Multiple sclerosis (MS) is a chronic disease that damages the protective sheath surrounding nerve fibers in the brain and spinal cord. The immune system mistakenly attacks this sheath. Symptoms vary but can include vision problems, muscle weakness, and impaired coordination. The cause is unknown but likely involves genetic and environmental factors. Diagnosis involves ruling out other conditions and looking for lesions in the brain and spinal cord by MRI or lumbar puncture. There is no cure for MS but treatments can help manage symptoms and reduce relapses. Lifestyle changes and medications aim to reduce inflammation and manage symptoms like pain, fatigue, and bladder problems. Prognosis depends on the type and severity of early symptoms.
This document provides information about multiple sclerosis (MS), including:
- MS is an immune-mediated disease that attacks the myelin sheath surrounding nerves in the central nervous system.
- Symptoms vary between individuals but can include fatigue, mobility issues, sensory changes, and cognitive difficulties. Diagnosis involves ruling out other conditions and detecting lesions in the brain and spinal cord.
- Treatment involves managing relapses, symptoms, and slowing disease progression using disease-modifying therapies like interferons that aim to reduce inflammation. Prognosis depends on individual characteristics but the disease course is generally unpredictable.
Multiple sclerosis is an inflammatory demyelinating disorder of the central nervous system that is more common in northern latitudes and among Caucasian populations. It typically presents with sensory disturbances, weakness, and visual problems and is diagnosed based on disseminated lesions found on MRI. Management involves immunosuppression and physical/occupational therapy to address symptoms and maintain function. Prognosis depends on factors like age of onset, relapse rate, and the degree of disability.
This document discusses rehabilitation principles for multiple sclerosis (MS). It begins by defining MS as a chronic, progressive disease of the central nervous system characterized by demyelination of the brain and spinal cord. It then covers the epidemiology, pathogenesis, subtypes, common symptoms and signs, diagnosis using the McDonald criteria, disease severity as measured by EDSS, disease-modifying therapies, and approaches to managing common issues like gait impairment and fatigue through rehabilitation and exercise.
1. Multiple sclerosis is a disease of the central nervous system where the protective myelin sheath around the axons is damaged, leading to scarring and demyelination.
2. It commonly affects people between the ages of 20-40 and has a higher prevalence in northern European populations and temperate climates.
3. Symptoms vary widely and can include changes in sensation, vision problems, weakness, and balance issues. Diagnosis involves MRI imaging and ruling out other potential causes through blood and spinal fluid tests.
Multiple sclerosis (MS) is a disease of the central nervous system where the immune system attacks the protective myelin sheathing of nerves. Symptoms vary between people but can include numbness, impaired balance, vision changes, fatigue, and impaired motor function. MS is diagnosed through a patient's history and symptoms as well as MRI imaging. While there is no cure for MS, treatments aim to manage relapses and slow progression of the disease over time.
Multiple sclerosis is a complex disease of the central nervous system characterized by relapses and remissions that cause neurological symptoms. The symptoms vary between people and can include numbness, impaired balance, vision changes, fatigue, and more. While there is no cure for MS currently, treatments aim to manage relapses and slow progression of the disease over time.
This document provides information about Multiple Sclerosis (MS). It defines MS as a chronic neurological disorder that affects the central nervous system, where myelin is destroyed in the brain and spinal cord, causing scarring in multiple sites. MS is the most common disabling condition in young adults. While its cause is unknown, it involves an immunological reaction destroying myelin. Symptoms vary between patients and can include vision changes, numbness, weakness, and problems with coordination or bladder control. Diagnosis involves MRI imaging and other tests. Currently, there is no cure for MS but treatments can help reduce symptoms and slow progression.
Myasthenia Gravis is a neuromuscular disorder characterized by fluctuating weakness that worsens with activity and improves with rest. It results from antibodies blocking or lessening the effects of acetylcholine at the neuromuscular junction. Symptoms often begin with weakness of the eye muscles or face. While treatments can help control symptoms, there is currently no cure. Management involves anticholinesterase medications, immunosuppressants, plasmapheresis, thymectomy, and ventilatory support during myasthenic crises.
This document provides information about multiple sclerosis (MS), including:
- MS is an immune-mediated disease that attacks the myelin sheath surrounding nerves in the central nervous system.
- Symptoms vary between individuals but can include fatigue, mobility issues, sensory changes, and cognitive difficulties. Diagnosis involves ruling out other conditions and detecting lesions in the brain and spinal cord.
