Multiple sclerosis overview: Difference between revisions
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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. | 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. | ||
==Differentiating Multiple Sclerosis from other Diseases== | |||
The signs and symptoms of MS can be similar to other medical problems, such as [[Devic's disease|neuromyelitis optica]], [[stroke]], [[acute disseminated encephalomyelitis|brain inflammation]],[[infection]]s such as [[Lyme disease]] (which can produce identical MRI lesions and CSF abnormalities<ref>Garcia-Monco JC; Miro Jornet J; Fernandez Villar B; Benach JL; Guerrero Espejo A; Berciano JA. ''[Multiple sclerosis or Lyme disease? a diagnosis problem of exclusion]'' Med Clin (Barc) 1990 May 12;94(18):685-8.PMID 2388492</ref><ref>Hansen K; Cruz M; Link H. ''Oligoclonal Borrelia burgdorferi-specific IgG antibodies in cerebrospinal fluid in Lyme neuroborreliosis.'' J Infect Dis 1990 Jun;161(6):1194-202. PMID 2345300</ref><ref>Schluesener HJ; Martin R; Sticht-Groh V.''Autoimmunity in Lyme disease: molecular cloning of antigens recognized by antibodies in the cerebrospinal fluid.'' Autoimmunity 1989 2(4):323-30. PMID 2491615</ref><ref>Kohler J; Kern U; Kasper J; Rhese-Kupper B; Thoden U. ''Chronic central nervous system involvement in Lyme borreliosis'' Neurology 1988 Jun;38(6):863-7. PMID 3368066</ref>), [[tumor]]s, and other autoimmune problems, such as [[lupus erythematosus|lupus]]. Additional testing may be needed to help distinguish MS from these other problems. | |||
==Treatment== | |||
===Alternative Therapies=== | |||
Different alternative treatments are pursued by many patients, despite the paucity of supporting, comparable, replicated scientific study. Examples are [[Diet (nutrition)|dietary]] regimens,<ref name="pmid17253500">{{cite journal |author=Farinotti M, Simi S, Di Pietrantonj C, ''et al.''|title=Dietary interventions for multiple sclerosis |journal=Cochrane database of systematic reviews (Online) |volume= |issue=1 |pages=CD004192 |year=2007 |pmid=17253500|doi=10.1002/14651858.CD004192.pub2}}</ref>, [[herbal medicine]], including the use of [[marijuana]] to help alleviate symptoms,<ref>{{cite journal |author=Chong MS, Wolff K, Wise K, Tanton C, Winstock A, Silber E |title=Cannabis use in patients with multiple sclerosis |journal=Mult. Scler. |volume=12 |issue=5|pages=646–51|year=2006 |pmid=17086912 |doi=}}</ref><ref>{{cite journal |author=Zajicek JP, Sanders HP, Wright DE, Vickery PJ, Ingram WM, Reilly SM, Nunn AJ, Teare LJ, Fox PJ, Thompson AJ |title=Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up |journal=J. Neurol. Neurosurg. Psychiatr. |volume=76 |issue=12 |pages=1664–9 |year=2005|pmid=16291891|doi=10.1136/jnnp.2005.070136}}</ref> or [[hyperbaric oxygenation]].<ref name="pmid14974004">{{cite journal |author=Bennett M, Heard R|title=Hyperbaric oxygen therapy for multiple sclerosis |journal=Cochrane database of systematic reviews (Online) |volume= |issue=1|pages=CD003057|year=2004 |pmid=14974004 |doi=10.1002/14651858.CD003057.pub2}}</ref> | |||
On the other hand the [[Martial arts therapy|therapeutic practice of martial arts]] such as tai chi, relaxation disciplines such as yoga, or general exercise, seem to mitigate fatigue and improve quality of life.<ref name="pmid15184614">{{cite journal |author=Oken BS, Kishiyama S, Zajdel D, ''et al.''|title=Randomized controlled trial of yoga and exercise in multiple sclerosis |journal=Neurology|volume=62|issue=11 |pages=2058–64 |year=2004 |pmid=15184614 |doi=}}</ref> | |||
===Secondary Prevention=== | |||
A physiotherapist can help to reduce spasticity and avoid the development of [[contracture]]s with techniques such as passive stretching.<ref name="pmid10871810">{{cite journal |author=Cardini RG, Crippa AC, Cattaneo D |title=Update on multiple sclerosis rehabilitation |journal=J. Neurovirol. |volume=6 Suppl 2|issue= |pages=S179–85|year=2000 |pmid=10871810 |doi=}}</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Primary care]] | |||
[[Category:Autoimmune diseases]] | |||
[[Category:Neurological disorders]] | |||
[[Category:multiple sclerosis]] | |||
[[Category:Neurology]] | |||
[[Category:Orthopedics]] | |||
[[Category:Disease]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 20:05, 30 April 2013
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Multiple sclerosis Microchapters |
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Multiple sclerosis overview On the Web |
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American Roentgen Ray Society Images of Multiple sclerosis overview |
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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.
