Multiple Sclerosis, A Simple Guide To The Condition, Treatment And Related Conditions

Multiple Sclerosis is a progressive degenerative disease of the central nervous system with recurrent episodes of neurologic dysfunction disconnected in time and space and associated with evidence of demyelization of the central nervous system.
It affects the patient in different areas of the nervous system at various points in time.
The cause is unknown but believed to be related to an auto immune disease resulting from a viral infection.
Multiple sclerosis results in destruction of the myelin surrounding the nerves of the CNS.
The destruction is thought to be caused by the body's immune system attacking the myelin sheath disrupting the transmission of information in the CNS and lead to the symptoms seen in multiple sclerosis.
The typical symptoms of Multiple Sclerosis are multiple and variable which explains its name.
There may be mild cases which do not need treatment or severe cases which need confinement to wheelchairs.
There is a typical course of exacerbations and remissions over a period of years and increased residual neurological deficit
1. Impairment of vision is usually an early sign of MS
2. Diplopia can occur with optic neuritis
3. Unsteady gait due to the effect of the disease on the cerebellum which control balance and co-ordination
4. Paresthesia or tingling sensation in the fingers and toes
5. Weakness of the muscles leading to hemiplegia
6. Facial paresis, vertigo and hearing loss
7. Seizures when foci in the brain are over stimulated
8. Constipation and urinary incontinence may also occur as a result of the weakened muscles
9. One peculiar trait is that higher temperatures aggravate the symptoms in MS patients.
Nerve conduction at higher temperature such as a hot shower cause the slowing in the transmission of messages in nerves that have already lost myelin
The diagnosis of Multiple Sclerosis is difficult and involve
1. History of a multiple symptoms involving the nervous system
2. Physical and neurological examinations for peripheral neurological deficit.
3. Blood count and chemistry, urine analysis is all routine laboratory tests used to rule out other diagnoses
4. Cerebral spinal fluid evaluation may show mild mononuclear pleocytosis (less than 40 cells per cubic meter, protein normal or raised and high gamma globulin IgG.
5. MRI can search for changes within the brain or spinal cord that are particular to multiple sclerosis.
Multiple Sclerosis cannot be cured but can be suppressed:
Supportive measures
1. Bed rest
2. Proper diet and nutrition to strengthen the muscles of the body
3. Physiotherapy to strengthen muscles
4. Occupational therapy to help stimulate the mind
5. Speech therapy for speech and swallowing
6. Social support
7. Avoid triggers
Medications:
1. Glatiramer acetate is able to reduce the relapse rates of multiple sclerosis by about one-third and appears to reduce the overall progression of multiple sclerosis
2. Natalizumab is a monoclonal antibody that binds to white blood cells which are thought to play a role in causing the nervous system damage in multiple sclerosis.
It also reduces the rates of relapses of MS by two thirds.
3. Fingolimod is a daily oral medication to treat MS by reducing the number of lymphocytes which is believed to cause inflammation in MS.
4. Interferon which is an anti-viral agent has found to reduce relapses of MS by one third.
5. Previous treatment used to be ACTH injections and corticosteroids. These are seldom used.
MS is a multiple systemic disease which can affect the muscles, vision, bladder and bowels, cognitive function, genital dysfunction, anxiety and depression

TABLE OF CONTENT
Introduction
Chapter 1 Multiple Sclerosis
Chapter 2 More Facts of Multiple Sclerosis
Chapter 3 Treatment of Multiple Sclerosis
Chapter 4 Sarcoidosis
Chapter 5 Vasculitis
Chapter 6 Hashimoto Thyroiditis
Chapter 7 Transverse Myelitis
Epilogue