- Treatment involves managing relapses, symptoms, and slowing disease progression using disease-modifying therapies like interferons that aim to reduce inflammation. Prognosis depends on individual characteristics but the disease course is generally unpredictable.
Multiple sclerosis is an inflammatory demyelinating disorder of the central nervous system that is more common in northern latitudes and among Caucasian populations. It typically presents with sensory disturbances, weakness, and visual problems and is diagnosed based on disseminated lesions found on MRI. Management involves immunosuppression and physical/occupational therapy to address symptoms and maintain function. Prognosis depends on factors like age of onset, relapse rate, and the degree of disability.
This document discusses rehabilitation principles for multiple sclerosis (MS). It begins by defining MS as a chronic, progressive disease of the central nervous system characterized by demyelination of the brain and spinal cord. It then covers the epidemiology, pathogenesis, subtypes, common symptoms and signs, diagnosis using the McDonald criteria, disease severity as measured by EDSS, disease-modifying therapies, and approaches to managing common issues like gait impairment and fatigue through rehabilitation and exercise.
1. Multiple sclerosis is a disease of the central nervous system where the protective myelin sheath around the axons is damaged, leading to scarring and demyelination.
2. It commonly affects people between the ages of 20-40 and has a higher prevalence in northern European populations and temperate climates.
3. Symptoms vary widely and can include changes in sensation, vision problems, weakness, and balance issues. Diagnosis involves MRI imaging and ruling out other potential causes through blood and spinal fluid tests.
Multiple sclerosis (MS) is a disease of the central nervous system where the immune system attacks the protective myelin sheathing of nerves. Symptoms vary between people but can include numbness, impaired balance, vision changes, fatigue, and impaired motor function. MS is diagnosed through a patient's history and symptoms as well as MRI imaging. While there is no cure for MS, treatments aim to manage relapses and slow progression of the disease over time.
Multiple sclerosis is a complex disease of the central nervous system characterized by relapses and remissions that cause neurological symptoms. The symptoms vary between people and can include numbness, impaired balance, vision changes, fatigue, and more. While there is no cure for MS currently, treatments aim to manage relapses and slow progression of the disease over time.
This document provides information about Multiple Sclerosis (MS). It defines MS as a chronic neurological disorder that affects the central nervous system, where myelin is destroyed in the brain and spinal cord, causing scarring in multiple sites. MS is the most common disabling condition in young adults. While its cause is unknown, it involves an immunological reaction destroying myelin. Symptoms vary between patients and can include vision changes, numbness, weakness, and problems with coordination or bladder control. Diagnosis involves MRI imaging and other tests. Currently, there is no cure for MS but treatments can help reduce symptoms and slow progression.
Myasthenia Gravis is a neuromuscular disorder characterized by fluctuating weakness that worsens with activity and improves with rest. It results from antibodies blocking or lessening the effects of acetylcholine at the neuromuscular junction. Symptoms often begin with weakness of the eye muscles or face. While treatments can help control symptoms, there is currently no cure. Management involves anticholinesterase medications, immunosuppressants, plasmapheresis, thymectomy, and ventilatory support during myasthenic crises.
Multiple sclerosis: Medical and Nursing ManagementsReynel Dan
Multiple sclerosis (MS) is a chronic, progressive neurological disease involving demyelination of the central nervous system. It is characterized by exacerbations and remissions of symptoms that vary depending on the location of lesions in the brain and spinal cord. Common clinical manifestations include fatigue, weakness, sensory disturbances, and impaired coordination. While the exact cause is unknown, it is thought to involve an autoimmune response. Treatment focuses on managing relapses, reducing disease progression, and alleviating symptoms. Nursing care emphasizes education, rehabilitation, and supportive measures to help patients maintain optimal functioning.
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
MultipleSclerosis.ppt MSN II nervous systemswatisheth8
Multiple sclerosis (MS) is an autoimmune disease where the body's immune system attacks the protective myelin sheath that surrounds the nerves in the central nervous system. It is a lifelong disease with no known cure. Symptoms vary between individuals but can include motor problems, sensory issues, vision problems, and cognitive changes. The disease course is usually relapsing-remitting but can also be progressive. Diagnosis is based on symptoms, neurological exam findings, and MRI evidence of lesions in the brain and spinal cord. Treatment focuses on managing symptoms and reducing relapses and progression using medications like interferons and corticosteroids.
1. Acute flaccid paralysis (AFP) is defined as sudden onset of weakness or paralysis over 15 days in patients under 15 years old. It suggests involvement of the lower motor neuron complex.
