P48. Demyelinating disease affecting the central and peripheral nervous system

Abstract

Inflammatory demyelinating diseases are common in the field of neurology and lead to a destruction of the myelin sheath. Either Oligodendrocytes of the central nervous system (e.g. encephalomyelitis disseminata) or Schwann cells- of the peripheral nervous system (e.g. chronic inflammatory demyelinating polyneuropathy) are affected, but never are both of them at the same time. Within this article we report one of the first documentated two cases of simultaneous demyelination of the central and the peripheral nervous system (Mao and Hu, 2014). First, a 33-year-old male after allogenic stem cell transplantation due to a hodgkins-lymphoma. Our second case is a healthy 28-year-old female patient. Both developed at first a demyelination of the peripheral nervous system and secondly, after four and eight weeks a subacute demyelination of the central nervous system. Both cases showed electrophysiological findings of demyelination, gadolinum -enhanced lesions in MRI and positive oligoclonal bands with high IgG-indices in the cerebrospinal fluid. Up to our knowledge these are the first two cases of a central and a peripheral demyelination. As a consequence of the affection of both: peripheral and central myelin sheath we postulate that there has to be a similar antigen between these two different cell-identities: oligodendrocytes and Schwann cells . Further we address the question of a not yet known pathomechanism, affecting both nervous systems simultaneously and leading to the postulation of a finding of a new demyelinisating disease identity, affecting the two different- and dissimiliar- nervous-systems.