Single schwaan

This improvement occurs over weeks to months and many patients, even those who are severely affected, recover completely.

The more severe the symptoms and the older the patient, the more likely there is to be residual damage.

Multiple sclerosis has been defined as "multiple white matter lesions separated in space and time".The diagnosis of the condition can be tricky especially at the onset.As with GBS (and for the same reason) it often abolishes reflexes even in clinically unaffected muscles.The putative mechanism for the condition is "molecular mimicry" with either the microbe itself or the changes in body cells produced by infectious agents producing an immune reaction that finds similar epitopes expressed on the Schwann cell.Typically, after a period of progression that can last a week or two, the condition stabilizes and then spontaneously improves (with proliferation of the Schwann cells and reconstitution of the myelin sheath).

Single schwaan

This condition often involves the largest sensory nerve fibers as well.Because the largest, most heavily myelinated sensory fibers are the muscle stretch fibers, and since these fibers and the motor axons are direct parts of the reflex arc, deep tendon reflexes are almost always lost very early in the course of the condition, even in muscles that are not yet clinically weak.Therefore, some demyelinating disorders attack the central nervous system (the prototype is multiple sclerosis), while others affect the peripheral nervous system (the prototype being Guillain-Barre syndrome).There is evidence that the Guillain-Barre Syndrome (GBS) is mediated by immune attack on peripheral nerve myelin.This group of diseases (see Table 23-1) is characterized by lesions that are associated with loss of myelin with relative sparing of axons.


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