2. Common causes of AFP include poliomyelitis, Guillain-Barré syndrome, transverse myelitis, botulism, and non-polio enteroviruses. Clinical features and investigations can help differentiate between these causes.
3. Treatment depends on the underlying etiology but may include supportive care, IV immunoglobulin, plasmapheresis, and corticosteroids. Prognosis ranges from full recovery to residual deficits or death, depending on the cause and extent of
1. Acute flaccid paralysis (AFP) is defined as sudden onset of weakness or paralysis over 15 days in patients under 15 years old. It suggests involvement of the lower motor neuron complex.
2. Common causes of AFP include poliomyelitis, Guillain-Barré syndrome, transverse myelitis, botulism, and non-polio enteroviruses. Clinical features and investigations can help differentiate between these causes.
3. Treatment depends on the underlying etiology but may include supportive care, IV immunoglobulin, plasmapheresis, and corticosteroids. Prognosis ranges from full recovery to residual deficits or death, depending on the cause and extent of
This document provides an overview of multiple sclerosis, including its history, causes, diagnosis, types, treatment, and prognosis. It discusses how MS is an inflammatory demyelinating disease of the central nervous system that most commonly affects people aged 20-40. The diagnosis involves evaluating symptoms, lesions on MRI scans, and ruling out other potential causes through tests. While the exact cause is unknown, it is considered an immune-mediated disease influenced by genetic and environmental factors. Disease-modifying treatments can help reduce relapses but do not cure MS, and research into new therapies is ongoing.
Mrs. E.W., a 73-year-old woman, presented with dizziness, clumsiness in her left hand, and unsteadiness over one week. Her symptoms progressed to include speech problems, weakness on her left side, and balance issues. Testing revealed abnormalities in her cerebellum but no acute cause was found. Over several weeks her condition deteriorated further. Additional testing uncovered a small tumor in her right breast. She was ultimately diagnosed with paraneoplastic cerebellar degeneration caused by an underlying primary B-cell lymphoma of the breast.
This document provides information on multiple sclerosis (MS), including its epidemiology, pathogenesis, clinical presentations, diagnosis, and treatment options. It summarizes that MS is the most common autoimmune demyelinating disease of the central nervous system characterized by inflammation and demyelination in the brain and spinal cord. Current first-line treatments for relapsing-remitting MS include interferon beta, glatiramer acetate, fingolimod, fumarate, teriflunomide, natalizumab, mitoxantrone, and alemtuzumab, which aim to reduce relapse rates and progression of disability.
The document provides information about multiple sclerosis including causes, symptoms, diagnosis, treatment, prognosis, and complementary therapies like yoga. It discusses how multiple sclerosis is an autoimmune disease affecting the central nervous system that causes patches of sclerosis in the brain and spinal cord. Common symptoms include visual issues, weakness, numbness, and mood changes. Diagnosis involves MRI, spinal taps, and ruling out other conditions. Treatment focuses on managing symptoms and includes medications and therapies to slow progression. Yoga is mentioned as a complementary practice that can help with stress reduction and symptom relief.
Multiple sclerosis and newer concept in management till 2014 maydrnikhilver
This document provides information about Multiple Sclerosis (MS), including what it is, possible causes, types, diagnosis, treatment and newer concepts in management. It defines MS as a chronic neurological disorder affecting the central nervous system, where myelin is destroyed in the brain and spinal cord. The exact cause is unknown but is believed to involve immunological, viral, environmental and genetic factors. Diagnosis involves clinical symptoms and tests like MRI, CSF examination and evoked potentials. Treatment includes managing acute attacks, reducing disease activity through medications, and symptom management. Newer oral medications and concepts in disease-modifying therapies are discussed.
This document discusses idiopathic inflammatory myopathies (IIMs), including polymyositis, dermatomyositis, and inclusion body myositis. It reviews the clinical features, diagnostic criteria, pathology, and treatment strategies for these conditions. It also presents a case of a patient presenting with proximal muscle weakness who is diagnosed with polymyositis based on elevated CK, myopathic EMG findings, and muscle biopsy consistent with polymyositis. Treatment options discussed for IIMs include corticosteroids, immunosuppressants, rituximab, and intravenous immunoglobulin.
The document describes a case of a 14-year old boy who developed abnormal movements and weakness following treatment for snake bite with anti-venom serum (ASV). MRI later revealed lesions in the basal ganglia. He was diagnosed with acute disseminated encephalomyelitis (ADEM) caused by an immune response to the anti-venom. Steroid treatment improved his symptoms and he recovered fully after 3 months. ADEM is an inflammatory demyelinating condition that can be triggered by infections or vaccines and presents with polyneurological symptoms.
