Demyelination is often secondary to an infectious, ischemic, metabolic, or hereditary disorder or to a toxin (eg, alcohol, ethambutol). In primary demyelinating disorders, cause is unknown, but an autoimmune mechanism is suspected because the disorder sometimes follows a viral infection or viral vaccination.
For other uses, see Realm (disambiguation). A realm /ËrÉlm/ is a community or territory over which a sovereign rules; it is commonly used to describe a kingdom or other monarchical or dynastic state. The Old French word reaume, modern French royaume, was the word first adopted in English; the fixed modern spelling does not appear until the beginning of the 17th century.
Commonwealth realm. A Commonwealth realm is a country in the Commonwealth of Nations which has Queen Elizabeth II as monarch. In each of the countries outside the UK, the Queen appoints a Governor-General to represent her, who, after consulting with the government of the realm, has all of the powers and duties of the queen.