Multiple sclerosis overview: Difference between revisions
No edit summary |
No edit summary |
||
| Line 24: | Line 24: | ||
==Historical Perspective== | ==Historical Perspective== | ||
Multiple sclerosis was first described by a [[neurologist]], Dr jean martin charcot in 1868 and named sclerose en plaque. The [[signs]] and [[symptoms]] including [[dysarthria]], [[ataxia]] and [[tremor]] were called charcot’s triad. | |||
==Classification== | ==Classification== | ||
Multiple sclerosis may be classified into four groups according to [[clinical]] course of the [[disease]] including: Relapsing-remitting, secondary-progressive, | Multiple sclerosis may be classified into four groups according to [[clinical]] course of the [[disease]] including: Relapsing-remitting, secondary-progressive, | ||
| Line 36: | Line 34: | ||
==Pathophysiology== | ==Pathophysiology== | ||
Multiple sclerosis is a [[disease]] of [[central nervous system]] and it’s known to be multi factorial. Whatever the trigger is, it will lead to acquired [[immune response]] followed by [[Inflammation|inflammatory]] reactions. This reactions lead to secretion of [[cytokines]] in [[CNS]] [[parenchyma]] and activation of resident [[microglia]]. [[Microglia]] cells activate [[astrocytes]] to release more [[Inflammation|inflammatory]] [[cytokines]] leading to recruitment and [[Infiltration (medical)|infiltration]] of circulatory [[leukocytes]]. This burst events cause destruction of [[myelin sheath]] and form focal sclerotic white matter plaques which are characteristic of multiple sclerotic disease. | |||
==Causes== | ==Causes== | ||
Multiple sclerosis may be caused by different categories of causes include: [[Autoimmunity]], [[genetic]], [[infectious]] and [[Degeneration (medical)|degeneration]]. | |||
==Differentiating Multiple Sclerosis from other Diseases== | ==Differentiating Multiple Sclerosis from other Diseases== | ||
Multiple sclerosis must be differentiated from other diseases that can mimic this disease [[Clinical|clinically]] or [[Radiological|radiologically]] such as [[Inflammation|Inflammatory]]/[[autoimmune]] conditions, [[Infection|Infections]],[[Metabolic]] and [[Genetic]]/Heriditary Disorders, [[CNS]] [[lymphoma]] and [[Spinal cord|spinal]] diseases. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
The majority of multiple sclerosis cases are reported in northern Europe, continental North America, and Australasia, which is about one of every 1000 citizens. Factors including sunlight exposure, climate, [[diet]], [[toxins]], [[genetic]] factors, geomagnetism, Childhood environmental factors and [[infections]] have been proved to cause this differences in [[MS]] prevalence. [[MS]] is at least two times more common among women than men. | |||
==Risk Factors== | ==Risk Factors== | ||
Common [[risk factors]] in the development of multiple sclerosis are smoking, [[genetic]], [[Ethnic group|ethnic]], [[infection]], low vitamine D and stress. | |||
== Natural History, Complications and Prognosis== | == Natural History, Complications and Prognosis== | ||
Multiple sclerosis usually start between age of fifteen to forty years, rarely before age fifteen or after age sixty with symptoms such as [[optic neuritis]], [[diplopia]], [[sensory]] or motor loss, [[vertigo]] and [[Balance disorder|balance]] problems. It may be classified into four groups according to [[clinical]] course of the [[disease]] including: Relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing.