Child Neurology Society, Philippines, Inc.
Neuro-inflammation
and Neuro-immunology
What is neuro-inflammation and how does it affect me?
By: Michelle G. Sy, MD
Last edited: September 22, 2025
Inflammation is the immune system’s natural response to injury, illness, or infection. When tissue in the brain or spinal cord becomes inflamed, this is referred to as neuroinflammation.
Any injury to the brain, spine and nerves, causes direct CNS tissue damage and cell dysfunction, and induces inflammatory and repair responses. Whether triggered by a pathogen or by direct damage from a physical impact, both neuro-immune responses and intrinsic repair processes influence functional recovery
The degree of neuroinflammation depends on the context, duration, and course of the primary stimulus or insult. challenges to the peripheral immune system are sensed by the CNS.
Two of the most complex organ systems in the body – the nervous system and the immune system communicate with one another in a bi-directional manner. Normal communication between the brain and immune system involves neuroinflammatory processes that are both beneficial and evolutionarily adaptive, such as behavioral and physiological changes necessary to redirect one’s resources to fight infection, repair tissue and influence brain plasticity. Normal immune response also provides a method for training the innate immune system toward neuro-protectiveness.
Majority of current research looks into​ maladaptive and pathological aspects of neuroinflammation caused by chronic or uncontrolled inflammation, which produce disruptions in the relationship between the immune system and the brain.
What causes neuro-inflammation?
Every organ in the body is being surveilled by the immune system. Short-range and long-range neural–immune communication mechanisms and interactions modulate neuro-inflammatory responses.
About 70% of the cells in the central nervous system are supporting cells or glial cells. Two important types of glial cells are microglia and reactive astrocytes. Microglia act like guards, watching for signs of injury or infection. Astrocytes help control blood flow and chemical levels in the brain to create the best conditions for healing. Immune cells are also stationed in the meninges — the tissue that covers the brain and spinal cord — where they sample fluid as it washes out of the brain. If the cells detect signs of infection, disease or injury, they are prepared to initiate an immune response to confront the problem.
If the brain’s first immune response doesn’t work, glial cells activate a chain of stronger immune responses. Neuropeptides, autonomic modulation and neuro-endocrine molecules influence immune system response. Activated immune cells release inflammatory substances influencing neural cells and pathways.
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While a balanced immune response in the nervous system is healthy--even protective, it is the excessive, maladaptive or chronic neuro-inflammatory response that causes disease.
What are the different neuro-immune or neuro-inflammatory diseases in children?
Inflammation can occur when there is exposure to certain stressors such as medications, toxins and chemicals, trauma, and adverse life events that may trigger an autoimmune response; it can come from infection-triggered mechanisms; some tumors and genetic conditions can incite or contribute to an auto-immune reaction.
When inflammatory processes affect the brain, spinal cord, and peripheral nerves, they produce a variety of symptoms, with some causing immediate decline in function, while others follow a more chronic disease course with multiple complications
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Autoimmune neuro-inflammation results when abnormal immune responses in the nervous system cause increased inflammation and tissue damage. These often result in dramatic changes in the child's level of function. While many conditions improve with the right and timely intervention, widespread damage can lead to permanent and severe disability.
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Chronic neuro-inflammation occurs when the immune system stays activated longer than it should and begins to attack normal cells.
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Studies have shown that inflammation stops some neurons from maturing in the developing brain and has been found to be a risk factor in certain neurodevelopmental, psychiatric and childhood neurodegenerative conditions.​ Even maternal inflammation during pregnancy is associated with an increased risk of neuro-developmental disorders in the offspring
More frequently treated neuro-inflammatory or neuro-immune illnesses in children include the following:
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Autoimmune encephalitis
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Acute disseminated encephalomyelitis
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Rasmussen encephalitis
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Pediatric acute-onset neuropsychiatric syndrome
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Optic Neuritis and Neuromyelitis optica
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Transverse myelitis
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Pediatric multiple sclerosis
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Guillan-Barre syndrome
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Myasthenia gravis
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Dermatomyositis
Management often involves extensive testing in search of evidence of neuro-inflammation which may include imaging, neurophysiologic tests, blood examination and lumbar puncture.
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Treatment options generally include management of symptoms, steroids, immuno-suppressive and immune modulating agents, plasma exchange, and occasionally tumor removal or neuro-surgical intervention.
While much is yet to be known about how neuro-inflammation and auto-immune conditions cause diseases that affect our bodies and brain health, we know that healthy habits and lifestyle choices can vastly improve our body's capacity to decrease inflammation and improve our sense of well-being.
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Continued understanding of the mechanisms of neuro-inflammation at the molecular, cellular, and systems levels is essential to developing treatments and improving ways of protecting the brain from the consequences of inflammation.​
References:
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DiSabato DJ, Quan N, Godbout JP. Neuroinflammation: the devil is in the details. J Neurochem. 2016 Oct;139 Suppl 2(Suppl 2):136-153. doi: 10.1111/jnc.13607. Epub 2016 May 4. PMID: 26990767; PMCID: PMC5025335.
Bersano, A., Engele, J. & Schäfer, M. Neuroinflammation and Brain Disease. BMC Neurol 23, 227 (2023). https://doi.org/10.1186/s12883-023-03252-0
Zhang, W., Xiao, D., Mao, Q. et al. Role of neuroinflammation in neurodegeneration development. Sig Transduct Target Ther 8, 267 (2023). https://doi.org/10.1038/s41392-023-01486-5
Hauptman AJ, Ferrafiat V. Neuroinflammatory syndromes in children. Curr Opin Psychiatry. 2023 Mar 1;36(2):87-95. doi: 10.1097/YCO.0000000000000846. Epub 2023 Jan 3. PMID: 36705007.
Bhagavati S. Autoimmune Disorders of the Nervous System: Pathophysiology, Clinical Features, and Therapy. Front Neurol. 2021 Apr 14;12:664664. doi: 10.3389/fneur.2021.664664. PMID: 33935958; PMCID: PMC8079742.
Gagliano A, Cucinotta F, Giunta I, Di Modica I, De Domenico C, Costanza C, Germanò E, Frankovich J. The Immune/Inflammatory Underpinnings of Neurodevelopmental Disorders and Pediatric Acute-Onset Neuropsychiatric Syndrome: A Scoping Review. International Journal of Molecular Sciences. 2025; 26(16):7767. https://doi.org/10.3390/ijms26167767
