Mona Odiakosa October 26,2012 Term Project

Multiple Sclerosis
I Etiology(Cause of Disease)

The etiology of Multiple Sclerosis is found to have an unknown cause, which is assumed to be part of a autoimmune disease. Multiple Sclerosis can however be a factor of environmental and genetics. Multiple Sclerosis is a chronic disease that strikes the Central Nervous System. The Central Nervous System is composed of the brain, optics nerves and our spinal cord. The has been some research that shows the bodys immune reacts abnormally and strikes the Central Nervous System, harming the myelin. Usually the immune system is supposed to protect the body from foreign invaders, such as bacteria and viruses. In Multiple Sclerosis the myelin is at risk for invasion. The people who are affected Multiple Sclerosis are Americans, aged 20-45 years old. For some reason women seem to be more at risk for Multiple Sclerosis as oppose to men. Epidemiologist have studied environmental element that activate Multiple Sclerosis. There is date that supports this, which shows that whites of Western and European Origin who reside in a temperature zone over the 40th parallel rather in people residing in the tropics. After all, he people who are harmed are the ones that reside for about fifteen years of life in a moderate climate. Then they migrate to the tropics, giving them a grater risk, that they will get in a their original climate.
II Pathogenesis (Disease Process)

The pathogenesis of Multiple Sclerosis is defined as a disease that is related to the Immune System. Multiple Sclerosis is a disease that raids the Central Nervous System. The Central Nervous System consist of the brain, spinal cord optic nerves. The Multiple Sclerosis begins to become activated by a intrinsic susceptible single mixture of one or more environmental agents. Throughout this process in the central nervous system, the myelin becomes impaired along with the nerve fibers. The impaired myelin begins to form a scar. The scar from the tissue is known as sclerosis, and that is where the disease gets its name from. Whenever any part of he myelin or nerve fiber is impaired, the nerve impulses begin to become mobile. The impulses move to and from the brain to the spinal cord. Then the brain and the spinal cord become disfigured, making room for symptoms to occur. Throughout this disease process, people with Multiple Sclerosis tend to experience a four disease course. This four disease course ranges from pain in a mild to severe manner. The first course is called Replasing-Remitting Multiple Sclerosis. In this course people experience neurological functions that become aggravated. Which is then continued by relapses called flare-ups, followed by half and full reformation (remission) periods. During this time, no disease advances. However only about 85% of patients with Multiple Sclerosis are said to have Replasing-Remitting Multiple Sclerosis. The second experience for patients is called Primary-Progressive Multiple Sclerosis. This experience is described as slowly worsening neurological function from the initial start of the experience. There is no lucid relapse or remission of this experience. The rate of remission may alter over a certain period of time. But only 10% of the people with Multiple Sclerosis have Progressive MS. Third, there is Secondary-Progressive

Multiple Sclerosis. This is secondary because it continues the initial time frame for relapsing and remission Multiple Sclerosis. About 50% of the people with Multiple Sclerosis (Secondary-Progressive), develop this form of the disease within 10 years of their diagnosis. Last is Progressive-Replasing Multiple Sclerosis. This type of experience is the most rare form. About 5% of the people, have outbreaks of horrible neurological functions, and the disease advance without remission.
III Diagnosis(Laboratory Test & Medical Findings)

The diagnosis of Multiple Sclerosis is focused mainly on clinical features. There are a number of laboratory test are helpful in supporting the diagnosis of Multiple Sclerosis. On of the diagnostic tools that are used for Multiple Sclerosis is a Magnetic Resonance Imaging(MRI). The MRI provides the diagnosis by illustrating disseminated white matter lesions in space. But in the same manner showing a likeness of abnormalities that are characteristics of demyelization. The characteristics count for the corpus callosum involvement, oval/ round shaped lesions and brain stem lesions. The MRI diagnostic has been flourished to advance specificity. The second way to test for Multiple Sclerosis is a Electro-Physiological test. This test examines the impulses moving thru the nerves, which then shows the out of the impulses. Showing whether or not the impulses are moving normally or too slow. Theses are the ways physicians can determine if a person has Multiple Sclerosis or not. As for the Genetics of Multiple Sclerosis, there has been a classic study on twins, that determines whether or not that there are environmental aids which cause Multiple Sclerosis. This study is population-based on Multiple Sclerosis, and the people used are identical twins. The identical twins revealed a 28% similarity rate for Multiple Sclerosis, compared to that of the non-identical twins with 4%. If one of the identical twins shows

