Multiple sclerosis
Multiple sclerosis, formerly known as disseminated sclerosis or encephalomyelitis disseminate is a chronic, inflammatory, demyelinating disease that affects the central nervous system (CNS).
MS affects the neurons in the areas of the brain and spinal cord known as the white matter. These cells carry signals in between the grey matter areas, where the processing is done between these and the rest of the body.
The transition of multiple sclerosis into the category of treatable neurological illness has fueled exponential growth in the MS literature.
Particularly remarkable has been the surge in publication relating to the immunology of M.S. Application of current and future therapies. It should be kept in mind however that a more complete understanding of the M.S process requires an application of the psychological aspect of central nervous system immune surveillance and neurobiology, as well as the intricacies of abnormal immune neural interaction. This includes dynamics at the level of BLOOD BRAIN BARRIER (B.B.B), the impact of immune mediators on neural responses and CNS repair, and in turn, the effect of CNS responses on the invading immune cells. Sclerosis is a chronic and progressive incurable disease of the central nervous system
Signs and symptoms
MS can cause a variety of symptoms, including changes in sensation (hypoesthesia), muscle weakness, abnormal muscle spasms, or difficulty in moving; difficulties with coordination and balance (ataxia); problems in speech (dysarthria) or swallowing (dysphasia), visual problems (nystagmus, optic neuritis, or diplopic), fatigue and acute or chronic pain syndromes, bladder and bowel difficulties, cognitive impairment, or emotional symptomatology (mainly depression). It is considered a classic MS finding, but it can be seen in several other conditions as well.
Diagnosis
Multiple sclerosis is difficult to diagnose in its early stages. A definite diagnosis cannot be made until other disease processes (differential diagnoses) have been ruled out and, in the case of relapsing-remitting MS, there is evidence of at least two anatomically separate demyelinating events separated by at least thirty days. In the case of primary progressive, a slow progression of signs and symptoms over at least 6 months is required.
Different Type Of Multiple Sceloris
Immune Cell Interaction with the Blood-Brain Barrier
It has adhesion, attraction, and invasion. When the immune cell system becomes activities they upregulate the expression of several families of molecules that facilitate their migration across endothelial barriers and into the target organ. The process of transmigration involved a tightly regulated sequence of events. Unregulated selections and integrands on the activated immune cell interact with legends expressed on the endothelial cells of the BBB, resulting in immune cells” Rolling” and “Tethering-arresting’, respectively.
Magnetic Resonance Imaging (MRI)
The common MRI appearance is multiple white matter lessons with periventricular pre-dominance. It would be unusual if this region.was sparred in M.S. lessons can occur in any central nervous system tissue. Where there is myelin including the cortex. However, most of the lessons are missed with conventional MRI due to similarities in signal intensities of MS lesions and gray matter and partial volume effect of CSF within adjacent cellulose. Lesions are also often temporal lobes and gray-white matter junction. The brain stem, cerebellum, optic nerves, and spinal cord. Spinal cord lesions were only found in 6% of patients with another neurological disease. These are more common in the sevicalcord than the thoracic cord.
The disease attacks those in the age group of 21 to 30 years. Women are more affected than men can occur at any age.
Bladder
Bladder problems appear in 70-80% of MS patients and they have an important effect both in hygiene habits and social activity. However bladder problems are usually related with high levels of disability and pyramidal signs in lower limbs. There are a number of treatments under investigation that may curtail attacks or improve function.
Bibliography
- Mark Freedom. Multiple Sclerosis and demyelinating Diseases New York: Pocket, 1993.
- Rosati G. “The prevalence of multiple sclerosis in the world : an Update” (2001) 39-117.
- Poser C. “The dissemination of multiple sclerosis : a Viking saga? A historical essay ”. (1994) 43-231.
- Dhanam publications. “Multiple sclerosis” The Hindu 11 APR. 2005: A3.