This document defines multiple sclerosis and discusses its pathophysiology, risk factors, classification, clinical features, investigations, and management. Multiple sclerosis is an inflammatory disease that damages the myelin sheaths around nerve axons in the brain and spinal cord, leading to demyelination and scarring. It typically affects young adults and is more common in females. While the cause is unknown, it may involve genetic and environmental factors. MRI is the most accurate test for diagnosis, showing lesions in the white matter. Treatment aims to reduce relapses using disease-modifying drugs like interferons or glatiramer acetate.
Multiple Sclerosis (MS) and Myasthenia Gravis (MG) are autoimmune disorders where the immune system attacks the body's own healthy cells. MS affects the central nervous system by damaging the protective myelin sheath surrounding nerve fibers, while MG affects the neuromuscular junction by blocking or destroying acetylcholine receptors. Common symptoms of MS include sensory issues, muscle weakness, fatigue and vision problems. MG symptoms often begin with eye weakness and drooping eyelids and may progress to generalized weakness. While there is no cure for either condition, treatments can help manage symptoms and delay disease progression.
This document discusses multiple sclerosis (MS), a demyelinating disease of the central nervous system. It begins by defining MS and describing its characteristic features, including inflammation, demyelination, and scarring in the brain and spinal cord. It then covers the clinical manifestations of MS, diagnostic testing methods, treatment approaches including disease-modifying drugs, and potential side effects of treatments.
This document provides an overview of demyelinating diseases of the central nervous system, with a focus on multiple sclerosis. It discusses the etiology, pathogenesis, clinical features, diagnosis, treatment and management of multiple sclerosis. Key points include: MS results from an autoimmune attack on the myelin sheath surrounding nerves in the brain and spinal cord; diagnosis involves evidence of lesions disseminated in space and time via MRI or other tests; and treatments include steroids for acute attacks and disease-modifying drugs such as interferons to reduce relapse rates long-term.
This document provides a summary of clinical syndromes and neurological conditions for medical students. It includes tables comparing upper and lower motor neuron signs. It also provides descriptions of various conditions like herpes simplex encephalitis, Guillain-Barre syndrome, cauda equina syndrome, multiple sclerosis, motor neuron disease, myasthenia gravis, Parkinson's disease, and Bell's palsy. Example cases are presented and the appropriate diagnosis and investigations are discussed for each case. Overall the document serves as a review of key neurology topics for medical students.
This document discusses the nervous system and provides information on epilepsy and multiple sclerosis. It defines epilepsy as recurrent seizures caused by abnormal electrical activity in the brain. Epilepsy is classified as focal or generalized. Multiple sclerosis is a demyelinating disease of the central nervous system characterized by patches of demyelination in the brain and spinal cord. Common symptoms include sensory and motor issues. Diagnosis involves clinical evaluation and MRI imaging. Treatment aims to modify the disease course and manage symptoms.
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
Multiple sclerosis: Medical and Nursing ManagementsReynel Dan
Multiple sclerosis (MS) is a chronic, progressive neurological disease involving demyelination of the central nervous system. It is characterized by exacerbations and remissions of symptoms that vary depending on the location of lesions in the brain and spinal cord. Common clinical manifestations include fatigue, weakness, sensory disturbances, and impaired coordination. While the exact cause is unknown, it is thought to involve an autoimmune response. Treatment focuses on managing relapses, reducing disease progression, and alleviating symptoms. Nursing care emphasizes education, rehabilitation, and supportive measures to help patients maintain optimal functioning.
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
MultipleSclerosis.ppt MSN II nervous systemswatisheth8
Multiple sclerosis (MS) is an autoimmune disease where the body's immune system attacks the protective myelin sheath that surrounds the nerves in the central nervous system. It is a lifelong disease with no known cure. Symptoms vary between individuals but can include motor problems, sensory issues, vision problems, and cognitive changes. The disease course is usually relapsing-remitting but can also be progressive. Diagnosis is based on symptoms, neurological exam findings, and MRI evidence of lesions in the brain and spinal cord. Treatment focuses on managing symptoms and reducing relapses and progression using medications like interferons and corticosteroids.
1. Acute flaccid paralysis (AFP) is defined as sudden onset of weakness or paralysis over 15 days in patients under 15 years old. It suggests involvement of the lower motor neuron complex.
2. Common causes of AFP include poliomyelitis, Guillain-Barré syndrome, transverse myelitis, botulism, and non-polio enteroviruses. Clinical features and investigations can help differentiate between these causes.
