Nerve fibers consist of an axon running through the center and a myelin sheath surrounding it (see figure "Myelin sheath of peripheral nerves, myelin sheath of central nerves"). The myelin sheath is mostly made up of fat and is involved in the mechanism that speeds up electrical conduction in the nerves. Demyelinating diseases occur when this myelin sheath is destroyed (demyelinating changes), and can be caused by viral infections, alcohol and other poisonings, or nutritional disorders, but some have unknown causes. These cases with unknown causes are called idiopathic demyelination, and when people talk about demyelinating diseases, they are usually referring to idiopathic demyelination. It is believed that demyelinating diseases are caused by immune disorders such as allergies and autoimmunity. Since demyelinating lesions occur widely in the cerebrum, cerebellum, brain stem, and spinal cord, various symptoms appear in a complex intertwining manner, such as motor and sensory disorders of the eyes, face, mouth, tongue, throat, and limbs, and rectal and bladder disorders. Multiple sclerosis and acute disseminated encephalomyelitis are two representative demyelinating diseases. Source: Shogakukan Home Medical Library Information |
神経線維(しんけいせんい)は、中心部を走る軸索(じくさく)とその外側をかこむ髄鞘(ずいしょう)から成り立っています(図「末梢神経の髄鞘、中枢神経の髄鞘」)。髄鞘は、大部分が脂肪で構成されていて、神経の電気伝導を速めるしくみにかかわっています。 この髄鞘が破壊される(脱髄変化(だつずいへんか))のが脱髄疾患で、ウイルス感染、アルコールなどによる中毒、栄養障害が原因でおこりますが、原因不明のものもあります。この原因不明のものを特発性脱髄(とくはつせいだつずい)といい、ふつう、脱髄疾患といえば、特発性脱髄をさします。 脱髄疾患は、アレルギー、自己免疫(じこめんえき)などの免疫異常がかかわって発症すると推定されています。脱髄病変が大脳(だいのう)、小脳(しょうのう)、脳幹(のうかん)、脊髄(せきずい)に広く散らばって発生するため、目・顔・口・舌・のど・手足の運動障害や知覚障害、直腸膀胱障害(ちょくちょうぼうこうしょうがい)など、いろいろな症状が複雑に絡み合って出現してきます。多発性硬化症(たはつせいこうかしょう)と急性散在性脳脊髄炎(きゅうせいさんざいせいのうせきずいえん)の2つが脱髄疾患の代表です。 出典 小学館家庭医学館について 情報 |
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