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Introduction
This is a disease that leads to recurring attacks of symptoms that are neurological. This deterioration in nervous function is related to demyelination which is damage of the myelin sheath which helps electrical impulses to conduct quickly and efficiently down an axon’s length. | |
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Classification
These are determined by the course the disease takes. They are:
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Relapsing-remitting
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Primarily-progressive
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Secondary-progressive
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Progressive-relapsing
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Causes & Risk factors
Underlying causes are yet to be pinpointed.
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Autoimmune attack on myelin producing cells is attributed as the cause.
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Environmental factors-still not understood
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Genetic factors-yet to be understood. Suspected to relate to multiple genes and no single gene abnormality.
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Other factors-a virus as well as hormonal activity are also suspected to cause MS.
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Symptoms and signs
MS symptoms are hard to generalize since every patient is affected differently. The common symptoms come in attacks which vary each time the patient has them.
Here are the types of possible symptoms of multiple sclerosis:
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Sensory-Which include numbness, pain and tingling
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Motor-weakness in limbs, tremors, facial paralysis, spasticity and muscle spasm
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Coordination and Balance-lack of fine motor/gross motor coordination, clumsiness, difficulty in walking, loss of balance
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Speech: Slurry
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Vision: Blurry, blindness
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Non-specific symptoms: fatigue, heat sensitivity, impaired thinking, dizziness
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Diagnosis
A thorough neurological examination and good medical history helps the doctor to identify the aspects that are consistent with Multiple Sclerosis.
Here is the criteria used once all clinical information is gathered:
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Onset of the disease
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Objective symptoms which are preferable to disease of the brain as well as the spinal cord
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MRI evidence
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Investigations
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MRI: It helps to identify, describe, and in some instances date lesions in the brain.
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An electro-physiological test, evoked potentials, examines the impulses travelling through the nerves to know if the impulses are moving normally or too slowly. It includes Brainstem Auditory Evoked Potentials (BAEP), Visual Evoked Potentials (VEP) and Sensory Evoked Potentials (SEP).
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Lumbar Puncture/ CSF examination: It may identify abnormal chemicals (antibodies) or cells that suggest the presence of multiple sclerosis.
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There are no blood tests to diagnose Multiple Sclerosis. However, blood tests may be done to rule out Lyme disease, HIV, some rare genetic disorders and collagen-vascular diseases.
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Treatment
Treatment is aimed at improving quality of life by:
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Minimizing symptom severity
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Treating the symptoms
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Slowing down disease progression
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Preventing attacks
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References
Carroll WM. Oral therapy for multiple sclerosis--sea change or incremental step? N Engl J Med. 2010 Feb 4;362(5):456-8. Epub 2010 Jan 20. | |