3. Treatment depends on the underlying etiology but may include supportive care, IV immunoglobulin, plasmapheresis, and corticosteroids. Prognosis ranges from full recovery to residual deficits or death, depending on the cause and extent of
1. Acute flaccid paralysis (AFP) is defined as sudden onset of weakness or paralysis over 15 days in patients under 15 years old. It suggests involvement of the lower motor neuron complex.
2. Common causes of AFP include poliomyelitis, Guillain-Barré syndrome, transverse myelitis, botulism, and non-polio enteroviruses. Clinical features and investigations can help differentiate between these causes.
3. Treatment depends on the underlying etiology but may include supportive care, IV immunoglobulin, plasmapheresis, and corticosteroids. Prognosis ranges from full recovery to residual deficits or death, depending on the cause and extent of
This document provides an overview of multiple sclerosis, including its history, causes, diagnosis, types, treatment, and prognosis. It discusses how MS is an inflammatory demyelinating disease of the central nervous system that most commonly affects people aged 20-40. The diagnosis involves evaluating symptoms, lesions on MRI scans, and ruling out other potential causes through tests. While the exact cause is unknown, it is considered an immune-mediated disease influenced by genetic and environmental factors. Disease-modifying treatments can help reduce relapses but do not cure MS, and research into new therapies is ongoing.
Mrs. E.W., a 73-year-old woman, presented with dizziness, clumsiness in her left hand, and unsteadiness over one week. Her symptoms progressed to include speech problems, weakness on her left side, and balance issues. Testing revealed abnormalities in her cerebellum but no acute cause was found. Over several weeks her condition deteriorated further. Additional testing uncovered a small tumor in her right breast. She was ultimately diagnosed with paraneoplastic cerebellar degeneration caused by an underlying primary B-cell lymphoma of the breast.
This document provides information on multiple sclerosis (MS), including its epidemiology, pathogenesis, clinical presentations, diagnosis, and treatment options. It summarizes that MS is the most common autoimmune demyelinating disease of the central nervous system characterized by inflammation and demyelination in the brain and spinal cord. Current first-line treatments for relapsing-remitting MS include interferon beta, glatiramer acetate, fingolimod, fumarate, teriflunomide, natalizumab, mitoxantrone, and alemtuzumab, which aim to reduce relapse rates and progression of disability.
The document provides information about multiple sclerosis including causes, symptoms, diagnosis, treatment, prognosis, and complementary therapies like yoga. It discusses how multiple sclerosis is an autoimmune disease affecting the central nervous system that causes patches of sclerosis in the brain and spinal cord. Common symptoms include visual issues, weakness, numbness, and mood changes. Diagnosis involves MRI, spinal taps, and ruling out other conditions. Treatment focuses on managing symptoms and includes medications and therapies to slow progression. Yoga is mentioned as a complementary practice that can help with stress reduction and symptom relief.
Multiple sclerosis and newer concept in management till 2014 maydrnikhilver
This document provides information about Multiple Sclerosis (MS), including what it is, possible causes, types, diagnosis, treatment and newer concepts in management. It defines MS as a chronic neurological disorder affecting the central nervous system, where myelin is destroyed in the brain and spinal cord. The exact cause is unknown but is believed to involve immunological, viral, environmental and genetic factors. Diagnosis involves clinical symptoms and tests like MRI, CSF examination and evoked potentials. Treatment includes managing acute attacks, reducing disease activity through medications, and symptom management. Newer oral medications and concepts in disease-modifying therapies are discussed.
This document discusses idiopathic inflammatory myopathies (IIMs), including polymyositis, dermatomyositis, and inclusion body myositis. It reviews the clinical features, diagnostic criteria, pathology, and treatment strategies for these conditions. It also presents a case of a patient presenting with proximal muscle weakness who is diagnosed with polymyositis based on elevated CK, myopathic EMG findings, and muscle biopsy consistent with polymyositis. Treatment options discussed for IIMs include corticosteroids, immunosuppressants, rituximab, and intravenous immunoglobulin.
The document describes a case of a 14-year old boy who developed abnormal movements and weakness following treatment for snake bite with anti-venom serum (ASV). MRI later revealed lesions in the basal ganglia. He was diagnosed with acute disseminated encephalomyelitis (ADEM) caused by an immune response to the anti-venom. Steroid treatment improved his symptoms and he recovered fully after 3 months. ADEM is an inflammatory demyelinating condition that can be triggered by infections or vaccines and presents with polyneurological symptoms.
