MultipleSclerosis
What is Multiple Sclerosis? It is an Auto Immune Disease which is when the bodystarts to destroy itself. It is a life-lo...
History of Multiple Sclerosis Multiple Sclerosis, also known as MS, was given its name,multiple because of the numerous si...
What Causes MS?“Despite extensive research, we still don’t know what causes MS” (OConnor 8).  However they have found asso...
Genetic FactorsSex:      Women are more likely to have MS than men by a 2:1ratio. They also think that this is true becaus...
E nvironmental FactorsLatitude:              As you increase latitude, mainly above and below40° latitude, MS is more comm...
What actually happens in the                    Immune System?  “T immune syst – acompl net or ofspeciaized cels a or ns –...
Diagnosing MS• “The most important principle to consider when  diagnosing MS is whether the person fulfils the diagnostic ...
Diagnostic categories of MS    •   “The phrase ‘multiple abnormalities in space and time’ sums up        what a physician ...
Courses of MSListed below are the different paths that MS can take.• Relapse-remitting MS (RRMS): •      Secondary-progres...
Symptoms of MS•   Fatigue                •   Weakness•   Depression             •   Dizziness/Unsteadiness•   Memory chang...
Is disability inevitable? As mentioned above there are numerous  different paths that MS can take you on.“Although MS as a...
Can I still have children?   This question is important to many sufferers. This   question is mainly for women though. It ...
Medications used for MS•   Spasticity- Baclofen, Tizanidine, Diazepam, Dantrolene•   Optic Neuritis- Methlyprednisolone, O...
Disease-Modifying Drugs• Interferon Beta 1a                  • Interferon Beta 1b  (Avonex and Rebif):                   (...
Disease-Modifying Drugs (con’t)• Glatiramer Acetate ( Copaxone):                            “is a       small fragment of ...
At naiv Teament                ler t e r t s•   Acupuncture            • Homeotherapy•   Aromatherapy           • Injectio...
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madicine.Multiplesclerosis.(dr.muhamad tahir)

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madicine.Multiplesclerosis.(dr.muhamad tahir)

  1. 1. MultipleSclerosis
  2. 2. What is Multiple Sclerosis? It is an Auto Immune Disease which is when the bodystarts to destroy itself. It is a life-long disease with no cure. In MS, the body attacks and destroys the fatty tissue calledmyelin that insulates an axon/nerve, and is calleddemyelination. If damage is severe it can also destroy the nerve/axon itself. MS affects the central nervous system and inflames thewhite matter in the brain which creates plaques. White matteris below the top layer of our brain and spinal cord. Plaquesblock a signal from being passed from the body to the spinalcord and brain. Currently in the US, 250,000-300,000 people have beendiagnosed with MS and there are 200 new cases diagnosedevery week.
  3. 3. History of Multiple Sclerosis Multiple Sclerosis, also known as MS, was given its name,multiple because of the numerous sites of demyelination and ‘sclerosis’ which means scarring. “There are accounts of probable MS dating back to the 14th century but the history of the disease really begins in the 19th century with the first illustrations and clear clinical description of the diseasebeginning to appear in 1838” (Barnes 16). It was in Hollandon August 4, 1421, that the earliest descriptions were seen. Even though the previous description, the first actual case was first diagnosed in 1849. It was Jean-Martin Charcot who is credited with giving us the first signs and symptoms of Multiple Sclerosis.
  4. 4. What Causes MS?“Despite extensive research, we still don’t know what causes MS” (OConnor 8). However they have found associations and links between many factors including genetic and environmental.GeneticEnvironmentalSex LatitudeRacial Group SESFamily history Migration Infections
  5. 5. Genetic FactorsSex: Women are more likely to have MS than men by a 2:1ratio. They also think that this is true because women are ingeneral more likely to have an Auto immune Disease.Racial Group: “Whites are more than twice as likelyas other races to develop MS” ( Hope 2).Family History: In a normal population the chanceof someone to exhibit the symptoms of MS is only 0.1%. Now ifsomeone in your family has MS, the risk increases. If your parent,brothers, or sisters (your first-degree relatives) have MS yourchance increases to 3%. If a second-degree relative has it, youonly have a 1% chance of having MS. If both of your parents havethe disease you have a risk of 20%. Other percentages are if youhave a half sister/brother, identical twin, or fraternal twin yourrisks are as follows, 1.5%, 30%, and 3-4%.***Remember that women have a slightly higher risk and that ifone identical twins has MS it is not 100% positive that the othertwin will have MS due to the environmental factors.
