Demyelinating Disorders of the Central Nervous System

Patients with central nervous system (CNS) inflammatory demyelinating disease (IDD) usually have acute relapses of neurologic symptoms that frequently remit spontaneously or after corticosteroid administration; they may also present with a progressive neurodegenerative condition, either de novo or after 1 or more acute relapses. Most patients with acute relapses of demyelinating disease do not have severe disability and can be treated as outpatients. Most hospitalizations for patients with multiple sclerosis (MS), for instance, are for reasons unrelated to MS, such as infection. However, patients with CNS IDD occasionally present with serious, emergent complications caused directly by CNS inflammation or indirectly by secondary complications, either of which can require critical care management.