They say that perivenous demyelination is a hallmark for ADEM instead of MS, and that MS presents something called "confluent demyelination". What is that?
Source: http://www.ncbi.nlm.nih.gov/pubmed/20129932
Distinction between acute disseminated encephalomyelitis and acute multiple sclerosis is often clinically difficult. Perivenous demyelination is the pathological hallmark of acute disseminated encephalomyelitis, whereas confluent demyelination is the hallmark of acute multiple sclerosis. We investigated whether perivenous demyelination versus confluent demyelination distinguishes acute disseminated encephalomyelitis from multiple sclerosis. Patients with perivenous demyelination (n = 13; median age 43 years, range 5-67) on brain biopsy and/or autopsy, ascertained retrospectively, were compared with a cohort with confluent demyelination only (n = 91; 84% multiple sclerosis, 16% isolated syndrome at follow-up; median age 39 years, range 10-69).
what is confluent demyelination?
what is confluent demyelination?
I was looking for perivenous demyelination articles, assuming they would be related to MS, and I have found this one:
Re: what is confluent demyelination?
http://neuropathology-web.org/chapter6/chapter6aMs.html
Huh. Here's what it's not: confluent demyelination is not multiple focal lesions. There's an MRI image of the brain in Shilder's disease and instead of the familiar usual MS lesions, the white just keep going.Schilder's disease is an acute relentlessly progressive form of MS seen most commonly in children and young adults. It causes extensive confluent demyelination instead of multiple focal lesions.
I think it's not saying that all MS that presents with confluent demyelination, but "acute MS" does.frodo wrote:They say that perivenous demyelination is a hallmark for ADEM instead of MS, and that MS presents something called "confluent demyelination". What is that?
Re: what is confluent demyelination?
I suspect it refers to the joining point of two or more veins or arteries which results in localized regions of blood flow turbulence. At this point endothelial cells may be weakened giving rise to localized de-myelination. Similar effects occur on the arterial side near confluences, giving rise to arteriosclerosis inflammation at these points.
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