Post on 28-Dec-2015
Multiple SclerosisAlan Chen
4/1/14
General Information
• Other names: disseminated sclerosis or encephalomyelitis disseminata
• Inflammatory disease that affects the insulating covers of nerve cells
• Causes wide range of symptoms • Physical, mental and sometimes
psychiatric
• No known cure or cause
• Affects women twice as often as men
• Disease presents itself between ages 20 and 50
Causes
• Causes are currently not known
• Could be a combination of environmental, genetic, and viral/bacterial components
• Genetics• Probability of inheritance is higher
in relatives of affected person • However, not considered a
“hereditary” condition
• Infectious agents • Some microbes have been
proposed to trigger MS; none confirmed
• Human herpes, Epstein-Barr, measles, mumps, rubella have all been proposed to potentially contribute to MS
Pathophysiology - Lesions • “Multiple sclerosis” scars that
form in the nervous system
• Affects white matter in optic nerve, brain stem, basal ganglia spinal cord • White matter is the
“communication” part of the brain
• Loss of oligodendrocytes thinning or complete loss of myelin sheath • Neurons cannot conduct signals• Scar-like plaque builds up around
damaged neurons
Pathophysiology – Blood-brain Barrier and
Inflammation• Blood-brain barrier becomes
permeable• Mechanism is not completely
understood
• Inflammation caused by T cells entering the BBB and attacking myelin • T cells may recognize myelin
as foreign
• Cytokines and antibodies are released by other immune cells during inflammation, preventing transmission of information • Enhances loss of myelin • Could even cause axon to
break down entirely
Signs and Symptoms
• Most common signs are neurological • Usually associated with
autonomic, visual, motor, sensory problems
• Loss of sensitivity, changes in sensation
• Uhthoff’s phenomenon higher temperatures worsen symptoms
• Lhermitte’s sign electrical sensation running down back when bending your neck
Diagnostic Methods
• Look for key signs• Issues with CNS, neurological signaling problems • Administer neurological exam to test for reduced nerve
function
• Neuroimaging MRI• Show areas of demyelination, lesion, plaque
• Analysis of cerebrospinal fluid• Can provide evidence of inflammation• Test for inflammation markers, such as IgG
• Visual and sensor- evoked potentials• Look for less activity to stimulation in optic and sensory
nerves
Healthy Brain vs. Brain with Multiple Sclerosis
Treatment
• There is no known cure for MS, however there are some therapeutic measures and drugs that one can take to manage the attacks • Intravenous corticosteroids can
assist in decreasing the severity attacks
• Generally, drug therapy has been seen to reduce the severity of attacks, or in some cases can help to reduce the number of attacks and frequency
• Some potential alternative treatments are yoga, relaxation techniques, medical marijuana, acupuncture
• Physical Therapy and Occupational Therapy have been seen to help as well