<ref name="pmid8780061">{{cite journal |vauthors=Lublin FD, Reingold SC |title=Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis |journal=Neurology |volume=46 |issue=4 |pages=907–11 |date=April 1996 |pmid=8780061 |doi= |url=}}</ref> [[Complications]] that can develop as a result of mutiple sclerosis are: medication complication, [[Fatigue]]<ref name="pmid16900749">{{cite journal |vauthors=Krupp L |title=Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease |journal=Mult. Scler. |volume=12 |issue=4 |pages=367–8 |date=August 2006 |pmid=16900749 |doi=10.1191/135248506ms1373ed |url=}}</ref>, [[mood]] problems<ref name="pmid8618657">{{cite journal |vauthors=Sadovnick AD, Remick RA, Allen J, Swartz E, Yee IM, Eisen K, Farquhar R, Hashimoto SA, Hooge J, Kastrukoff LF, Morrison W, Nelson J, Oger J, Paty DW |title=Depression and multiple sclerosis |journal=Neurology |volume=46 |issue=3 |pages=628–32 |date=March 1996 |pmid=8618657 |doi= |url=}}</ref>, [[Spasticity]]<ref name="pmid17868019">{{cite journal |vauthors=Boissy AR, Cohen JA |title=Multiple sclerosis symptom management |journal=Expert Rev Neurother |volume=7 |issue=9 |pages=1213–22 |date=September 2007 |pmid=17868019 |doi=10.1586/14737175.7.9.1213 |url=}}</ref>, [[Bowel]] and [[bladder]] dysfunction<ref name="pmid10631634">{{cite journal |vauthors=Hennessey A, Robertson NP, Swingler R, Compston DA |title=Urinary, faecal and sexual dysfunction in patients with multiple sclerosis |journal=J. Neurol. |volume=246 |issue=11 |pages=1027–32 |date=November 1999 |pmid=10631634 |doi= |url=}}</ref>, [[Cognitive impairment]]<ref name="pmid12640060">{{cite journal |vauthors=Achiron A, Barak Y |title=Cognitive impairment in probable multiple sclerosis |journal=J. Neurol. Neurosurg. Psychiatry |volume=74 |issue=4 |pages=443–6 |date=April 2003 |pmid=12640060 |pmc=1738365 |doi= |url=}}</ref><ref name="pmid15774439">{{cite journal |vauthors=Deloire MS, Salort E, Bonnet M, Arimone Y, Boudineau M, Amieva H, Barroso B, Ouallet JC, Pachai C, Galliaud E, Petry KG, Dousset V, Fabrigoule C, Brochet B |title=Cognitive impairment as marker of diffuse brain abnormalities in early relapsing remitting multiple sclerosis |journal=J. Neurol. Neurosurg. Psychiatry |volume=76 |issue=4 |pages=519–26 |date=April 2005 |pmid=15774439 |pmc=1739602 |doi=10.1136/jnnp.2004.045872 |url=}}</ref><ref name="pmid2027484">{{cite journal |vauthors=Rao SM, Leo GJ, Bernardin L, Unverzagt F |title=Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction |journal=Neurology |volume=41 |issue=5 |pages=685–91 |date=May 1991 |pmid=2027484 |doi= |url=}}</ref><ref name="pmid15277630">{{cite journal |vauthors=Huijbregts SC, Kalkers NF, de Sonneville LM, de Groot V, Reuling IE, Polman CH |title=Differences in cognitive impairment of relapsing remitting, secondary, and primary progressive MS |journal=Neurology |volume=63 |issue=2 |pages=335–9 |date=July 2004 |pmid=15277630 |doi= |url=}}</ref>, Heat sensitivity.<ref name="pmid7550931">{{cite journal |vauthors=Selhorst JB, Saul RF |title=Uhthoff and his symptom |journal=J Neuroophthalmol |volume=15 |issue=2 |pages=63–9 |date=June 1995 |pmid=7550931 |doi= |url=}}</ref>, [[Incoordination]]<ref name="pmid25573524">{{cite journal |vauthors=Rinker JR, Salter AR, Walker H, Amara A, Meador W, Cutter GR |title=Prevalence and characteristics of tremor in the NARCOMS multiple sclerosis registry: a cross-sectional survey |journal=BMJ Open |volume=5 |issue=1 |pages=e006714 |date=January 2015 |pmid=25573524 |pmc=4289717 |doi=10.1136/bmjopen-2014-006714 |url=}}</ref>, [[Pain]]<ref name="pmid26087108">{{cite journal |vauthors=Drulovic J, Basic-Kes V, Grgic S, Vojinovic S, Dincic E, Toncev G, Kezic MG, Kisic-Tepavcevic D, Dujmovic I, Mesaros S, Miletic-Drakulic S, Pekmezovic T |title=The Prevalence of Pain in Adults with Multiple Sclerosis: A Multicenter Cross-Sectional Survey |journal=Pain Med |volume=16 |issue=8 |pages=1597–602 |date=August 2015 |pmid=26087108 |doi=10.1111/pme.12731 |url=}}</ref><ref name="pmid23318126">{{cite journal |vauthors=Foley PL, Vesterinen HM, Laird BJ, Sena ES, Colvin LA, Chandran S, MacLeod MR, Fallon