 Hello, I am Dr. Rohit Pai, Consultant Neurologist in KMC Hospital, Ambitur Circle, Mangalore. Today I would like to talk to you about neuro-immunological disorders. Neuro-immunological disorders are disorders which are caused due to production of antibodies which are called as auto-antibodies in the bloodstream which act against the proteins in the brain as well as nervous system. Common neuro-immunological disorders which we see in day-to-day practice are AIDP, CIDP, Mycinogravus and multiple sclerosis. AIDP which is commonly called as GB syndrome is caused by antibodies against the nerves in the body. It can present as weakness of the upper limb and lower limb. In severe cases, it can affect respiratory muscles as well as the autonomic nervous system. When it affects the respiratory muscles, it can cause impaired ventilation and the patient may need mechanical ventilation for his survival. This can be easily diagnosed by an investigation which is called as nerve conduction test. This picks up what we call as demyelination in the nerves. After confirmation of GB syndrome, we can easily treat the patient with two modalities of treatment. The easier modality which we use is intravenous immunoglobulin which is an injection which is given for five days to the patient. It can also be treated by a modality called as plasmapheresis where the blood is purified and plasma is injected into the patient. With this, patient gradually improves over two to three weeks. If this disease progresses beyond two months, we call it as a disease called as CIDP or chronic inflammatory demyelinating polyneuropathy. These two is diagnosed by a nerve conduction test. We may also need a nerve biopsy which is a procedure where a small twig of the nerve is removed and sent for pathological testing. CIDP2 is easily treated with oral medications. We use oral steroids and immunosuppression for CIDP. Myosinogravus is another important neuromunological disorder. Here the autoantibodies form against the neuromuscular junction. The antibodies commonly found in myosinogravus is esthylcholine receptor antibody. This antibody attaches to the esthylcholine receptor and impairs the neuromuscular transmission. Because of this, the patient can present with nervous system disorders like extracular movement problems, ptosis or limb weakness. When it affects only the muscles of the eye, we call it as ocular myosinium. The patient may present with ptosis, extracular muscle palsy which can result in diplopia. It can affect the jaw muscles, bulbar muscles which are responsible for swallowing. If it affects the muscles of the body, we call it as generalized myosinia. In severe cases, it can affect respiratory muscles. When it affects the respiratory muscles, we call it as myosinic crisis. Myosinogravus also can be easily treated with medicines. We usually treat patients with oral steroids and immunosuppression. There are very many newer immunosuppression drugs which can be used in myosinia including rituximab. In cases of crisis where there is respiratory paralysis, patient may require intravenous immunoglobulin or plasmapheresis. Multiple sclerosis is another immunorheumological disorder which we see commonly in day-to-day practice. Here autoendibodies are formed against the white matter proteins in the brain as well as spinal cord. So the patient may present with visual symptoms if it affects the eye, which we call as optic neuritis. If it affects the white matter of the brain, the patient may present with weakness, with imbalance. If it affects the white matter of the spinal cord, the patient may present with weakness of the lower limbs or upper limbs. Or the patient may also have bladder problems. These two can be easily treated. We have injection steroids for acute relapse of multiple sclerosis whereas for a chronic treatment, we use prophylactic medicines. Initially the prophylactic medicines which were used earlier were interferons which were injections. But in today's date and age, we have many oral tablets which one is very convenient for the patient. Two, they are more effective than the injections. So with this multiple sclerosis can be easily treated, managed and we can fight over the disease.