Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system characterized by inflammation, demyelination, axonal loss and gliosis. It is considered an autoimmune disease where the body's immune system attacks the protective myelin sheath surrounding the nerves. There are several types including relapsing-remitting MS where patients experience clearly defined attacks followed by periods of remission, primary progressive MS where symptoms worsen from the onset without remission, and secondary progressive MS where an initial relapsing-remitting course transitions to progressive worsening over time. Symptoms vary between patients and over time but can include sensory impairment, visual impairment, motor impairment, cognitive issues, and bladder/bowel
Here is very good and amazing presentation on Multiple sclerosis ..its about brain
read this carefully and work on this because the work on brain is very good for future research...
Here is very good and amazing presentation on Multiple sclerosis ..its about brain
read this carefully and work on this because the work on brain is very good for future research...
Multiple sclerosis (MS) is a demyelinating disease of central nervous system which includes brain and spinal cord.
it affect the myelin and by damaging the the myelin producing cell -Oligodendrocytes, which leads to sensory, motor and cognitive problems.
Multiple sclerosis: Introduction, Risk Factors, Diagnosis and TreatmentEnriqueAlvarez93
Introduction about Multiple Sclerosis.
Risk factors affect to Multiple Sclerosis.
When to Suspect Multiple Sclerosis.
Evaluation and Diagnosis of Multiple Sclerosis.
How to treatment of Multiple Sclerosis.
Treatment of Multiple Sclerosis with Monoclonal Antibody.
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
Multiple sclerosis (MS) is a demyelinating disease of central nervous system which includes brain and spinal cord.
it affect the myelin and by damaging the the myelin producing cell -Oligodendrocytes, which leads to sensory, motor and cognitive problems.
Multiple sclerosis: Introduction, Risk Factors, Diagnosis and TreatmentEnriqueAlvarez93
Introduction about Multiple Sclerosis.
Risk factors affect to Multiple Sclerosis.
When to Suspect Multiple Sclerosis.
Evaluation and Diagnosis of Multiple Sclerosis.
How to treatment of Multiple Sclerosis.
Treatment of Multiple Sclerosis with Monoclonal Antibody.
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
Understanding, Diagnosing, and Classifying MS Symptom Managementericss1234_msvn
Understanding, Diagnosing, and Classifying MS Symptom Management. Presented by Tricia Pagnotta, MSN, ARNP, CNRN, MSCN at the MS Views and News Education Seminar Maitland, Fl on April 2013
Multiple sclerosis (MS) is a chronic, sometimes disabling, disease of the central nervous system affecting approximately 400,000 people in the United States, according to the National Multiple Sclerosis Society. It affects two to three times as many women as men
A brief description about Demyelination topics by Dr Sabu Augustine for MBBS Students in Medical school.
References from textbooks and other presentations.
references:
Phases and Phenotypes of Multiple Sclerosis By Orhun H. Kantarci, MD.
Diagnosis of Multiple Sclerosis By Jiwon Oh, MD, PhD, FRCPC
Nature Reviews | Disease Primers
Multiple sclerosis Massimo Filippi1,2*, Amit Bar- Or3, Fredrik Piehl4,5,6, Paolo Preziosa1,2, Alessandra Solari7, Sandra Vukusic8 and Maria A. Rocca1,2
Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS , the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
2. Definition
Multiple sclerosis
Multiple sclerosis is a chronic inflammatory
demyelinating disease of the central nervous
system manifested morphologically by
inflammation, demyelination, axonal loss and
gliosis.
3. Dr.Jean Charcot charcot in 1868 who
defined the disease by its
characteristic clinical and
pathological finding paralysis and
cardinal symptoms of nystagmus,
intention tremor and scanning
speech, later termed as Charcot triad.
Cardinal features
4. Ethology
• The precise ethology is unknown. Its an autoimmune disease in which body own auto
immune attacks the CNS.
• Exposure to common viruses- Rubella, Rubeola, Canine distemper
• Genetic factors- MHC protein, encoded on the chromosome 6 that linked to antibody
production and MS.
