What is Devic's syndrome (opticomyelitis)?

1.What is Devic's syndrome (opticomyelitis)

Devic's syndrome is a special form of multiple sclerosis, characterized by a rapid course and severe symptoms. Pathogenetically, neuromyelitis optica belongs to the group of autoimmune diseases. The neurological manifestations of Devic's syndrome are caused by a combination of optic neuritis and damage to the protective fat-like membrane of the spinal cord (transverse myelitis). Developing symptoms affect vision, motor functions, as well as processes regulated by the autonomic nervous system.

Devic's syndrome predominantly develops in old age, and women are more often affected. Foci of transverse myelitis are usually localized at the level of the thoracic or cervical segment of the spinal cord. Vision may decrease symmetrically or in only one eye. The degree and speed of its loss varies from person to person, up to complete blindness. Severe clinical manifestations also include decreased sensitivity, leading to dysfunction of the intestines and bladder.

The reasons for the development of Devic's syndrome are not clear. There is some connection with past infectious diseases - in most patients, the first manifestations of the disease were preceded by fever and other phenomena characteristic of a viral or bacterial infection. It is difficult to say whether they were a true manifestation of a possible immune reaction to pathogenic flora or whether they represented a prodromal period of neuromyelitis optica itself.

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How to deal with brain demyelination

To date, there is no single treatment method that is equally effective for every patient with brain demyelination. Although new drugs are being introduced every year, there is no way to cure the disease simply by prescribing a certain type of medication. In most cases, conservative complex therapy will be required.

To prescribe a course of treatment, it is necessary to first establish the stage of pathological disorders and the type of disease.

MRI in the diagnosis of demyelination

The human brain protects the skull; strong bones prevent damage to brain tissue. The anatomical structure does not make it possible to examine the patient’s condition and make an accurate diagnosis using a conventional visual examination. The magnetic resonance imaging procedure is intended for this purpose.

A tomography examination is safe and helps to see disturbances in the functioning of different parts of the hemispheres. The MRI method is especially effective if it is necessary to find areas of demyelination of the frontal lobe of the brain, which cannot be done using other diagnostic procedures.

The examination results are absolutely accurate. They help a neurologist or neurosurgeon determine not only disturbances in the activity of neural communication, but also establish the cause of such changes. MRI diagnostics of demyelinating diseases is the “gold standard” in the study of pathological disorders in the functioning of nerve fibers.

Traditional medicine treatment methods

Traditional medicine uses drugs that improve conduction functions and block the development of degenerative changes in brain function. The most difficult thing to treat is an old demyelinating process.

With this diagnosis, the administration of beta-interferons helps reduce the risk of further development of pathological changes and reduces the likelihood of complications by approximately 30%. Additionally, the following drugs are prescribed:

Muscle relaxants - inactive foci of demyelination do not affect the functioning of muscle tissue. But reflexive tension may remain. Muscle relaxants relax the muscle corset and help restore motor functions of the body.
Anti-inflammatory drugs are prescribed for the timely cessation of damage to nerve fibers due to an infectious inflammatory process. At the same time, a complex of antibiotics is prescribed.
Nootropic drugs – help with chronic demyelinating disease. They have a positive effect on brain function and restoration of nerve conduction activity. Together with nootropic drugs, the use of amino acid complexes and neuroprotectors is recommended.

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Traditional medicine for demyelinating disease

Traditional methods of treatment are aimed at relieving unpleasant symptoms and have a beneficial preventive effect.

Traditionally, the following plants are used to treat brain diseases:

Anise lofant is a plant widely used in Tibetan medicine, along with ginseng. The advantage of anise lofant is the long-lasting effect of taking the decoction. The composition is prepared as follows. 1 tbsp. l. crushed leaves, stems or flowers are poured into 250 ml. water. The resulting composition is placed on low heat for approximately 10 minutes. Add a teaspoon of honey to the cooled broth. Take the composition of aniseed lofant, 2 tbsp. l. before every meal.
Diascorea Caucasica - the root is used. You can buy a ready-made crushed composition or prepare it yourself. Used in the form of tea. 0.5 teaspoon of Caucasian diascorea is poured with a glass of boiling water, after which it is treated in a water bath for another 15 minutes. Take 1 tbsp before meals. l.