MT |title=Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis |journal=Pain |volume=154 |issue=5 |pages=632–42 |date=May 2013 |pmid=23318126 |doi=10.1016/j.pain.2012.12.002 |url=}}</ref>, [[Sexual dysfunction]]<ref name="pmid26003254">{{cite journal |vauthors=Lew-Starowicz M, Gianotten WL |title=Sexual dysfunction in patients with multiple sclerosis |journal=Handb Clin Neurol |volume=130 |issue= |pages=357–70 |date=2015 |pmid=26003254 |doi=10.1016/B978-0-444-63247-0.00020-1 |url=}}</ref><ref name="pmid10618700">{{cite journal |vauthors=Zivadinov R, Zorzon M, Bosco A, Bragadin LM, Moretti R, Bonfigli L, Iona LG, Cazzato G |title=Sexual dysfunction in multiple sclerosis: II. Correlation analysis |journal=Mult. Scler. |volume=5 |issue=6 |pages=428–31 |date=December 1999 |pmid=10618700 |doi=10.1177/135245859900500i610 |url=}}</ref>, Sleep disorders<ref name="pmid17942519">{{cite journal |vauthors=Manconi M, Rocca MA, Ferini-Strambi L, Tortorella P, Agosta F, Comi G, Filippi M |title=Restless legs syndrome is a common finding in multiple sclerosis and correlates with cervical cord damage |journal=Mult. Scler. |volume=14 |issue=1 |pages=86–93 |date=January 2008 |pmid=17942519 |doi=10.1177/1352458507080734 |url=}}</ref><ref name="pmid8787103">{{cite journal |vauthors=Amarenco G, Kerdraon J, Denys P |title=[Bladder and sphincter disorders in multiple sclerosis. Clinical, urodynamic and neurophysiological study of 225 cases] |language=French |journal=Rev. Neurol. (Paris) |volume=151 |issue=12 |pages=722–30 |date=December 1995 |pmid=8787103 |doi= |url=}}</ref><ref name="pmid23078359">{{cite journal |vauthors=Schürks M, Bussfeld P |title=Multiple sclerosis and restless legs syndrome: a systematic review and meta-analysis |journal=Eur. J. Neurol. |volume=20 |issue=4 |pages=605–15 |date=April 2013 |pmid=23078359 |doi=10.1111/j.1468-1331.2012.03873.x |url=}}</ref>, [[vertigo]]<ref name="pmid11094117">{{cite journal |vauthors=Frohman EM, Zhang H, Dewey RB, Hawker KS, Racke MK, Frohman TC |title=Vertigo in MS: utility of positional and particle repositioning maneuvers |journal=Neurology |volume=55 |issue=10 |pages=1566–9 |date=November 2000 |pmid=11094117 |doi= |url=}}</ref>, [[visual loss]]<ref name="pmid16554529">{{cite journal |vauthors=Balcer LJ |title=Clinical practice. Optic neuritis |journal=N. Engl. J. Med. |volume=354 |issue=12 |pages=1273–80 |date=March 2006 |pmid=16554529 |doi=10.1056/NEJMcp053247 |url=}}</ref>. there are some factors associated with a particularly poor [[prognosis]] among [[patients]] with multiple sclerosis such as: Relapsing versus progressive disease<ref name="pmid8017890">{{cite journal |vauthors=Weinshenker BG |title=Natural history of multiple sclerosis |journal=Ann. Neurol. |volume=36 Suppl |issue= |pages=S6–11 |date=1994 |pmid=8017890 |doi= |url=}}</ref><ref name="pmid11078767">{{cite journal |vauthors=Confavreux C, Vukusic S, Moreau T, Adeleine P |title=Relapses and progression of disability in multiple sclerosis |journal=N. Engl. J. Med. |volume=343 |issue=20 |pages=1430–8 |date=November 2000 |pmid=11078767 |doi=10.1056/NEJM200011163432001 |url=}}</ref><ref name="pmid16434648">{{cite journal |vauthors=Tremlett H, Paty D, Devonshire V |title=Disability progression in multiple sclerosis is slower than previously reported |journal=Neurology |volume=66 |issue=2 |pages=172–7 |date=January 2006 |pmid=16434648 |doi=10.1212/01.wnl.0000194259.90286.fe |url=}}</ref>, early symptoms<ref name="pmid17172607">{{cite journal |vauthors=Langer-Gould A, Popat RA, Huang SM, Cobb K, Fontoura P, Gould MK, Nelson LM |title=Clinical and demographic predictors of long-term disability in patients with relapsing-remitting multiple sclerosis: a systematic review |journal=Arch. Neurol. |volume=63 |issue=12 |pages=1686–91 |date=December 2006 |pmid=17172607 |doi=10.1001/archneur.63.12.1686 |url=}}</ref>, Demographics<ref name="pmid15596747">{{cite journal |vauthors=Cree BA, Khan O, Bourdette D, Goodin DS, Cohen JA, Marrie RA, Glidden D, Weinstock-Guttman B, Reich D, Patterson N, Haines JL, Pericak-Vance M, DeLoa C, Oksenberg JR, Hauser SL |title=Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis |journal=Neurology |volume=63 |issue=11 |pages=2039–45 |date=December 2004 |pmid=15596747 |doi= |url=}}</ref>, Sex<ref name="pmid8017890" />, Smoking<ref name="pmid23628463">{{cite journal |vauthors=Roudbari SA, Ansar MM, Yousefzad A |title=Smoking as a risk factor for development of Secondary Progressive Multiple Sclerosis: A study in IRAN, Guilan |journal=J. Neurol. Sci. |volume=330 |issue=1-2 |pages=52–5 |date=July 2013 |pmid=23628463 |doi=10.1016/j.jns.2013.04.003 |url=}}</ref>. | |||
== Diagnosis == | == Diagnosis == | ||
=== | ===History and Symptoms=== | ||
The most common [[symptoms]] of multiple sclerosis include: [[Fatigue]], [[mood]] problems, [[spasticity]], [[bowel]] and [[bladder]] dysfunction, [[cognitive impairment]], eye movement problems, heat sensitivity, [[incoordination]], [[pain]], [[sexual dysfunction]], [[Sleep disorders|sleep disorder]], [[vertigo]] and [[visual loss]]. | |||
=== Physical Examination === | === Physical Examination === | ||
[[Physical examination]] of patients with multiple sclerosis is usually remarkable for [[lhermitte's sign]], [[spasticity]] and increased [[reflexes]], [[internuclear ophthalmoplegia]], [[optic neuritis]] and [[gait disturbance]]. | |||
=== Laboratory Findings === | === Laboratory Findings === | ||
An elevated concentration of [[CSF]] [[oligoclonal bands]] is [[diagnostic]] of multiple sclerosis. | |||
===Imaging Findings=== | ===Imaging Findings=== | ||
On [[MRI]], multiple sclerosis is characterized by [[cerebral]] plaques which are [[demyelinating]] areas. These [[Lesion|lesions]] are commonly ovoid, and located in periventricular [[white matter]], [[cerebellum]] and [[brain stem]]. These lesions are hyperintense on T2 sections of [[MRI]]. | |||
enhanced [[lesions]] in double delayed high dose [[CT scan]] may be helpful in the [[diagnosis]] of multiple sclerosis. | |||
=== Other Diagnostic Studies === | === Other Diagnostic Studies === | ||
[[Visual evoked potential|visual evoked potential studies]] and anti[[myelin]] [[antibodies]] may be helpful in the [[diagnosis]] of multiple sclerosis. | |||
==Treatment== | ==Treatment== | ||
===Medical Therapy=== | ===Medical Therapy=== | ||
The predominant therapy for multiple sclerosis is Disease-modifying treatment in relapsing-remitting multiple sclerosis, [[Immunosuppression|immunosuppressive threpay]] in progressive multiple sclerosis and [[Glucocorticoid]] therapy in acute exacerbation. | |||
=== Surgery === | |||
Surgery can be helpful in controlling [[trigeminal neuralgia]] and [[tremor]] and [[ataxia]]. | |||
=== | === Alternative Therapies === | ||
Alternative treatments for multiple sclerosis are: [[Diet (nutrition)|Dietary]] regimens [[herbal medicine]] ( [[marijuana]] ) [[hyperbaric oxygenation]] [[Martial arts therapy|therapeutic practice of martial arts.]] | |||
=== | === Prevention === | ||
Primary: Effective measures for the [[primary prevention]] of multiple sclerosis include: [[Vitamin D]] supplement, [[smoking]] cessation, early exposure to [[infection]]. | |||
Secondary: There is no established method for [[secondary prevention]] of multiple sclerosis. | |||
Tertiary: There is strong evidence that [[exercise]] therapy can improve [[muscle]] function and [[mobility]] in multiple sclerosis patients. | |||
==References== | ==References== | ||
Revision as of 20:48, 6 March 2018
| https://https://www.youtube.com/watch?v=yzH8ul5PSZ8 |350}} |
|