symptoms, most likely the other twin will also become sick, this is said to be true in about 25% of the cases. The accumulation in the similarity rate for genetically identical twins shows a big genetic element in the susceptibility of Multiple Sclerosis. Although a greater part of the identical twins did not show signs of Multiple Sclerosis , when the other did. This information poses for environmental factors, which also include epigenetic aids as well.
IV Clinical Features ( Signs and Symptoms)

People who have Multiple Sclerosis show different signs and symptoms. There a various different signs and symptoms that range from mild to severe. Majority of the patients, about 70%, show an early onset of signs and symptoms. The most common type of sign for people with Multiple Sclerosis is visual problems. A patient may become aware of the fact that their vision is becoming blurred or impaired. They also experience a hard distinguishing colors and loss of vision in one of their eyes. The visual signs and symptoms are due to the optic neuritis, followed by eye pain. Another important symptom for patients are bowel and bladder experiences. Patients have constipation, urine leakage and find it hard to start urinating. Other symptoms may be numbness, fatigue, and muscle spasms. There are also about 50% of people who go through mental symptoms as well. They experience memory loss, impaired judgment and loss of concentration. The complications from Multiple Sclerosis is Osteoporosis, depression and side affect from medicine. In addition, women that are pregnant and are already diagnosed with Multiple sclerosis, experience less pain, especially during their third trimester.
V Treatment ( Medication, Behavior change etc.)

Despite the fact that there is no cure for Multiple Sclerosis yet, there have been ways to modify the disease. One of the treatments for Multiple sclerosis is the use of steroids. These steroids can be prescribed by doctors, and can be taken orally or through an IV. Patients who have exacerbations that are mild and severe should use corticosteroids, in order to make it throughout the day. Exacerbates are flare-ups or relapses that bring harm to old inflammations in Multiple Sclerosis patients. Steroids were one of the first desirable drugs for patients, and maintain their exacerbates. Another treatment for Multiple Sclerosis is Rehabilitation. The main purpose for rehab is to improve and maintain function. Emphasizing good health, lower fatigue, and body conditioning. There are a couple of different rehabs/therapies that patients can access. First kind of rehab is Physical Therapy. Patients are advised to do exercises, such as walking, balance/posterior and stretching. The main goal for physical therapy is to maintain functioning and prevent complications in muscle weakness. The, second kind of rehab is Occupational Therapy. This therapy is to give the patient a sense of independence, productivity when it come to personal care and careers. Third is Cognitive Rehab, where Neurophysiologist treat the way people think, reason and concentrate. The main goal is to help patients with their cognitive skills. Even thought there are many ways to treat and diagnosis Multiple Sclerosis, the cause and cure has yet to be found among researchers.

Bibliography (Reference)

Frankel D, James H. Living with Multiple Sclerosis. New York, NY : National Multiple Sclerosis Society, 2011. Cross, A, Cross K, & Piccio, L. 2012, update on multiple sclerosis, its diagnosis and treatment, Clinical Chemistry; Laboratory Medicine, 50, 7, pp. 1203-1210 Academic Search Premier, EBSCOhost. Viewed 24 October 2012. Damjanov Ivan. Pathology for the Health Professions. 4th Edition. Arthur K Asbury. Guy M Mc Fhann. Diseases of the Nervous System. Clinical Neuroscience and Theraupeutic Principles. 3rd Edition David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.