• Epidemiological factors-Northern US, Northern europe, Southern Canada,
Scandenavian countries
5. Pathophysiology
The pathologic hallmark of multiple sclerosis (MS) is multiple focal areas of myelin loss
within the CNS called plaques or lesions.Demyelination is accompanied by variable gliosis
and inflammation and by relative axonal preservation. Lesions are disseminated throughout
the CNS but have a predilection for optic nerves, subpial spinal cord, brainstem, cerebellum
The, and juxtacortical and periventricular white matter regions. Although MS has historically
been considered a disease primarily affecting the CNS white matter, recent pathologic and
imaging studies have established that demyelinated lesions are also commonly found in the
cortical grey matter of MS patients.
8. Sensory impairment
• Paresthesias- Pin and needle sensation
• Numbness
• Disturbance of position sense and vibration sense
• Dysesthesia- abnormal burning and aching (common in MS)
• Hyperpathia
• Trigeminal neuralgia
• Lhermitte’s sign
• Chronic pain
9. Visual impairment
• Impairment of optic nerve alter visual acuity rarely blindness
• Optic neuritis
• Scotoma - A dark spot at the centre of visual field
• Pain may present behind the eyes worsen with eye movements
• Marcus Gunn pupil
• Nystagmus and internuclear ophthalmoplegia
• Diplopia
10. Motor impairment
• Upper motor neurone syndrome due damage of corticospinal tract causes paresis,
spasticity, brisk tendon reflexes, involuntary flexor and extensor spam, clonus,
Babinski’s sign, exaggerated cutaneous reflexes and of precise autonomic control.
• Movements become slow and week due to loss of orderly recruitment and reduced
firing
• Fatigue- relatively refreshed in the morning and worsened fatigue in afternoon and
evening. Heat, humidity, stress, depression, vigorous exercise aggravate the fatigue.
Improvement has been reported with rest, sleep, moderate exercise, prayer, relaxation,
cooled water bath.
11. • Demyelinating lesion of cerebellum
and its tracts are common it leads to
Ataxia, postural tremor, ataxia during
gait, intention tremor ie gross tremor
or fine tremor
• dysmetria, dyssynergia,
dysdiadochokinesia
• Dizziness, vertigo, nausea, worsen
with eye and head movement. This
leads to a period of hyperventilation
Cerebellum and brain stem
involvement produce dysarthria,
scanning speech, dysphagia,
aspiration pneumonia can develop.
• Dysphagia leads to poor nutritional
intake and dehydration and weight
loss
12. Cognitive and behavioural dysfunction
• Deficit of memory, attention, concentration, learning , conceptional reasoning, speed of
information processing and reaction time and executive functions.
• Frontal lesion causes cognitive inflexibility, global dementia may occur in malignant
• MS. Depression is common in MS patient
• Emotional dysregulation, Euphoria, bipolar affective disorders
13. Bladder and bowel dysfunction
• Loss of volitional and synergistic control of micturition reflexes due to demyelination of
posterior and lateral spinal tracts
• Types of bladder dysfunction includes spastic, flaccid and dyssynergic bladder.
Common symptom includes urinary urgency, urinary frequency, hesitancy in starting
urination, nocturne, dribbling and incontinence. Recurrent urinary infection are
common.
• Bowel dysfunction may also occur. The CNS lesion affects gastrocolic reflex.
Constipation may occurs due to inactivity, less water intake and as the Side effect of
drug.
• Sexual dysfunction may occurs.
14. Pattern of symptoms
• Vary greatly from person to person
• Vary over time in each individual affected
• First symptoms usually in young adults
• Early symptoms are usually transient and it include problem with vision.
• Problem develop in more than one nervous system function.
• Acute symptoms followed by months or years and usually followed by month or years of
remission.
15. Exacerbating factors
• Bacterial and viral infection( cold, flu, hepatitis)
• Change in the chemical composition of blood affects normal brain and spinal cord
function.
• stress( loss of job, divorce, death)
• Uthoff’s symptom- heat worsen Ms temporary ie hot bath, hot weather, increased
internal body temperature.
• Hyperventilation also occurs as symptoms worsen.
• Dehydration, malnutrition, and sleep deprivation affects.
