Multiple sclerosis

Posted by e-Medical PPT Friday, September 3, 2010
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged,leading to demyelination and scarring.Multiple sclerosis affects the ability of nerve cells in the brain and spinal cord to communicate with each other. Nerve cells communicate by sending electrical signals called action potentials down long fibers called axons, which are wrapped in an insulating substance called myelin. In MS, the body's own immune system attacks and damages the myelin. When myelin is lost, the axons can no longer effectively conduct signals.Disease onset usually occurs in young adults, and it is more common in females.

Several subtypes, or patterns of progression, have been identified
  • relapsing remitting - characterized by unpredictable relapses followed by periods of months to years of remission with no new signs of disease activity
  • primary progressive - approximately 10–15% of individuals never have remission after their initial MS symptoms
  • secondary progressive - around 65 % of those with an initial relapsing-remitting MS,then begin to have progressive neurologic decline between acute attacks without any definite periods of remission
  • progressive relapsing - from onset, have a steady neurologic decline but also suffer clear superimposed attacks
The person with MS can suffer from any neurological symptom or sign, including changes in sensation such as hypoesthesia and paraesthesia, muscle weakness, muscle spasms, or difficulty in moving; difficulties with coordination and balance (ataxia); dysarthria or dysphagia, visual problems (nystagmus, optic neuritis or diplopia), fatigue, acute or chronic pain, and bladder and bowel difficulties.Cognitive impairment of varying degrees and emotional symptoms of depression or unstable mood are also common.Uhthoff's phenomenon, an exacerbation of extant symptoms due to an exposure to higher than usual ambient temperatures, and Lhermitte's sign, an electrical sensation that runs down the back when bending the neck, are particularly characteristic of MS although not specific.

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