Folk remedies for the demyelinating process improve blood circulation and stabilize the body's metabolism. Since some medications cannot be taken simultaneously with decoctions of certain plants, you will need to consult your doctor before use.

An abnormal condition of the body in which the white matter (myelin) of the brain is destroyed is called the demyelinating process. This problem is very dangerous. The disease affects the functioning of the entire body, since it is an autoimmune pathology. In recent years, the number of cases of detection of demyelinating diseases has been increasing.

2. Clinical picture and diagnosis of Devic syndrome

Manifestations of Devic's disease are not specific. They may well have a different origin. However, the picture always includes severe neurological disorders, such as:

decreased visual acuity, blindness in one or both eyes;
paralysis and paresis of the lower extremities;/li>
loss of skin sensitivity;
dysfunction of the bladder, intestines, sphincters.

The full symptom complex develops over two months with a gradual increase in the severity of the disorders. The disease occurs in multiphases. Characteristic is the alternation of relative remission with acute periods. Usually, at the first manifestations, patients go to the hospital because they significantly lose important functions. For the purpose of differential diagnosis, a set of diagnostic measures is carried out. Devic's syndrome can be distinguished from other types of multiple sclerosis, as well as any other neurological pathology can be excluded, based on the following signs:

the presence of diffuse foci of inflammation, atypical for multiple sclerosis, leading to cerebral edema and hemorrhages;
magnetic resonance imaging reveals plaques in the spinal cord, optic nerve and periventicular substance;
necrotic lesions affect three or more segments of the spinal cord;
there is a total or subtotal lesion across the diameter;
at the initial stages, thickening of the spinal cord is diagnosed in areas affected by inflammation, and in the long term they atrophy;
The optic disc is also initially characterized by swelling, and subsequently by atrophy;
the brain is affected predominantly by small foci of inflammation.

Devic's syndrome can be differentiated from other diseases with similar symptoms through analysis that identifies specific markers.

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Diagnostic techniques

No specialist can identify the disease based only on the nature of its course. To establish a correct diagnosis for a patient, the doctor will need to resort to a comprehensive examination of the body. To begin with, the physician needs to perform a standard examination of the patient, as a result of which it is possible to determine the nature of the course of the deviation, individual and family predispositions. The doctor is obliged to fully study the medical history. You will need to undergo certain clinical procedures:

Donate blood for biochemical and classical testing.
Give urine for analysis.
Visit a radiologist's office to perform an MRI scan with an additional amplifier in the form of a contrast agent (only this testing method can show the affected areas as accurately as possible, thanks to highly accurate and detailed images).

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3. Treatment options for Devic syndrome and prognosis

Devic's disease can have an acute course. Pathology in this form most often develops as a complication of acute respiratory viral infection and is diagnosed as post-infectious demyelinating encephalomyelitis. In this case, treatment includes intravenous administration of immunoglobulin, methylprednisolone, and corticosteroids. If the disease does not acquire a chronic form, then the prognosis is quite favorable - we can talk about the possibility of a complete cure or with the preservation of minor residual disorders.

Severe chronic forms of Devic syndrome are incurable. The pathology progresses in waves and leads to death. Therapy for such patients includes symptomatic and supportive treatment.

In rare cases, Devic syndrome is diagnosed in children. In this case, the disease, as a rule, has a single-phase acute course. After achieving remission, exacerbations are not typical. Timely treatment, including immunosuppressive therapy and corticosteroids, gives a favorable prognosis. Relapses in those affected in childhood are rare.

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