Pathological heterogeneity of inflammatory demyelination

Wolfgang Brück, Professor of Neuropathology and Director Department of Neuropathology, University Medical Centre Göttingen, Germany

Multiple sclerosis (MS) belongs to the spectrum of inflammatory demyelinating disorders of the central nervous system including classic MS, acute disseminated encephalomyelitis (ADEM), neuromyelitis optica spectrum disorders (NMOSD) and anti-MOG antibody associated demyelination.

The present lecture summarizes the characteristics of the different disease entities mentioned above and their pathological commonalities and differences. MS reveals extensive white and grey matter demyelination as well as involvement of the normal appearing brain tissue. NMOSD is a primary astrocyte disorder with secondary demyelination. Anti-MOG antibody associated demyelination is heterogeneous and shows features of ADEM-like perivascular demyelination and confluent MS-like demyelination.

In summary, the major pathological differences between the different inflammatory demyelinating disease entities in different disease stages are described in detail.