating polyradiculppathy (AIDP). Another issue can be exposure to toxins like organophosphates, which rapidly destroy myelin in the body.
As myelin erodes, nerves cannot conduct signals as efficiently and accurately. The patient might start to develop tremors, loss of muscle control, and stiffness. Pain can occur along the affected nerves, along with weakness. If the condition spreads, it can cause increasingly serious symptoms, eventually leading to respiratory failure when the nerves that control breathing can no longer function.
This makes it impossible to breathe independently, which means they may need mechanical ventilation to live. It can also expose patients to risks like pneumonia from food aspiration, as they often lose control over chewing and swallowing as well. Acute demyelination patients may require carefully managed care to get adequate nutrition and respiratory support.
If a doctor suspects acute demyelination on the basis of symptoms, medical imaging can provide information. It may also be necessary to take biopsy specimens and blood samples to learn more about the processes inside the patient. Understanding the case can help the doctor prescribe a course of treatment. Anti-inflammatory drugs, for example, can suppress immune reactions to stop the body before it eats its own myelin, while supportive care may help people recover from organophosphate exposure.
Stabilizing a patient with acute demyelination is important, as is attempting to arrest the damage to prevent further injury. Once the patient’s condition appears to be stable, the doctor can discuss options like therapy to improve muscle strength and coordination. This can help a patient retain independence and may allow people to return to previous activities, depending on the location and extent of the damage. Recommendations to prevent a repeat of the injury may also be provided, such as controlling pesticides better to limit exposure to organophosphates.