Multiple sclerosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Multiple sclerosis overview On the Web |
|
American Roentgen Ray Society Images of Multiple sclerosis overview |
|
Risk calculators and risk factors for Multiple sclerosis overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Multiple sclerosis (abbreviated MS, formerly known as disseminated sclerosis or encephalomyelitis disseminata) is a chronic, inflammatory, demyelinating disease that affects the central nervous system (CNS). Disease onset usually occurs in young adults, is more common in women and the disease has a prevalence that ranges between 2 and 150 per 100,000 depending on the country or specific population.[1] MS was first described in 1868 by Jean-Martin Charcot.
MS affects the neurons in the areas of the brain and spinal cord known as the white matter. These cells carry signals in between the grey matter areas, where the processing is done, and between these and the rest of the body. More specifically, MS destroys oligodendrocytes which are the cells responsible for creating and maintaining a fatty layer, known as the myelin sheath, which helps the neurons carry electrical signals. MS results in a thinning or complete loss of myelin and, less frequently, the cutting (transection) of the neuron's extensions or axons. When the myelin is lost, the neurons can no longer effectively conduct their electrical signals. The name multiple sclerosis refers to the scars (scleroses -better known as plaques or lesions) in the white matter. Loss of myelin in these lesions causes some of the symptoms that may vary widely depending upon which signals are interrupted. However, more advanced forms of imaging are now showing that much of the damage happens outside these regions. A consequence of this course of action is that almost any neurological symptom can accompany the disease.
Multiple sclerosis may take several forms, with new symptoms occurring either in discrete attacks (relapsing forms) or slowly accumulating over time (progressive forms). Most people are first diagnosed with relapsing-remitting MS but develop secondary-progressive MS (SPMS) after a number of years. Between attacks, symptoms may resolve completely, but permanent neurological problems often persist, especially as the disease advances.
Although much is known about the mechanisms involved in the disease process, the cause remains elusive. The theory with the most adherents is that it results from attacks to the nervous system by the body's own immune system. Some believe it is a metabolically dependent disease while others think that it might be caused by a virus such as Epstein-Barr. Still other people believe that its virtual absence from the tropics points to a deficiency of vitamin D during childhood.
The disease currently does not have a cure, but several therapies have proven helpful. The aims of treatment are returning function after an attack, preventing new attacks, and preventing disability. As with any treatment, medications have several adverse effects, and many therapies are still under investigation. At the same time different alternative treatments are pursued by many patients, despite the paucity of supporting scientific study.
The prognosis, or expected course of the disease, for a person depends on the subtype of the disease; the characteristics of the individual, the initial symptoms; and the degree of disability the person experiences as time advances. However life expectancy of patients is nearly the same as that of the unaffected population and in many cases a normal life is possible.
Historical Perspective
Multiple sclerosis was first described by a neurologist, Dr jean martin charcot in 1868 and named sclerose en plaque. The signs and symptoms including dysarthria, ataxia and tremor were called charcot’s triad.
