Download Multiple Sclerosis

Multiple Sclerosis
Alan 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 – Bloodbrain 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