Pathology

Stadelman C, BruckW. Lessons from the neuropathology of atypical forms of multiple sclerosis. NeurolSci. 25: S319-S322 2004

This is an "old" paper since itg describes NMO as "idiopathic." It cites a Brain paper (1999) authored by A Bitsch (that is first initial A, last name.)The lesions are destructive and necrotic with cavitation, acute axonal pathology (spheroids), decreased oligodendrocytes within lesions, many macrophages andgranulocytes and eosinophils. Only sparse CD3+ and CD8+ T lymphocytes are detectable. There was perivascular IGm deposition and the terminal complement component (C9neo antigen) within lesions. There was prominent vascular fibrosis and hyalinization seen. Theyt resemble the antibody-complement mediated pattern of MS suggesting a role for humoral antibodies. Antibody deposition, complement activation and eosinophilic granulocytes suggest a TH2 based immune response.