Classification
Multiple sclerosis may be classified into four groups according to clinical course of the disease including: Relapsing-remitting, secondary-progressive,
primary-progressive and progressive-relapsing[2]
Other variants of Multiple sclerosis include clinically isolated syndrome and radiologically isolated syndrome.[3]
Pathophysiology
Multiple sclerosis is a disease of central nervous system and it’s known to be multi factorial. Whatever the trigger is, it will lead to acquired immune response followed by inflammatory reactions. This reactions lead to secretion of cytokines in CNS parenchyma and activation of resident microglia. Microglia cells activate astrocytes to release more inflammatory cytokines leading to recruitment and infiltration of circulatory leukocytes. This burst events cause destruction of myelin sheath and form focal sclerotic white matter plaques which are characteristic of multiple sclerotic disease.
Causes
Multiple sclerosis may be caused by different categories of causes include: Autoimmunity, genetic, infectious and degeneration.
Differentiating Multiple Sclerosis from other Diseases
Multiple sclerosis must be differentiated from other diseases that can mimic this disease clinically or radiologically such as Inflammatory/autoimmune conditions, Infections,Metabolic and Genetic/Heriditary Disorders, CNS lymphoma and spinal diseases.
Epidemiology and Demographics
The majority of multiple sclerosis cases are reported in northern Europe, continental North America, and Australasia, which is about one of every 1000 citizens. Factors including sunlight exposure, climate, diet, toxins, genetic factors, geomagnetism, Childhood environmental factors and infections have been proved to cause this differences in MS prevalence. MS is at least two times more common among women than men.
Risk Factors
Common risk factors in the development of multiple sclerosis are smoking, genetic, ethnic, infection, low vitamine D and stress.
Natural History, Complications and Prognosis
Multiple sclerosis usually start between age of fifteen to forty years, rarely before age fifteen or after age sixty with symptoms such as optic neuritis, diplopia, sensory or motor loss, vertigo and balance problems. It may be classified into four groups according to clinical course of the disease including: Relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing.[4] Complications that can develop as a result of mutiple sclerosis are: medication complication, Fatigue[5], mood problems[6], Spasticity[7], Bowel and bladder dysfunction[8], Cognitive impairment[9][10][11][12], Heat sensitivity.[13], Incoordination[14], Pain[15][16], Sexual dysfunction[17][18], Sleep disorders[19][20][21], vertigo[22], visual loss[23]. there are some factors associated with a particularly poor prognosis among patients with multiple sclerosis such as: Relapsing versus progressive disease[24][25][26], early symptoms[27], Demographics[28], Sex[24], Smoking[29].
Diagnosis
History and Symptoms
The most common symptoms of multiple sclerosis include: Fatigue, mood problems, spasticity, bowel and bladder dysfunction, cognitive impairment, eye movement problems, heat sensitivity, incoordination, pain, sexual dysfunction, sleep disorder, vertigo and visual loss.
Physical Examination
Physical examination of patients with multiple sclerosis is usually remarkable for lhermitte's sign, spasticity and increased reflexes, internuclear ophthalmoplegia, optic neuritis and gait disturbance.
Laboratory Findings
An elevated concentration of CSF oligoclonal bands is diagnostic of multiple sclerosis.
Imaging Findings
On MRI, multiple sclerosis is characterized by cerebral plaques which are demyelinating areas. These lesions are commonly ovoid, and located in periventricular white matter, cerebellum and brain stem. These lesions are hyperintense on T2 sections of MRI.
enhanced lesions in double delayed high dose CT scan may be helpful in the diagnosis of multiple sclerosis.
Other Diagnostic Studies
visual evoked potential studies and antimyelin antibodies may be helpful in the diagnosis of multiple sclerosis.
Treatment
Medical Therapy
The predominant therapy for multiple sclerosis is Disease-modifying treatment in relapsing-remitting multiple sclerosis, immunosuppressive threpay in progressive multiple sclerosis and Glucocorticoid therapy in acute exacerbation.
Surgery
Surgery can be helpful in controlling trigeminal neuralgia and tremor and ataxia.
Alternative Therapies
Alternative treatments for multiple sclerosis are: Dietary regimens herbal medicine ( marijuana ) hyperbaric oxygenation therapeutic practice of martial arts.
Prevention
Primary: Effective measures for the primary prevention of multiple sclerosis include: Vitamin D supplement, smoking cessation, early exposure to infection.
Secondary: There is no established method for secondary prevention of multiple sclerosis.
Tertiary: There is strong evidence that exercise therapy can improve muscle function and mobility in multiple sclerosis patients.