  6. 6. E nvironmental FactorsLatitude: As you increase latitude, mainly above and below40° latitude, MS is more common. These are temperate and coolerclimates. It is five times more likely in these regions.SES: Your socioeconomic status can also affect the occurrence ofMS. It is least common in the lower class and in rural residence.Migration: The age at which you may move may also be animportant factor. “If you move before the age of 15, your risk is that ofthe people in the country you move to. If you move after the age of 15,your risk stays fixed at that of the country you grew up in” (O’Connor15).Infection: “They believe MS is a delayed reaction to a viralinfection contracted during childhood by a genetically susceptibleperson” (O’Connor 13). The viral infections may include shingles,chicken pox, measles, or certain herpes. An idea they also have is theage at which you get the infection. The older you are the higher the riskfor MS.***Remember that in warm countries, children contract viruses at ayounger age.
  7. 7. What actually happens in the Immune System? “T immune syst – acompl net or ofspeciaized cels a or ns – defends t bodya inst at cks by he em ex w k l l nd ga he ga ta“for inv der such a ba er , v uses, fungi, a paa es” (Hope 3 Itgoes outl eign a s s ct ia ir nd r sit ). ooking fort inv der a he a s nd kils t In ourbodyw ha e differ a igens, w ca a immune r l hem. e v ent nt hich use n esponse, fordiffer inv der W ent a s. hent r inv dera a igen met t a igen mulipl t destoyt inv der Tcels ae aso impora in t r e he ight a nd nt , he nt t es o r he a . - l r l t nt he olofM T hel keep t immune syst in or a dir l destoyt infect orda ged cel. Howdo t S. hey p he em der nd ecty r he ed ma l hese Tcels knowt tt cel t ae at cking is a inv der W lon ea ofourcels t e ae maker t tl our - l ha he l hey r ta n a ? el ch l her r r s ha etimmune syst knowitis ourow cel orafor body. Since M is aa oimmune disea t tper bodydoes em n l eign S ut se ha sons notknowt differ bet een sel a non- fcels. A hera oft immune syst t tt ae l he ence w f nd sel l not spect he em ha hey r ooking a is t bl br in t he ood- a bar (bbb). T bbb is amembr ne t tsuround t br in a al s subst nces t cr fr t bl t t rier he a ha r he a nd low a o oss om he ood o hecent a ner ous syst Some feelt tt bbb is br ched a some oft immune syst defense cr ov a rl v em. ha he ea nd he em oss er nd ca da ge t t CNS. use ma o he
  8. 8. Diagnosing MS• “The most important principle to consider when diagnosing MS is whether the person fulfils the diagnostic criteria on clinical grounds” (Barnes 29).• To date there is no diagnostic or blood test for MS.• Family physician will send you to a neurologist who goes over your symptoms and history.• You can be given one of four test to help the doctor see if there is damage to the spinal cord and brain. These test are only half of the diagnostic process. The tests you can take are MRI, MRS, evoked potentials, and lumbar puncture.• These tests may be able to rule out a viral infection that can exhibit the same symptoms as an MS attack.• Remember that these tests are just as important as a clinical evaluation.
  9. 9. Diagnostic categories of MS • “The phrase ‘multiple abnormalities in space and time’ sums up what a physician needs to find a diagnosis of MS” (O’Connor 32). • There are three categories of MS; Definite, Probable, and Possible MS. • Definite MS: “Consistent course (relapse-remitting course with at least 2 bouts separated by at least 1 month or slow or stepwise progressive course for at least 6 months) of documented neurological signs of lesions in more than one site of brain or spinal cord white matter” ( Hope 7). The age of onset is between 10 and 50 years of age. • Probable MS: Here the signs are not previously documented and there is one current sign of MS. There is more than one site of lesions, they have a good recovery and have a history of relapse- remitting symptoms. • Possible MS: There is no documented signs of MS and more than one lesion. There is also a history of one relapse-remitting symptoms.
