[The pathogenesis of postinfectious encephalomyelitis and polyradiculoneuritis]

Area of Science:

• Neuroimmunology
• Infectious Diseases
• Neurology

Context:

• Neurological syndromes can arise after microbial infections, particularly viral ones.
• While most infections resolve without lasting effects, rare cases develop serious post-infectious neurological syndromes.
• These syndromes are presumed to be idiosyncratic immune reactions to the initial infection.

Purpose:

• To explore the immune-mediated pathomechanisms underlying post-infectious neurological syndromes.
• To discuss novel concepts in immunopathogenesis, including anti-idiotypic antibodies, molecular mimicry, superantigens, heat shock proteins, and viral protein immunomodulation.
• To highlight the involvement of humoral and cellular immunity in the pathogenesis of these neurological conditions.

Summary:

• Post-infectious neurological syndromes are characterized by immune-mediated pathomechanisms, as the causative microbe is not directly detectable.
• Pathological findings resemble experimental allergic encephalomyelitis and neuritis, suggesting an autoimmune basis.
• The pathogenesis involves intricate interactions between viruses, the nervous system, and the host's immune response, encompassing both humoral and cellular immunity.

Impact:

• Advances understanding of the complex interplay between infections and neurological disorders.
• Provides insights into the immune system's role in rare but severe post-infectious complications.
• Lays the groundwork for future research aimed at elucidating precise pathomechanisms and potential therapeutic targets.