16. Assessment
• Cognitive assessement-MMSE
• Affective and psychosocial function
• Sensory integrity
• Visual assessment
• Pain assessment
• Cranial nerve assessment
• ROM assessment
• Postural assessment
17. • Assessment of muscle performance- MMT,isokinetic dynamometer
• Fatigue assessment- modified fatigue impact scale
• Assessment of temperature sensitivity- tympanic membrane thermometer
• Assessment of motor function
• a)corticospinal sign assessment, b)cerebellar sign, c) vestibular dysfunction
• Assessment of gait and locomotion
• Assessment of assistive devices
• Assessment of balance
• Assessment aerobic capacity and endurance
18. • Assessment of skin integrity and condition
• Functional assessment
• Environmental assessment
• General health measures
• Disease specific measures
• Expanded disability status measures
• Minimum record of disability
• Multifunctional quality of life measures.
20. Relapsing And remitting MS
The most common disease course – is characterised by clearly defined attacks of new or
increasing neurologic symptoms. These attacks also called relapses or exacerbations – are
followed by periods of partial or complete recovery (remissions). During remissions, all
symptoms may disappear, or some symptoms may continue and become permanent.However,
there is no apparent progression of the disease during the periods of remission. At different
points in time, RRMS can be further characterized as either active (with relapses or evidence of
new MRI activity) or not active, as well as worsening (a confirmed increase in disability over a
specified period of time following a relapse) or not worsening.Approximately 85
percent of people with MS are initially diagnosed with RRMS.
21. Primary progressive MS (PPMS)
It is characterized by worsening neurologic function (accumulation of disability) from the
onset of symptoms, without early relapses or remissions. PPMS can be further
characterized at different point in time as either active (with an occasional relapse or
evidence of new MRI activity) or not active, as well as with progression (evidence of
disease worsening on an objective measure of change over time, with or without relapse
or new MRI activity) or without progression.Approximately 15 percent of people with MS
are diagnosed with PPMS.
22. Secondary progressive MS (SPMS)
SPMS follows an initial relapsing-remitting course. Some people who are diagnosed
with RRMS will eventually transition to a secondary progressive course in which there
is a progressive worsening of neurologic function (accumulation of disability) over time.
SPMS can be further characterised at different points in time as either active (with
relapses and/or evidence of new MRI activity) or not active, as well as with progression
(evidence of disease worsening on an objective measure of change over time, with or
without relapses) or without progression.
23. Progressive-relapsing multiple sclerosis (PRMS)
Progressive-relapsing multiple sclerosis (PRMS) is the least common
form of the disease.The condition is characterised by a progressive
worsening of the condition from the beginning, similar to
primary-progressive multiple sclerosis (PPMS). There are occasional
relapse episodes of intensified symptoms similar to those experienced
by relapsing-remitting MS (RRMS).The progressive worsening of the
condition in PRMS is caused by nerve damage or loss, while the
relapse episodes are due to inflammation.
24. Benign MS
Benign MS is a misleading and controversial term. Some neurologists don't recognise
this as a form of MS at all. Those who meet the criteria for having benign MS tend to
disagree and report that it feels anything but benign. It's believed that if people make it
to 10 years without significant disability, they will not really progress to needing
assistance to walk and may be able to stop treatment. However, some simply disagree
with the classification and don't make treatment decisions based on a "benign"
designation.
25. Malignant MS
Malignant MS is an aggressive and rare form of MS. It's characterized by
rapidly progressive inflammation and destruction of myelin (protective covering
surrounding the nerves) and increased formation of lesions and plaque in the
brain and spine. The loss of myelin affects the brain's ability to transmit
electrochemical impulses between the nerve cells of the brain, and the spinal
cord, resulting in diminished or loss of neurological functioning and death within
in relative short time.
26.
27. Medical History
The doctor will ask a number of questions about the symptoms that you are currently experiencing and any
that you have experienced in the past and ask about any medications you are taking and the results of any
medical tests you may have had in the past. Also be asked several questions about the medical history of
relatives, drug and alcohol use, as well as other prior health issues.
28. CSF Examination
• Cell count and protein count are normal or slightly elevated. Shows
elevated gamma globulin(IgG) more than 15% of total protein and
oligoclonal band IgG on agarose electrophoresis.Elevated myelin
basic protein or myelin proteolytic fragments in higher than normal
concentration indicates active demyelination in acute episode of
disease.