References
- ↑ Rosati G (2001). "The prevalence of multiple sclerosis in the world: an update". Neurol. Sci. 22 (2): 117–39. PMID 11603614.
- ↑ Lublin FD; Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology 1996 Apr;46(4):907-11. PMID 8780061
- ↑ Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, Wolinsky JS, Balcer LJ, Banwell B, Barkhof F, Bebo B, Calabresi PA, Clanet M, Comi G, Fox RJ, Freedman MS, Goodman AD, Inglese M, Kappos L, Kieseier BC, Lincoln JA, Lubetzki C, Miller AE, Montalban X, O'Connor PW, Petkau J, Pozzilli C, Rudick RA, Sormani MP, Stüve O, Waubant E, Polman CH (2014). "Defining the clinical course of multiple sclerosis: the 2013 revisions". Neurology. 83 (3): 278–86. doi:10.1212/WNL.0000000000000560. PMC 4117366. PMID 24871874.
- ↑ Lublin FD, Reingold SC (April 1996). "Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis". Neurology. 46 (4): 907–11. PMID 8780061.
- ↑ Krupp L (August 2006). "Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease". Mult. Scler. 12 (4): 367–8. doi:10.1191/135248506ms1373ed. PMID 16900749.
- ↑ Sadovnick AD, Remick RA, Allen J, Swartz E, Yee IM, Eisen K, Farquhar R, Hashimoto SA, Hooge J, Kastrukoff LF, Morrison W, Nelson J, Oger J, Paty DW (March 1996). "Depression and multiple sclerosis". Neurology. 46 (3): 628–32. PMID 8618657.
- ↑ Boissy AR, Cohen JA (September 2007). "Multiple sclerosis symptom management". Expert Rev Neurother. 7 (9): 1213–22. doi:10.1586/14737175.7.9.1213. PMID 17868019.
- ↑ Hennessey A, Robertson NP, Swingler R, Compston DA (November 1999). "Urinary, faecal and sexual dysfunction in patients with multiple sclerosis". J. Neurol. 246 (11): 1027–32. PMID 10631634.
- ↑ Achiron A, Barak Y (April 2003). "Cognitive impairment in probable multiple sclerosis". J. Neurol. Neurosurg. Psychiatry. 74 (4): 443–6. PMC 1738365. PMID 12640060.
- ↑ Deloire MS, Salort E, Bonnet M, Arimone Y, Boudineau M, Amieva H, Barroso B, Ouallet JC, Pachai C, Galliaud E, Petry KG, Dousset V, Fabrigoule C, Brochet B (April 2005). "Cognitive impairment as marker of diffuse brain abnormalities in early relapsing remitting multiple sclerosis". J. Neurol. Neurosurg. Psychiatry. 76 (4): 519–26. doi:10.1136/jnnp.2004.045872. PMC 1739602. PMID 15774439.
- ↑ Rao SM, Leo GJ, Bernardin L, Unverzagt F (May 1991). "Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction". Neurology. 41 (5): 685–91. PMID 2027484.
- ↑ Huijbregts SC, Kalkers NF, de Sonneville LM, de Groot V, Reuling IE, Polman CH (July 2004). "Differences in cognitive impairment of relapsing remitting, secondary, and primary progressive MS". Neurology. 63 (2): 335–9. PMID 15277630.
- ↑ Selhorst JB, Saul RF (June 1995). "Uhthoff and his symptom". J Neuroophthalmol. 15 (2): 63–9. PMID 7550931.
- ↑ Rinker JR, Salter AR, Walker H, Amara A, Meador W, Cutter GR (January 2015). "Prevalence and characteristics of tremor in the NARCOMS multiple sclerosis registry: a cross-sectional survey". BMJ Open. 5 (1): e006714. doi:10.1136/bmjopen-2014-006714. PMC 4289717. PMID 25573524.
- ↑ Drulovic J, Basic-Kes V, Grgic S, Vojinovic S, Dincic E, Toncev G, Kezic MG, Kisic-Tepavcevic D, Dujmovic I, Mesaros S, Miletic-Drakulic S, Pekmezovic T (August 2015). "The Prevalence of Pain in Adults with Multiple Sclerosis: A Multicenter Cross-Sectional Survey". Pain Med. 16 (8): 1597–602. doi:10.1111/pme.12731. PMID 26087108.