This document defines multiple sclerosis and discusses its pathophysiology, risk factors, classification, clinical features, investigations, and management. Multiple sclerosis is an inflammatory disease that damages the myelin sheaths around nerve axons in the brain and spinal cord, leading to demyelination and scarring. It typically affects young adults and is more common in females. While the cause is unknown, it may involve genetic and environmental factors. MRI is the most accurate test for diagnosis, showing lesions in the white matter. Treatment aims to reduce relapses using disease-modifying drugs like interferons or glatiramer acetate.
Multiple Sclerosis (MS) and Myasthenia Gravis (MG) are autoimmune disorders where the immune system attacks the body's own healthy cells. MS affects the central nervous system by damaging the protective myelin sheath surrounding nerve fibers, while MG affects the neuromuscular junction by blocking or destroying acetylcholine receptors. Common symptoms of MS include sensory issues, muscle weakness, fatigue and vision problems. MG symptoms often begin with eye weakness and drooping eyelids and may progress to generalized weakness. While there is no cure for either condition, treatments can help manage symptoms and delay disease progression.
This document discusses multiple sclerosis (MS), a demyelinating disease of the central nervous system. It begins by defining MS and describing its characteristic features, including inflammation, demyelination, and scarring in the brain and spinal cord. It then covers the clinical manifestations of MS, diagnostic testing methods, treatment approaches including disease-modifying drugs, and potential side effects of treatments.
This document provides an overview of demyelinating diseases of the central nervous system, with a focus on multiple sclerosis. It discusses the etiology, pathogenesis, clinical features, diagnosis, treatment and management of multiple sclerosis. Key points include: MS results from an autoimmune attack on the myelin sheath surrounding nerves in the brain and spinal cord; diagnosis involves evidence of lesions disseminated in space and time via MRI or other tests; and treatments include steroids for acute attacks and disease-modifying drugs such as interferons to reduce relapse rates long-term.
This document provides a summary of clinical syndromes and neurological conditions for medical students. It includes tables comparing upper and lower motor neuron signs. It also provides descriptions of various conditions like herpes simplex encephalitis, Guillain-Barre syndrome, cauda equina syndrome, multiple sclerosis, motor neuron disease, myasthenia gravis, Parkinson's disease, and Bell's palsy. Example cases are presented and the appropriate diagnosis and investigations are discussed for each case. Overall the document serves as a review of key neurology topics for medical students.
This document discusses the nervous system and provides information on epilepsy and multiple sclerosis. It defines epilepsy as recurrent seizures caused by abnormal electrical activity in the brain. Epilepsy is classified as focal or generalized. Multiple sclerosis is a demyelinating disease of the central nervous system characterized by patches of demyelination in the brain and spinal cord. Common symptoms include sensory and motor issues. Diagnosis involves clinical evaluation and MRI imaging. Treatment aims to modify the disease course and manage symptoms.
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
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1. Multiple Sclerosis
Name : Vihari Vichakshana Rajaguru
Group No : 32
4th year 1st semester (2016)
Kursk State Medical University
2. Introduction
Transmission of action potentials along myelinated
axons.
An action potential “jumps” from node to node.
Voltage-gated Na+ channels are present only at the
nodes of Ranvier.
3. What is MS ?
a chronic, typically progressive disease
involving damage to the sheaths of nerve
cells in the brain and spinal cord.
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. Eventually, the disease can cause
the nerves themselves to deteriorate or
become permanently damaged
6. Etiology
Cause of MS is still not known,
scientists believe that the interaction
of several different factors may be
involved.
Immunologic Factors
Environmental Factors
Infectious Factors
Genetic Factors
7. Path physiology
Blood-brain barrier
breakdown
The BBB prevent entrance of T cells into the nervous system.
The blood–brain barrier is normally not permeable to these types of
cells, unless triggered by infection or a virus, which decreases the
integrity of the tight junctions.
When the blood–brain barrier regains its integrity, usually after
infection or virus has cleared, the T cells are trapped inside the
brain.
Autoimmunology The immune system attacks the nervous system, forming plaques
or lesions.
Commonly involves white matter.
Destroys oligodendrocytes- causing demyelination
Remyelination occurs in early phase but not completely.
Repeated attacks lead to fewer remyelination.
Inflammation T-cells attacks on myelin triggers inflammatory processes,
stimulating other immune cells and soluble factors like cytokines
and antibodies.
Leaks form in the BBB cause swelling, activation of macrophages,
and more activation of cytokines and other destructive proteins
8.
9.
10.
11.
