Myelin is an insulating layer of lipids and proteins surrounding nerves. Myelin damage can cause problems with the nerves’ ability to send and receive electrical messages. Inflammatory disorders often cause myelin damage, but there are other causes.

When you think of myelin, imagine the insulation around an electrical wire.

Damage to myelin can make it harder for you to move around, perform ordinary tasks, and even see what you’re doing sometimes. Fatigue is also common.

Inflammation is one common cause of damage to myelin, but other things can cause demyelination, including:

Discover what disorders that can develop when your nerves experience damage to the myelin sheath around them.

There are two main categories of demyelinating disease: demyelinating disease of the central nervous system (CNS) and demyelinating disease of the peripheral nervous system (PNS).

CNS demyelinating disease

This category of disease includes conditions such as:

PNS demyelinating disease

This category includes conditions such as:

In many of these disorders, the exact cause isn’t known. Scientists are learning more about them, as research is ongoing, but here’s what they know now:

  • Multiple sclerosis: The exact cause is still unknown, although experts believe that genetic and environmental factors may be at work.
  • Optic neuritis: You are at increased risk for developing optic neuritis if you already have MS or NMO. Infections and other diseases sometimes give rise to inflammation of the optic nerve, too. But the exact cause is not yet completely understood.
  • Transverse myelitis: Experts speculate that it could be immune-mediated, or it could be the result of an infection. It sometimes develops as an early symptom of MS.
  • Acute disseminated encephalomyelitis: Again, while scientists still hope to pinpoint an exact cause, the general thinking is that a viral or bacterial infection may cause the inflammation that’s the hallmark of this condition. It tends to affect more children than adults.
  • Neuromyelitis optical: It often strikes in childhood, but it can also affect adults and is more common in women than in men.
  • Adrenoleukodystrophy: This disorder affects the nervous system and the adrenal glands. It’s an X-linked recessive inherited condition, which means that it’s caused by a mutation on a gene on the X chromosome. So it tends to affect more men than women.
  • Chronic inflammatory demyelinating polyneuropathy: Some experts suspect that this may be a chronic version of a common form of Guillain-Barré syndrome (GBS) known as acute inflammatory demyelinating polyneuropathy (AIDP), which appears to be an autoimmune disorder.
  • Guillain-Barré syndrome: Research suggests that there are four subtypes of GBS, and the causes can vary. Infection may be one notable culprit. For example, a recent infection with Campylobacter jejuni bacteria seems to cause GBS in about a quarter of people who are diagnosed.

Once a diagnosis is made, your doctor can begin discussing the most appropriate treatment for you.

  • Multiple sclerosis (MS): There are a number of different FDA-approved preventive treatments for reducing the frequency and severity of MS symptoms, including interferon beta-1a or glatiramer acetate, among others.
  • Optic neuritis: Sometimes optic neuritis symptoms will improve on their own, but your doctor may prescribe steroids to address the inflammation.
  • Transverse myelitis: Treatment may be given to address symptoms and reduce inflammation, and to address any infections that might be present. Possible treatments include: intravenous corticosteroid therapy or plasma exchange therapy.
  • Neuromyelitis optical: Your doctor may prescribe corticosteroids or immunosuppressants to reduce symptoms. Another possible option is a process called plasmapheresis, which removes certain antibodies from your blood that may be contributing to the symptoms.
  • Acute disseminated encephalomyelitis (ADEM): Intravenous steroids like methylprednisolone or oral steroids can help reduce the inflammation caused by ADEM. Plasmapheresis may also be an option with severe cases of this condition.
  • Adrenoleukodystrophy (ALD): One effective treatment for childhood ALD is a hematopoietic stem cell transplant, which is a bone marrow transplant.
  • Chronic inflammatory demyelinating polyneuropathy: The most commonly used treatments include corticosteroids, intravenous immunoglobulin (IVIg), and plasma exchange therapy to help modulate the immune system. Physiotherapy might help you build or maintain muscle strength and function, so you can be as mobile as possible.
  • Guillain-Barré syndrome (GBS): There’s no cure for GBS, but doctors may offer treatment such as high dose immunoglobulin therapy (IVIg) or plasma exchange to ward off nerve damage.

Living a normal life with a demyelinating disease can be challenging. You may encounter trouble seeing well and moving independently at times. These strategies for managing MS and other neurological diseases can help you live your life as fully as possible:

  1. Use voice-to-text software: If you’re living with numbness, tingling, or muscle weakness in your hands and arms, don’t stress yourself even more by trying to write or type.
  2. Use assistive devices or tools: There are devices that can make it easier to open jars, retrieve an item off a high shelf, or use a shower chair to sit upon if it’s too hard to stand.
  3. Choose attire that’s easy to put on and take off: Velcro shoes aren’t just for little kids who can’t tie their shoes. They’re also useful for adults whose hands are weak or shaky.
  4. See a little more clearly: You might try using a vision aid like a magnifying lens if your vision has been affected. Or if you’re experiencing double vision, or diplopia, talk to your doctor about prism glasses, which can help refract the light coming into your eyes to help you see better.
  5. Use a cane: If you’re not as steady on your feet as you’d like to be, try using a cane to give you extra support. Supportive braces might also help. A motorized scooter or wheelchair might be another option to help you get around safely and confidently.
  6. Rearrange your environment: Try to get rid of throw rugs that could trip you, and use non-skid bathmats in the bathroom. Store items that you use regularly within easy reach.
  7. Practice good sleep hygiene: Simple strategies like going to bed each night at the same time, keeping your bedroom cool and dark, and taking time to wind down trying to sleep may help.
  8. Eat a healthy diet: A 2016 randomized controlled trial found that people with MS who ate a low fat, plant-based diet experienced lower levels of fatigue. Ask your doctor about making dietary changes to see if they improve your energy levels.
  9. Seek out occupational therapy: If you’re experiencing muscle weakness, especially in your arms or hands, an occupational therapist may help with strategies.
  10. Join a support group: You aren’t the only one with this disease. Finding a support group, either in person or online, can be a lifeline.

Ongoing research, including research into stem cell therapies, may eventually bear fruit in the form of new effective treatments for a variety of disorders that affect the myelin covering of nerve cells.

In the meantime, communicating with your doctor about your symptoms, using strategies to help with your daily activities, and reaching out for support are good ways to manage your needs.