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What is demyelinating disease of the central nervous system?

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Posted on Tue, 15 Jul 2014
Question: I have been diagnosed with demyelinating disease of the central nervous system and polymyositis by my neurologist...can someone explain what all this is and what I am facing?
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Answered by Dr. Indu Kumar (9 hours later)
Brief Answer:
Please write clinical details & findings.

Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM

It is important to know your clinical details and MRI findings.I am not able to see MRI (Brain)findings with attached report.
Please upload all the reports for better interpretation.

Get well soon.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indu Kumar (8 hours later)
I am sending 2011 and 2013 brain MRI results along with a 2013 EMG report. Will this help?
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Answered by Dr. Indu Kumar (20 hours later)
Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXXX
Thanks for writing back

Sorry for replying late.There was some technical problem in my system.
Any way, I have thoroughly gone through your reports in detail.

In MRI(Brain),FLAIR or T2 weighted tiny hyper intensities less than five in number in deep white matter of brain or periventricular region can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,post traumatic and post infective sequel should also be ruled out with follow up scans.Diabetes mellitus and vitamin B12 deficiency also aggravates the situation.
Hyper intensities more than five in number should be the cause of concern and it need investigations.

You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,vitamin B12 estimation,ultrasound of abdomen.
If there is any more physical problems then it should be treated also.

You need follow up MRI (Brain)scan to see the progression of lesions.Demyelinating disorders are associated with many other neurological findings.You need clinical correlation.

You also need MRI of cervical and upper dorsal spine for proper evaluation of right shoulder weakness.

Mucosal cyst in left maxillary sinus is due to changes in chronic sinusitis.It also doesn't require any intervention.You only need control of sinusitis if you are suffering from it.

EMG report shows inflammatory changes in muscles of both lower limbs and para spinal muscles.However,it is good that nerve conduction study is normal.
It is for this reason,you have been prescribed steroid medicines.It will decrease inflammation in muscles.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. Indu Kumar

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Practicing since :2004

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What is demyelinating disease of the central nervous system?

Brief Answer: Please write clinical details & findings. Detailed Answer: Hello XXXXXXX Thanks for writing to HCM It is important to know your clinical details and MRI findings.I am not able to see MRI (Brain)findings with attached report. Please upload all the reports for better interpretation. Get well soon. Further queries are most welcome. Take Care Dr.Indu XXXXXXX