12. CLASSIFICATION OF MULTIPLE SCLEROS
PRMS Progressive Relapsing MS
SPMS Secondary Progressive MS
PPMS Primary Progressive MS
RRMS Relapsing/ Remitting MS
Gradual progression of the disease from its
onset with no relapses or remissions
Unpredictable attacks which may or may not leave
permanent deficits followed by periods of remission
Initial RRMS that suddenly begins to decline without
periods of remission and relapses.
Steady decline since onset with super-imposed
attacks.
13. Progressive Relapsing
Mild infrequent sensory exacerbations
with full recovery.
Secondary Progressive
Condition of patients with
relapsing/remitting disease begins to
gradually worsen over time with
resulting accumulation of neurological
signs and symptoms. In this form of the
disease, relapses become more severe
while remissions are less complete,
shorter in duration, and eventually non-
existent. The course of MS becomes
steadily progressive.
14. Primary Progressive
There is no history of relapse in these
patients. Disease begins with a slow
progression of neurologic deficits.
Problems appear and gradually worsen
over time. Common problems include
spastic paraparesis, cerebellar ataxia,
urinary incontinence.
Relapsing Remitting Multiple Sclerosis
Episodes of exacerbations and
remissions during which not all
symptoms resolve completely. The
patient may be left with permanent
disability which may vary in severity.
Relapses are often more severe than in
the previous group. Relapses also
become more severe with time.
15. The most common
initial symptoms
• changes in sensation
in the arms, legs or
face : numbness
(33%)
• Optic neuritis (20%)
• weakness (13%)
• double vision-
internuclear
opthalmoplegia (7%)
• unsteadiness when
walking (5%)
• and balance
16. sensory exam
◦ - ascending numbness starting in the
feet;
◦ - bilateral hand numbness;
◦ - hemiparesthesia;
◦ - dysesthesia in one of the above
distributions;
◦ - generalized heat intolerance
Objectively the most common sensory
findings in the"numb" areas are dorsal
column signs, such as reduction of
vibration, proprioception and stereognosis,
rather than problems with spinothalamic
tract.
17. Right internuclear
ophthalmoplegia in a
patient with multiple
sclerosis. In the initial
phase of leftward gaze
(upper photograph), only
the left eye is abducted.
The right eye follows,
after a delay (lower
photograph).
18. Lhermitte's
sign (25-40%)
is an electrical
sensation that
runs down the
back and into the
limbs and is
produced by
bending the neck
forwards. The
sign suggests a
lesion of the
dorsal columns of
the cervical cord
or of the caudal
Uhthoff's
phenomenon
is the worsening of
neurologic
symptoms in
multiple sclerosis
and other
neurological,
demyelinating
conditions when the
body gets
overheated from
hot weather,
19. Ongoing Symptoms and
Signs
Motor system:
◦ -weakness (variable severity mono-
and paraparesis, hemiparesis,
quadriparesis)
◦ -increased spasticity resulting in
spastic gait
◦ -pathologic signs (Babinski's,
Chaddock's, Hoffmann, Oppenheim's,
etc.) -dysarthria
Cerebellar signs:
◦ -incoordination (dysdiadochokinesia,
problems with heel-to-shin test)
◦ -slowing of rapid repeating movements
◦ -cerebellar ataxia (ataxic gait)
◦ -scanning speech
20. INVESTIGATION
CSF oligoclonal bands, abnormal colloidal gold curve, elevated γ-
globulin IgG, mild mononuclear pleocytosis (<40 cells/mL),
myelin debris, normal or slightly elevated protein. (Myelin basic
Protein)
Blood
test
•B-12 and folate levels or antinuclear antibody (ANA) titers.
•Antiphospholipid antibody syndrome must be undertaken in
patients with evidence of blood dyscrasia and in women with
unexplained miscarriages or history of deep venous thrombosis.
•elevated erythrocyte sedimentation rate (ESR) and positive
titers of rheumatoid factor (RF) should help identify the presence
of a vasculitic disorder that may be mimicking MS.
MRI MRI of the head and spine (more sensitive than CT): May show
many plaques.
MRI reveals multiple lesions with high T2 signal intensity and
one large white matter lesion. These demyelinating lesions may
sometimes mimic brain tumors because of the associated
edema and inflammation.
21.
22.
23.
24.