29. EVOKED POTENTIAL TEST
Three evoked potential tests can be used in evaluating MS. For all them, electrodes are applied to the scalp with
conducting gel, and placement depends on the test being performed.
Visual evoked potentials (VEPs): Visual evoked potential testing looks at your brain's response to light. It can
be particularly helpful in confirming a diagnosis of MS because it can reveal nerve damage along your optic nerve
pathways even if no associated symptoms.
Somatosensory evoked potentials (SSEP): SSEP measures the brain's response to sensation through
electrical pulses.
Brainstem auditory evoked potentials (BAEP): BAEP measures the brain's response to sound by playing
clicks, tones, or beeps into your ear through headphones.
Prolonged latencies and conduction disturbance can reveal the presence of silent lesions.
30. Magnetic Resonance Imaging
Some diagnoses of MS are made through a combination of clinical findings and evidence of
an MS lesion on an MRI.If MS is suspected, a special contrast material (gadolinium) injection
is usually administered at the time of the scan, as it reacts to areas of inflammation and will
"light up" when a lesion is active.1This indicates that demyelination is occurring now or has
occurred within the last several week,MRI is considered the best test for diagnosing MS, as
abnormal lesions appear on MRIs in more than 95 percent of people with the condition.In the
other 5 percent, MRI can lead to a false-negative.Some age-related damage or other
conditions, like a migraine or brain trauma, look like MS lesions and can produce a false-
positive.
31. Medical management of MS
• There is no treatment that prevent or cure MS. Medical management directed at the
overall disease process itself and for management of specific symptoms. Supportive
treatment are essential element of care.
• Immnuosuppressant- Initially high dose of corticosteroid are give intravenously followed
by gradual reduction of dosage for 5-6 weeks.Cyclophosphamide, azathioprine,
cyclosporin and methotrexate are also given for long term suppression of disease. Side
effects- Osteoporosis, Fluid retention,Ulcers, bleeding disorders, cataracts, risk of
infections
32.
33. Interferon Beta
Interferon beta is considered first-line therapy for RRMS and the other forms of MS. Interferon
beta-1a is available in an intramuscular (IM) and a subcutaneous (SC) formulation, and
interferon beta-1b is available in a SC formulation. The exact mechanism of action of
interferon beta in MS is still unknown but may be related to suppression of T-helper cell
response. It is thought that reducing T-cell migration into the CNS may decrease lesion
proliferation. In published trials, interferon beta delayed the time to sustained progression in
disability, reduced the frequency of exacerbations, and decreased subclinical disease . It
adverse side effects including hypotension and DVT.
36. STEM CELL THERAPY
There is exciting and innovative research and progress occurring related to the potential of many types of stem
cells for slowing MS disease activity and for repairing damage to the nervous system, particularly for those with
more progressive forms of the disease.
Stem cell therapy is any treatment that uses or targets stem cells, which are the types of cells that differentiate
into many different specialized cells in our bodies. Stem cells are found in both embryos and adults cells.
Many types of stem cells are being explored for their potential benefits for treating multiple sclerosis. Only when
the results of these and subsequent clinical trials are available will it be possible to determine what the optimal
cells, delivery methods, safety and actual effectiveness of these current experimental therapies might be for
people with MS.
Although cell based therapy has generated a great deal of interest and holds promise, the field is in its infancy
and much more research is needed before cell based therapies become a MS treatment option.
37. Different Types of Stem Cells
HSCs (haematopoietic stem cells) – adult stem cells that are found in bone marrow and blood. HSCs are
capable of producing all of the cells that make up the blood and the immune system.
MSCs (mesenchymal stem cells) – adult stem cells found in several places in the body, including the bone
marrow, skin and fat tissue. They produce cells which help other stem cells function properly.
NSCs (neural stem cells) – specialized stem cells responsible for repairing nerve-insulating myelin in the
brain. These can be derived from other types of stem cells such as mesenchymal cells.
hESCs (human embryonic stem cells) – stem cells derived from donated embryos. They can naturally
produce every type of cell in the body. One concern about their potential therapeutic use is that they have been
found to cause tumours.
iPSCs (induced pluripotent stem cells) -are engineered from adult cells to produce many types of cells. One
concern about their potential therapeutic use is that they have been found to cause tumours.