- ↑ Foley PL, Vesterinen HM, Laird BJ, Sena ES, Colvin LA, Chandran S, MacLeod MR, Fallon MT (May 2013). "Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis". Pain. 154 (5): 632–42. doi:10.1016/j.pain.2012.12.002. PMID 23318126.
- ↑ Lew-Starowicz M, Gianotten WL (2015). "Sexual dysfunction in patients with multiple sclerosis". Handb Clin Neurol. 130: 357–70. doi:10.1016/B978-0-444-63247-0.00020-1. PMID 26003254.
- ↑ Zivadinov R, Zorzon M, Bosco A, Bragadin LM, Moretti R, Bonfigli L, Iona LG, Cazzato G (December 1999). "Sexual dysfunction in multiple sclerosis: II. Correlation analysis". Mult. Scler. 5 (6): 428–31. doi:10.1177/135245859900500i610. PMID 10618700.
- ↑ Manconi M, Rocca MA, Ferini-Strambi L, Tortorella P, Agosta F, Comi G, Filippi M (January 2008). "Restless legs syndrome is a common finding in multiple sclerosis and correlates with cervical cord damage". Mult. Scler. 14 (1): 86–93. doi:10.1177/1352458507080734. PMID 17942519.
- ↑ Amarenco G, Kerdraon J, Denys P (December 1995). "[Bladder and sphincter disorders in multiple sclerosis. Clinical, urodynamic and neurophysiological study of 225 cases]". Rev. Neurol. (Paris) (in French). 151 (12): 722–30. PMID 8787103.
- ↑ Schürks M, Bussfeld P (April 2013). "Multiple sclerosis and restless legs syndrome: a systematic review and meta-analysis". Eur. J. Neurol. 20 (4): 605–15. doi:10.1111/j.1468-1331.2012.03873.x. PMID 23078359.
- ↑ Frohman EM, Zhang H, Dewey RB, Hawker KS, Racke MK, Frohman TC (November 2000). "Vertigo in MS: utility of positional and particle repositioning maneuvers". Neurology. 55 (10): 1566–9. PMID 11094117.
- ↑ Balcer LJ (March 2006). "Clinical practice. Optic neuritis". N. Engl. J. Med. 354 (12): 1273–80. doi:10.1056/NEJMcp053247. PMID 16554529.
- ↑ 24.0 24.1 Weinshenker BG (1994). "Natural history of multiple sclerosis". Ann. Neurol. 36 Suppl: S6–11. PMID 8017890.
- ↑ Confavreux C, Vukusic S, Moreau T, Adeleine P (November 2000). "Relapses and progression of disability in multiple sclerosis". N. Engl. J. Med. 343 (20): 1430–8. doi:10.1056/NEJM200011163432001. PMID 11078767.
- ↑ Tremlett H, Paty D, Devonshire V (January 2006). "Disability progression in multiple sclerosis is slower than previously reported". Neurology. 66 (2): 172–7. doi:10.1212/01.wnl.0000194259.90286.fe. PMID 16434648.
- ↑ Langer-Gould A, Popat RA, Huang SM, Cobb K, Fontoura P, Gould MK, Nelson LM (December 2006). "Clinical and demographic predictors of long-term disability in patients with relapsing-remitting multiple sclerosis: a systematic review". Arch. Neurol. 63 (12): 1686–91. doi:10.1001/archneur.63.12.1686. PMID 17172607.
- ↑ Cree BA, Khan O, Bourdette D, Goodin DS, Cohen JA, Marrie RA, Glidden D, Weinstock-Guttman B, Reich D, Patterson N, Haines JL, Pericak-Vance M, DeLoa C, Oksenberg JR, Hauser SL (December 2004). "Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis". Neurology. 63 (11): 2039–45. PMID 15596747.
- ↑ Roudbari SA, Ansar MM, Yousefzad A (July 2013). "Smoking as a risk factor for development of Secondary Progressive Multiple Sclerosis: A study in IRAN, Guilan". J. Neurol. Sci. 330 (1–2): 52–5. doi:10.1016/j.jns.2013.04.003. PMID 23628463.