Demyelinating central nervous system diseases: diagnosis and management – state of the art 2016

Abstract

In the past few years major advancements have been made with regards to the understanding of the pathophysiology of several autoimmune demyelinating diseases of the central nervous system (CNS) such as multiple sclerosis (MS), neuromyelitis optica (NMO), acute disseminated encephalomyelitis (ADEM), Susac syndrome and others. Moreover, recent findings in biomarker research (for example neuroimaging, retinal imaging, blood and CSF markers) may help clinicians with the clinically relevant distinction between various autoimmune CNS demyelinating conditions. This is increasingly relevant as ample clinical experience suggests that – for example – therapies efficacious in MS may be ineffective or even harmful in NMO. In NMO, the recognition of a broader clinical spectrum has led to the proposal of new diagnostic criteria for NMO spectrum disorders (NMOSD) in 2015, and the detection of antibodies to myelin oligodendrocyte glycoprotein (MOG) in some patients with a clinical NMO phenotype has raised the question as to whether these patients should be diagnosed with NMOSD or should receive an alternative diagnosis. Moreover, several new therapeutic options for patients with MS and NMO are emerging. This presentation will give a timely and thorough overview on the current state of the art of diagnosis, management and treatment of demyelinating CNS diseases.