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Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
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Related Experiment Video

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Plasmapheresis for neurological disorders.

Alexandra Schröder1, Ralf A Linker, Ralf Gold

  • 1Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse 56, 44791 Bochum, Germany. alexa.schroeder@gmx.de

Expert Review of Neurotherapeutics
|September 23, 2009
PubMed
Summary
This summary is machine-generated.

Therapeutic plasma exchange (PE) removes abnormal blood components to treat neurological disorders. This apheresis method is effective for both acute and chronic immune-mediated conditions, offering a generally well-tolerated treatment option.

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Area of Science:

  • Neurology
  • Immunology
  • Hematology

Background:

  • Apheresis encompasses extracorporeal blood purification techniques to remove abnormal blood constituents.
  • Therapeutic plasma exchange (PE) is the most prevalent apheresis procedure, involving plasma separation and replacement.

Purpose of the Study:

  • To review the application and efficacy of therapeutic plasma exchange in managing immune-mediated neurological disorders.
  • To highlight PE's role in both acute and chronic neurological conditions requiring immunosuppression.

Main Methods:

  • Plasma is separated from cellular blood components and substituted with a replacement fluid.
  • This non-specific method eliminates the entire plasma, including pathogenic immune factors and autoantibodies.

Main Results:

  • PE is utilized for acute conditions like Guillain-Barré syndrome and myasthenic crisis.
  • Successful application in chronic diseases includes chronic inflammatory demyelinating polyneuropathy, paraproteinemic polyneuropathy, stiff person syndrome, and paraneoplastic disorders.
  • PE serves as an escalation therapy for steroid-unresponsive multiple sclerosis relapses.

Conclusions:

  • Therapeutic plasma exchange is a valuable treatment for various immune-mediated neurological disorders.
  • The procedure is generally well-tolerated, with adverse reactions primarily linked to vascular access, replacement fluids, and anticoagulation.