Differentiating Multiple Sclerosis from other Diseases
The signs and symptoms of MS can be similar to other medical problems, such as neuromyelitis optica, stroke, brain inflammation,infections such as Lyme disease (which can produce identical MRI lesions and CSF abnormalities[2][3][4][5]), tumors, and other autoimmune problems, such as lupus. Additional testing may be needed to help distinguish MS from these other problems.
Treatment
Alternative Therapies
Different alternative treatments are pursued by many patients, despite the paucity of supporting, comparable, replicated scientific study. Examples are dietary regimens,[6], herbal medicine, including the use of marijuana to help alleviate symptoms,[7][8] or hyperbaric oxygenation.[9] On the other hand the therapeutic practice of martial arts such as tai chi, relaxation disciplines such as yoga, or general exercise, seem to mitigate fatigue and improve quality of life.[10]
Secondary Prevention
A physiotherapist can help to reduce spasticity and avoid the development of contractures with techniques such as passive stretching.[11]
References
- ↑ Rosati G (2001). "The prevalence of multiple sclerosis in the world: an update". Neurol. Sci. 22 (2): 117–39. PMID 11603614.
- ↑ Garcia-Monco JC; Miro Jornet J; Fernandez Villar B; Benach JL; Guerrero Espejo A; Berciano JA. [Multiple sclerosis or Lyme disease? a diagnosis problem of exclusion] Med Clin (Barc) 1990 May 12;94(18):685-8.PMID 2388492
- ↑ Hansen K; Cruz M; Link H. Oligoclonal Borrelia burgdorferi-specific IgG antibodies in cerebrospinal fluid in Lyme neuroborreliosis. J Infect Dis 1990 Jun;161(6):1194-202. PMID 2345300
- ↑ Schluesener HJ; Martin R; Sticht-Groh V.Autoimmunity in Lyme disease: molecular cloning of antigens recognized by antibodies in the cerebrospinal fluid. Autoimmunity 1989 2(4):323-30. PMID 2491615
- ↑ Kohler J; Kern U; Kasper J; Rhese-Kupper B; Thoden U. Chronic central nervous system involvement in Lyme borreliosis Neurology 1988 Jun;38(6):863-7. PMID 3368066
- ↑ Farinotti M, Simi S, Di Pietrantonj C; et al. (2007). "Dietary interventions for multiple sclerosis". Cochrane database of systematic reviews (Online) (1): CD004192. doi:10.1002/14651858.CD004192.pub2. PMID 17253500.
- ↑ Chong MS, Wolff K, Wise K, Tanton C, Winstock A, Silber E (2006). "Cannabis use in patients with multiple sclerosis". Mult. Scler. 12 (5): 646–51. PMID 17086912.
- ↑ Zajicek JP, Sanders HP, Wright DE, Vickery PJ, Ingram WM, Reilly SM, Nunn AJ, Teare LJ, Fox PJ, Thompson AJ (2005). "Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up". J. Neurol. Neurosurg. Psychiatr. 76 (12): 1664–9. doi:10.1136/jnnp.2005.070136. PMID 16291891.
- ↑ Bennett M, Heard R (2004). "Hyperbaric oxygen therapy for multiple sclerosis". Cochrane database of systematic reviews (Online) (1): CD003057. doi:10.1002/14651858.CD003057.pub2. PMID 14974004.
- ↑ Oken BS, Kishiyama S, Zajdel D; et al. (2004). "Randomized controlled trial of yoga and exercise in multiple sclerosis". Neurology. 62 (11): 2058–64. PMID 15184614.
- ↑ Cardini RG, Crippa AC, Cattaneo D (2000). "Update on multiple sclerosis rehabilitation". J. Neurovirol. 6 Suppl 2: S179–85. PMID 10871810.