Multiple Sclerosis
Definition
Chronic, progressive, degenerative disorder of the central nervous system
(CNS) characterised by segmental demyelination of nerve fibers of the
brain and spinal cord.
Onset between 20 and 50 years of age. Although it can occur in
young teens and much older adults. Women are affected 2-3 times more
than men. More prevalent in temperate climates
Etiology and Pathophysiology
• Cause is unknown.
• Related to infectious, immunologic and genetic factors
• Multiple genes confer susceptibility to multiple sclerosis (MS).
• Three pathologic processes characterise MS
• Chronic inflammation
• Demyelination
• Gliosis in the CNS
• Primary neuropathologic condition is an autoimmune process
orchestrated by activated T cells.
• Activated T cells migrate to CNS, causing blood-brain disruption.
• Likely the initial event in the development of MS
• Subsequent antigen-antibody reaction leads to demyelination of axons.
• Onset of the disease is often insidious and gradual, with vague
symptoms occurring intermittently over months or years.
• Initially, attacks cause damage to myelin sheaths of neurons in brain
and spinal cord.
• Nerve fiber is not affected.
• Patient may complain of noticeable impairment of function.
• With on-going inflammation, myelin loses ability to regenerate.
• Nerve impulse transmission is disrupted without myelin.
, CLINICAL MANIFESTATIONS
Primary Symptoms: Most common symptoms of MS
Fatigue
Weakness
Dizziness and vertigo
Sexual problems
Pain and itching
Emotional changes
Walking (gait) difficulties
Spasticity
Vision problems
bladder problems
Rowel problems
Cognitive changes
Depression
• Secondary Symptoms
Complications that can arise as a result of primary symptoms:
1) Bladder dysfunction: Can cause repeated urinary tract infections
Inactivity
2) Can cause loss of muscle tone, weakness (not related to
demyelination), poor posture, decreased bone density
(increased risk of fracture) and shallow, inefficient breathing
Immobility
3) Can cause pressure sores
# While secondary symptoms can be treated, the optimal goal is to
avoid them by treating the primary symptoms.
• Tertiary Symptoms
These result from the impact of the disease on a patient's life
Symptoms include
1) Social, vocational and psychological complications.
2) If the patient is no longer able to drive or walk, they may not be
able to hold down their usual job.
3) The stress and strain of dealing with MS often alters social
networks and sometimes fractures relationships.
Definition
Chronic, progressive, degenerative disorder of the central nervous system
(CNS) characterised by segmental demyelination of nerve fibers of the
brain and spinal cord.
Onset between 20 and 50 years of age. Although it can occur in
young teens and much older adults. Women are affected 2-3 times more
than men. More prevalent in temperate climates
Etiology and Pathophysiology
• Cause is unknown.
• Related to infectious, immunologic and genetic factors
• Multiple genes confer susceptibility to multiple sclerosis (MS).
• Three pathologic processes characterise MS
• Chronic inflammation
• Demyelination
• Gliosis in the CNS
• Primary neuropathologic condition is an autoimmune process
orchestrated by activated T cells.
• Activated T cells migrate to CNS, causing blood-brain disruption.
• Likely the initial event in the development of MS
• Subsequent antigen-antibody reaction leads to demyelination of axons.
• Onset of the disease is often insidious and gradual, with vague
symptoms occurring intermittently over months or years.
• Initially, attacks cause damage to myelin sheaths of neurons in brain
and spinal cord.
• Nerve fiber is not affected.
• Patient may complain of noticeable impairment of function.
• With on-going inflammation, myelin loses ability to regenerate.
• Nerve impulse transmission is disrupted without myelin.
, CLINICAL MANIFESTATIONS
Primary Symptoms: Most common symptoms of MS
Fatigue
Weakness
Dizziness and vertigo
Sexual problems
Pain and itching
Emotional changes
Walking (gait) difficulties
Spasticity
Vision problems
bladder problems
Rowel problems
Cognitive changes
Depression
• Secondary Symptoms
Complications that can arise as a result of primary symptoms:
1) Bladder dysfunction: Can cause repeated urinary tract infections
Inactivity
2) Can cause loss of muscle tone, weakness (not related to
demyelination), poor posture, decreased bone density
(increased risk of fracture) and shallow, inefficient breathing
Immobility
3) Can cause pressure sores
# While secondary symptoms can be treated, the optimal goal is to
avoid them by treating the primary symptoms.
• Tertiary Symptoms
These result from the impact of the disease on a patient's life
Symptoms include
1) Social, vocational and psychological complications.
2) If the patient is no longer able to drive or walk, they may not be
able to hold down their usual job.
3) The stress and strain of dealing with MS often alters social
networks and sometimes fractures relationships.
