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Updated: May 24, 2026
10:35
Reliable Isolation of Central Nervous System Microvessels Across Five Vertebrate Groups
Published on: January 12, 2020
[Plasmapheresis in central nervous system disorders].
1U.O. Neurologia IV - Neuroimmunologia e Patologia Muscolare, Fondazione Istituto Neurologico C. Besta, Milano, Italy. antozzi@istituto-besta.it
Summary
Therapeutic plasmapheresis (TPE) shows promise for certain central nervous system (CNS) conditions like neuromyelitis optica and specific autoimmune encephalitides. However, evidence remains limited for its widespread use in most CNS disorders, including paraneoplastic syndromes.
Area of Science:
- Neurology
- Immunology
- Nephrology
Context:
- Therapeutic plasmapheresis (TPE) is established for peripheral nervous system disorders.
- Its application in central nervous system (CNS) disorders lacks robust evidence-based data.
- Current use in CNS conditions often targets severe, refractory cases.
Purpose:
- To review the current evidence and clinical applications of TPE in CNS disorders.
- To evaluate the efficacy of TPE in specific neurological conditions.
- To identify areas where TPE use is supported or not supported by data.
Summary:
- TPE is used in acute demyelinating diseases (e.g., multiple sclerosis, acute encephalomyelitis) unresponsive to corticosteroids.
- Evidence supports TPE for neuromyelitis optica due to anti-aquaporin-4 antibodies.
- TPE shows potential in stiff-person syndrome and limbic encephalitis with specific autoantibodies, and selected refractory epilepsy cases.
Impact:
- Highlights the need for more evidence-based research on TPE in CNS disorders.
- Suggests TPE may be a viable option for specific, severe autoimmune CNS conditions.
- Discourages the use of TPE in most paraneoplastic CNS disorders due to insufficient data.
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