Multiple sclerosis (MS) or disseminated sclerosis is an auto immune disease characterized by chronic inflammation, demyelination, and scaring of the myelin sheath of the brain and spinal cord Early Symptoms of MS • Blurred or double vision • Thinking problems • Clumsiness or a lack of coordination • Loss of balance • Numbness • Tingling • Weakness in an arm or leg No two people have exactly the same symptoms of MS. You may have a single symptom, and then go months or years without any others. A problem can also happen just one time, go away, and never return. For some people, the symptoms become worse within weeks or months. Common Symptoms of MS These are the most common changes to the mind and body in someone with MS: Unusual sensations: People with MS often say they feel a "pins and needles" sensation. They may also have numbness, itching, burning, stabbing, or tearing pains. About half of people with MS have these uncomfortable symptoms. Fortunately, they can be managed or treated. Bladder problems: About 8 in 10 people have bladder problems, which can be treated. You may need to pee often, urgently, need to go at night, or have trouble emptying your bladder fully. Bowel problems, especially constipation, are also common. Trouble walking: MS can cause muscle weakness or spasms, which make it harder to walk. Balance problems, numb feet, and fatigue can also make walking hard. Dizziness: It's common to feel dizzy or lightheaded. You usually won't have vertigo, or the feeling that the room is spinning. Fatigue: About 8 in 10 people feel very tired. It often comes on in the afternoon and causes weak muscles, slowed thinking, or sleepiness. It's usually not related to the amount of work you do. Some people with MS say they can feel tired even after a good night's sleep. Muscle spasms: They usually affect the leg muscles. For about 40% of people they are an early symptom of MS. In progressive MS, muscle spasms affect about 6 in 10 people. You might feel mild stiffness or strong, painful muscle spasms. Sexual trouble: These include vaginal dryness in women and erection problems in men. Both men and women may be less responsive to touch, have a lower sex drive, or have trouble reaching orgasm. Speech problems: Sometimes MS can cause people to pause a long time in between words and have slurred or nasal speech. Some people also develop swallowing problems in more advanced stages of MS. Treatments for attacks Corticosteroids, such as oral prednisone and intravenous methylprednisolone,plasma exchange (plasmapheresis) are prescribed to reduce nerve inflammation. Treatments are avaliable to slow the progression of the disease, interferons,immuno suppressants immno modulators . Anyway treatment for MS is highly coastly

1. Presented by
vichithra

2. • Multiple sclerosis (MS) or disseminated
sclerosis is characterized by chronic
inflammation, demyelination, and scaring of
the myelin sheath of the CNS.

3. • The cause of multiple sclerosis is unknown. It
is believed to be an autoimmune disease, in
which the body's immune system attacks its
own tissues.

4. • Age : 20- 40 years
• Gender : women
• Certain infections
• Geographic regions

9. • Uhthoffs sign
• Lhermitte's sign
• Marcus gunn phenomenon
• Intentional tremor

10. Diagnosis
• MRI
• Evoked potentials
• CSF studies

12. Treatment
There is presently no cure for MS. However, many
treatment options are available that can help
manage the course and symptoms of this chronic
disease.
Treatment can help:
• slow the progression of MS
• minimize symptoms during exacerbations or flares
• improve physical and mental function

13. Interferons
• Interferons are a group of immune system proteins -
- alpha, beta, and gamma produced by the body.
They act in different ways to control the activity of
the immune system. They also have antiviral
properties.
• Avonex (interferon beta 1a)
• Betaseron (interferon beta 1b)
• Extavia
• Rebif ( high dose interferon beta 1a)

15. • Glatiramer acetate/ copaxon modify the way
our body's defense system .
• Used to treat RRMS
• This medication is also used to delay the onset
of MS in people who have experienced a
single flare-up of symptoms and have changes
that suggest MS in their magnetic resonance
imaging (MRI) scans.
Immunomodulators

16. Immunosuppressants
• Cytoxan is a therapy that may be given to people
with multiple sclerosis. It works by suppressing
the immune system.
• Imuran is an immune system-suppressing drug.
That means that it can theoretically halt the
attack of the immune system on your nerves if
you have multiple sclerosis. The drug can be used
to slow the progression of MS in people who are
not responding well to other treatments.

18. Corticosteroids
• Medications such as Solu- medrol and Decadron are
potent steroids that ease inflammation and are
often used to treat an acute attack of multiple
sclerosis.

19. • Botulinum toxin is derived from the
bacterium Clostridium botulinum and is in a class of
drugs called neurotoxins
• Botulinum toxin is a muscle-relaxing medication
used to decrease spasticity related to multiple
sclerosis and other neurological conditions.
• Botulinum toxin works to block the effect of
acetylcholine on the muscle, resulting in weakness
or paralysis.

20. • Tysabri is a laboratory-produced monoclonal
antibody. It is designed to hamper movement
of potentially damaging immune cells from
the bloodstream, across the “blood-brain
barrier” into the brain and spinal cord

21. • Progressive multifocal leukoencephalopathy (PML),
also known as progressive
multifocal leukoencephalitis, is a rare and usually
fatal viral disease characterized by progressive
damage or inflammation of the white matter of
the brain at multiple locations.

22. Spasticity
• Baclofen
• Tizanidine
• Diazepam
• Dantrolene
Sensory symptoms
• Amitriptyline
Urinary problems
• Oxybutynin
• prazosin

23. Tremors
• clonazepam
Neurotic pain
• Neurontin
• Carbamazepine
• Amitriptyline
Fatigue
• Amantidine
• Modafinil
Depression
• Citalopram
• Sertraline