  10. 10. Courses of MSListed below are the different paths that MS can take.• Relapse-remitting MS (RRMS): • Secondary-progressive MS Here you have an attack, go (SPMS): This stage of MS into complete or partial starts with RRMS symptoms remission, then have the and continues on to show signs symptoms return. of PPMS.• Primary-progressive MS • Progressive-relapsing MS (PPMS): Here you continually (PRMS): This is a rare form decline and have no remissions. but here it takes a progressive There may be a temporary route made worse by acute relief in symptoms. attacks.• A few patients have malignant MS which is where they have a • 20% of the people with MS quick decline which leaves have a benign form. Here they them severely disabled or even show little progression after the lead to death. first attack.
  11. 11. Symptoms of MS• Fatigue • Weakness• Depression • Dizziness/Unsteadiness• Memory change • Numbness/Tingling• Pain • Ataxia• Spasticity • Euphoria• Vertigo • Speech disturbance• Tremor • Bladder/Bowel/Sexual• Double Vision/Vision dysfunction Loss
  12. 12. Is disability inevitable? As mentioned above there are numerous different paths that MS can take you on.“Although MS as a disease is much feared, the prognosis in general is not as poor as commonly thought” (Barnes 15). 5-20% of all patients will develop benignMS, and another 33% will have little to no disabilities allowing them to live independently while not in relapse. Only 33% of MS patients will have a severe disability.
  13. 13. Can I still have children? This question is important to many sufferers. This question is mainly for women though. It was once thought that women should not have children at all if she was diagnosed with MS. Actually during the mothers’ last trimester there is a 70% reduction in therelapse rate. The thought behind this process is that themother’s immune system changes so her body does not reject the unborn child who has a different genetic makeup. Although there is a brief decrease in symptoms, within three months after the child is born, there is a similar increase in the relapse rate. Also, be aware of the medication and the effects it will have. Some drugs are not to be taken if you are going to become pregnant, are pregnant, or are nursing.
  14. 14. Medications used for MS• Spasticity- Baclofen, Tizanidine, Diazepam, Dantrolene• Optic Neuritis- Methlyprednisolone, Oral steroids• Fatigue- Antidepressant, Amantadine• Pain- Codeine, Aspirin• Sexual Dysfunction- Viagra, Pravatine• Tremor- Isoniazid, Primidone, Propranolol• Disease-Modifying Drugs- Interferon beta 1a and 1b, and Glatiramer acetate
  15. 15. Disease-Modifying Drugs• Interferon Beta 1a • Interferon Beta 1b (Avonex and Rebif): (Betaseron): is slightly is a protein that is a replica of different from our own human interferon. It suppress interferon. This medication the immune system and helps to does the same thing as beta 1a, maintain the blood-brain but is injected just under the barrier. You inject Avonex into skin every two days. Side the muscle once a week and effects include irritation, Rebif is injected under the skin bruising, and redness at the site three times a week. This drug of injection and the flu like is useful to people who have symptoms. This is also given definite progressive MS. One to people who have definite side effect of the drug is a flu progressive MS. like symptom.
  16. 16. Disease-Modifying Drugs (con’t)• Glatiramer Acetate ( Copaxone): “is a small fragment of a protein that resembles a protein in myelin” ( O’Connor 106). It decrease the reoccurrence of relapse. It is injected just under the skin every day. There is no flu like symptoms but occasional redness may occur at the injection site. A few amount of people do experience brief shortness of breathe.• In summary all three of these drugs decrease relapses by 33%, have manageable side effect, are injected, stabilize the disease, and tend to be costly.
  17. 17. At naiv Teament ler t e r t s• Acupuncture • Homeotherapy• Aromatherapy • Injection of Venom• Cannabis (Marijuana) such as snake and bee• Chiropractic • Massage• Cold Immersion • Meditation• Dietary Supplements • Reflexology• Herbal Medication • Tai Chi • Yoga

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