25. Diagnostic Criteria
Clinical Presentation Additional Data Needed
* 2 or more attacks (relapses)
* 2 or more objective clinical
lesions
None; clinical evidence will
suffice (additional evidence
desirable but must be consistent
with MS)
* 2 or more attacks
* 1 objective clinical lesion
Dissemination in space,
demonstrated by:
* MRI
* or a positive (cerebrospinal
fluid) CSF and 2 or more MRI
lesions consistent with MS
* or further clinical attack
involving different site
Diagnosis is based on McDonald’s Criteria (Revised
2010)
26. * 1 attack
* 2 or more objective clinical lesions
Dissemination in time, demonstrated
by:
* MRI
* or second clinical attack
* 1 attack
* 1 objective clinical lesion
(monosymptomatic presentation)
Dissemination in space demonstrated
by:
* MRI
* or positive CSF and 2 or more MRI
lesions consistent with MS
and
Dissemination in time demonstrated
by:
* MRI
* or second clinical attack
Insidious neurological progression
suggestive of MS
(primary progressive MS)
One year of disease progression
(retrospectively or prospectively
determined) andTwo of the following:
a. Positive brain MRI (nine T2 lesions
or four or more T2 lesions with
positive VEP)b. Positive spinal cord
MRI (two focal T2 lesions)c. Positive
CSF
27. Treatment
As of 2011, six treatments have been approved by
FDA
1. Interferon beta
1a (Avonex, CinnoVex,ReciGen and Rebif)
2. Interferon beta-1b (Betaseron )
3. Glatiramer acetate (Copaxone), a non-
steroidalimmunomodulator.
4. Mitoxantrone, is an immunosuppressant
5. Natalizumab (Tysabri)
Steroids: methylprednisolone (MP) 500–1,000 mg/d IV for 5
days
followed by tapered oral prednisone or MP 1 g/d IV for 3 days
± oral taper
28. MANAGEMENT
Spasticity Baclofen 5 mg PO 1–3 t.i.d. and increase as needed
Diazepam 2–5 mg PO at bedtime
Pain NSAIDs
Gabapentin effective vs. MS pain syndromes at 300 mg/d PO, may increase to
1,800 mg/d within 1 week, max dose 3,600 mg/d
Bladder
dysfunction
Propantheline 7.5 mg PO q3–4h to start, increase to 15 mg t.i.d. to q.i.d. plus
15–30 mg at bedtime
Oxybutynin chloride 5 mg PO t.i.d.–q.i.d.
Prophylactic antibiotics for urinary infections
Self-catheterizations for inadequate bladder emptying
Constipation: Stool softeners, bulk-producing agents, laxative suppositories
Incoordination or
tremors:
Incoordination or tremors:
Depression and
emotional lability
Antidepressant agents such as SSRIs.
Psychotherapy and support
Paranoia or
mania
Haloperidol lithium or atypical antipsychotic
Hemifacial and
dysesthesias
Carbamazepine 100–200 mg PO once or twice a day to start; increase to total
daily dosage of 600–1,600 mg t.i.d.–q.i.d.
Must monitor serum levels
29. Other regime
A main focus for MS patients is intake of foods that
lower inflammation, not aggravate it.
• Polyphenols (including flavonoids and nonflavonoids) and
carotenoids: vegetables, fruits, wine, spices, and herbs
• Polyunsaturated fats , omega-3 fatty acids and DHA: olive oil,
oily fish, fish oil.
◦ Limiting saturated
fats of animal origin
◦ limit caffeine consumption to decrease bone mineralization
loss
30. Vitamin B12 deficits is associated with
demyelination of nerve fibers so
supplementation of Vitamin B12 and
Vitamin B complex assists in prevention.
Calcium supplementation is important as
the incidence of osteoporosis , related to
decreased mobility, is higher in MS
patients.
vitamin D, selenium, and zinc have all
been found to decrease the production of
inflammatory molecules associated with
MS as well.
31. Prognostic Factors in Patients with
Multiple Sclerosis
Good prognosis
Optic Neuritis
Isolated sensory
symptoms
Long interval to
second relapse
No evidence of
disability after 5
years
Female gender
Poor Prognosis
‘Multifocal’ Clinically
Isolated Syndrome
Efferent
(motor/cerebellar)
systems
High relapse rate in 5
years
Substantial disability
after 5 years
Abnormal MRI with
32. Mortality Rates for Multiple
Sclerosis
The average life span of an individual with
MS is 25-35 years after initial diagnosis.
Most MS patients live into the 7th decade
Studies have shown that individuals with MS
die around 10 years earlier than the general
population
Studies have indicated that MS is not a cause
of death, whereas deaths occur as a result of
other chronic complications resulting from
immobility, chronic urinary tract infections,
dypsnea, dysphagia, aspiration & bacterial
pneumonia