Neuroimmunology
We provide specialized care for multiple sclerosis and other neuroimmune disorders.
What Is Neuroimmunology?
Neuroimmunology is a subspeciality of neurology. It focuses on conditions that occur when your immune system mistakenly attacks healthy cells in your brain, spinal cord and nerves.
Neuroimmune Disorders We Treat
The most common neuroimmune disorder we treat is multiple sclerosis (MS). In MS, your immune system targets myelin, a protein in the tissue that surrounds and protects nerve cells.
This process — called demyelination — damages the underlying nerves. MS affects the brain, spinal cord and eye (optic nerve), causing problems with thinking, movement, vision and other functions.
Other neuroimmune disorders also damage myelin. Because they’re less common than MS but have similar symptoms, they may be misdiagnosed as MS. Examples include:
- Acute disseminated encephalomyelitis (ADEM): ADEM causes inflammation and demyelination in the brain and spinal cord. It usually occurs after a viral or bacterial infection, such as influenza (flu).
- Myelin oligodendrocyte glycoprotein antibody disease (MOGAD): MOGAD causes attacks of inflammation and demyelination in the brain, spinal cord and optic nerve. The attacks may happen only once or repeatedly and worsen over time.
- Neuromyelitis optica spectrum disorder (NMOSD): NMOSD causes inflammation and myelin damage, especially in the optic nerve and spinal cord, where it can cause transverse myelitis. Unlike MS, NMOSD typically doesn’t affect the brain.
- Transverse myelitis (TM): TM causes inflammation, myelin damage and scarring in the spinal cord that interferes with nerve activity. Depending on the severity, TM can be temporary or continue after the inflammation goes away.
Neuroimmune conditions that don’t involve demyelination include:
- Autoimmune encephalitis: This group of conditions causes immune-related inflammation, mainly in the brain, affecting a wide range of brain functions.
- Neurosarcoidosis: Sarcoidosis is a condition in which tiny clusters of inflammatory cells (granulomas) form in organs in the body. In neurosarcoidosis, granulomas can develop in the brain, spinal cord and nerves. Symptoms vary widely but often include seizures, facial paralysis and problems with hearing and balance.
- Stiff person syndrome: In this condition, the immune system disrupts nerve signals in the body, making them overactive. It’s called stiff person syndrome because it causes muscle spasms that can make your body rigid.
Diagnosing Neuroimmune Disorders
Diagnosing neuroimmune conditions requires skill and experience. Our neurologists start by reviewing your symptoms and medical history and performing a neurological exam to assess:
- Involuntary processes, such as breathing, heart rate and digestion
- Muscle reflexes, balance and coordination
- Senses, such as touch, hearing, smell and vision
- Thinking and memory
Other tests we use to diagnose neuroimmune disorders include:
- Blood tests to check for markers of inflammation and irregular immune activity
- Electromyography (EMG) and nerve conduction studies to measure electrical activity in your muscles and nerve signals
- Evoked potentials tests to measure how quickly nerve signals travel to your brain
- Magnetic resonance imaging (MRI) to detect lesions or scarring on the brain, spinal cord or nerves
- Spinal tap to check the fluid around your spinal cord for signs of a neuroimmune disorder
Neuroimmunology Treatments
Neuroimmune diseases may come and go and worsen over time. In general, they don’t have a cure. The goal of treatment is typically to reduce symptoms so you can go about your daily activities.
At Memorial Neuroscience Institute, our neurologists work with a team of specialists to deliver the best possible care. Treatments we offer include:
We use a wide range of medications, including corticosteroids to reduce inflammation and disease-modifying medications to suppress your immune system. Other medications can help relieve symptoms, such as muscle spasms and seizures.
Medications come in different forms, including pills, injections and intravenous (IV) infusions. Memorial Neuroscience Institute pharmacists help us manage your medications and coordinate infusions.
Plasma exchange replaces the liquid part of your blood (plasma) with another fluid. This process removes the proteins your immune system produces to attack myelin (antibodies).
Memorial Rehabilitation Institute provides physical therapy and occupational therapy to help improve movement and reduce muscle stiffness and spasms (spasticity). Therapists also ensure you have the assistive devices you need, such as braces, canes, walkers and wheelchairs.
Other therapies offered by our neurorehabilitation specialists include:
- Baclofen pump: Baclofen is a medication that reduces spasticity. We place a pump under your skin with a thin tube that carries the baclofen to the fluid around your spine.
- Botulinum toxin injections: Botulinum toxin is a medication we inject into muscles to reduce muscle contractions and spasticity.
- Functional electrical stimulation (FES): FES is a treatment that delivers painless electrical impulses to your muscles. We use FES most often to improve strength in the legs, feet and hands.
An essential part of our care is monitoring patients for mental health concerns such as depression and other conditions. We provide care within Memorial’s Neuroscience Institute and also collaborate with other departments based on the patient’s need.
- Outpatient Behavioral Health: When needed, we coordinate referrals for treatment with our outpatient behavioral health team. Treatment and therapies include psychotherapy, access to our Mind/Body Wellness Clinic (which includes therapies such as massage, yoga and acupuncture), and support groups.
MS can cause changes in your brain that affect different functions. You may find it difficult to remember things, make decisions or find the right words. As part of your MS care, we may recommend neuropsychological testing. These specialized tests dive deep into how your brain works to help us identify and track changes over time.
As part of your treatment, your doctor may recommend lifestyle changes, such as quitting smoking, eating healthy and being more active. We understand that change is hard, so we provide resources and encouragement to support your journey.
Neuroimmunology- Part of our Multiple Sclerosis Center
Care for neuroimmunology is offered within Memorial Neuroscience Institute’s Multiple Sclerosis Center, which has been recognized by the National MS Society as a Center for Comprehensive MS Care. This distinction reflects the deep expertise of our neurologists, our team-based approach and care based on the latest research and guidelines.
Learn more about our Multiple Sclerosis Center and what sets us apart.
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Fawad Yousuf, MD Neuro-Hospitalist, Neuroimmunology