Introduction Multiple Sclerosis (MS) is one of the most common diseases of the Central Nervous System (CNS) which affects all ages and gender. MS is currently the leading cause of disability in young adults and found to be more prevalent in women and affects 2.5 million people worldwide. “Multiple Sclerosis is a progressive chronic immune - mediated disease characterized by disseminated demyelination of nerve fibers of the brain and spinal cord” (Mahan, Escott-Stump, 2008). MS was discovered in 1868 by Jean-Martin Charcot, at the time he was treating a female patient for tremors. Charcot began noticing similar neurological problems as his other patients and after the patient died he conducted an examination on her brain and discovered …show more content…
scars which indicated MS. In the 19th century Dr. Walter Moxon from England and Dr. Edward Seguin recognized MS as a specific disease that was more common in women than men. “As the 20th century began it was discovered that smaller organisms , viruses, and developed techniques for growing and studying bacteria and viruses in the lab.” (Ms society paper) By 1916 examinations were taking place on the brains of people who died using chemicals enhancements. After WWI abnormalities in the spinal cord were detected, 1919. them the myelin was being studied more under the microscope and the cells that produce myelin, (oligodendrocytes) were discovered in 1928. Further knowledge was gained in learning the role of myelin in nerve conduction and realizing that demyelinating nerves were not able to transmit impulses effectively. After WW2 an animal model of MS was developed. From this breakthrough researchers were able learn, immune cells (not viruses or circulation problems) produced MS - like illness. The National Multiple Sclerosis Society was founded in 1946 by Sylvia Lawry.
The MS Sociey bridged several gaps between neurologists, patients with MS, and the funding needed to advance in research. In 1947 Dr. Elvin Kabat at Columbia University identified abnormal immunologic proteins in the spinal fluid of people with MS. With the information already obtained in previous studies relating the Oligoclonal bands to proteins in the spinal fluid immune system and MS could now be connected. By the 1960’s neurologists and scientists were able to make an accurate diagnosis and measure how therapies could affect disability. A group of patients who were experiencing exacerbations (flare ups) were given adrenocorticotropic (ACTH) hormone (a hormone normally produced by the pituitary gland). The goal was for the ACTH to have anti-inflammatory and immune-suppressing effect. In comparison to the placebo group the hormone was a success. In 1978 CAT scans were performed and helped in the diagnosis of MS. Then in the 1980’s CAT scanning was replaced with the MRI scan which showed the brain in greater detail. Also in the 1980’s, there were several new treatment trials taking place. From 1990-current scientists have been able to show white blood cells (T cells) as having a direct correlation to MS. Neurons and axons were identified as being damaged leading to disability. There were improvements made in medications for symptom management and by 1993 the first injectible medication, Copaxone …show more content…
was introduced and in 2010 two infusion-based therapies were offered to those who had advanced or very-active MS. Etiology The etiology of Multiple Sclerosis is unknown.
However, a number of well-established findings have been incorporated into a hypothesis to explain the etiology of MS (Mahan & Escott-Stump, 2008). “Although a familial predisposition to MS has been noted in a minority of cases, familial tendency is not well established' no consistent pattern of Mendelian inheritance has emerged” (Victor & Ropper, 2005) (p.1093). MS is known to be a immune - mediated demyelinating, progressive disease the affects the CNS. The term Multiple Sclerosis is called multiple because multiple areas of the optic nerves, spinal cord, and brain undergo “Sclerosis” where myelin is replaced with sclera or scar
tissue. There are three identified disease courses of MS. Relapsing - remitting MS (RRMS) which affects approximately 85% of people who are diagnosed with MS. RRMS is clearly defined by increased neurological symptoms followed by periods of partial or complete recovery. Primary progressive MS (PPMS) affects approximately 15% of people who are diagnosed with MS. PPMS there are worsening neurological functions from the onset of symptoms without early relapses or remissions. The third disease course, Secondary progressive MS (SPMS) follows after RRMS and at different points in time with active or non active as well as with or without progression. Epidemiology Environmental factors such as geographical location have been attributed to the cause of MS. Prevalence varies considerably, from high levels in North America and Europe (>100/100,000 inhabitants) to low rates in Eastern Asia and sub-Saharan Africa (2/100,000 population). Studies have indicated the further one is from the equator (north) the less sun exposure therefore leading to a decrease in 1,25-dihydroxyvitamin D3 (hormonal form of vitamin D3). The decrease in sunlight leading to a decrease on vitamin D production is an environmental factor and that the hormonal form of vitamin D, is a selective immune system regulator inhibiting this disease (Mark and Carson, 2006). Treatment & Management Out of the fifteen FDA approved therapies, eight are injectible medications, three oral treatments, and two intravenous infusion treatments. The FDA strongly cautions anyone prescribed the disease modifying treatments for MS, to understand the warnings on the FDA labeling. Similar to the course of the disease itself, not everyone will experience the same side effects. Some are more common and others less frequent. However, there are some side effects that can be very serious, for instance, Tysabri. Tysabri has an increased risk of a rare, often fatal brain disease called PML (progressive multifocal leukoencephalophy). Other serious and life threatening side effects of the disease modifying treatments for MS can be, peripheral neuropathy, acute kidney failure, increased risk for malignancies such as thyroid cancer, melanoma, and blood cancers. Less serious side effects can include, flu like symptoms (chills, fever, muscle pain, fatigue, weakness, headache, itching) and injection site reactions such as swelling, redness, and pain. In conjunction with disease modifying therapies, corticosteroids are prescribed to treat exacerbations. However, this type of therapy only has short term effectiveness with the possibility of it not working at all. Side effects of steroid therapy include increased appetite, weight gain, fluid retention, nervousness, and insomnia. In addition to the 15 disease modifying treatments available, there is a wide variety of medications available to help manage symptoms such as, numbness, tingling cognitive dysfunction, fatigue, bladder dysfunction, muscle spasms, and bowel dysfunction, to name a few. The American Academy of Neurology defines Complementary and Alternative Medicine therapy as non-conventional treatment. Typically CAM is not offered in a hospital setting or prescribed by health care providers. CAM is often used with conventional treatment and sometimes used instead of conventional treatment. Examples of CAM therapy can include, physical therapy, speech therapy, occupational therapy, and cognitive rehabilitation. The AAN also states there is little evidence that CAM therapies are effective in the treatment of MS. MNT Presently there is no special “MS” diet or guidelines people who have been diagnosed with MS should follow. “Several dietary regimens have been studied for managing MS which include, allergen-free, gluten-free, pectin-free, and fructose-restricted. The MacDougal diet, Cambridge liquid diet and vitamin and mineral therapies have all been ruled ineffective”(Mahan & Escott-Stump, 2008). There is substantial evidence on the effective role of Vitamin D supplementation in slowing the progression of MS. In a recent study published by Johns Hopkins Medicine in 2015, 40 people with Multiple Sclerosis were taking 10,400 IU of Vitamin D3 supplements daily for six months had a reduction in the percentage of inflammatory T cells related to MS severity. “When the increase in Vitamin D levels in the blood over baseline levels was greater than 18 ng/ml, every additional 5 ng/ml increase in vitamin D led to a 1 percent decrease in the percentage of IL-17+CD4+T cells in the blood” (Hopkins study). There are several symptoms of MS such as numbness, tingling, dizziness, pain, and bladder dysfunction, just to name a few, which do require MNT. “As the disease progresses, neurologic deficits and dysphagia may occur as the result of damaged cranial nerves. Thus diet consistency may need to be modified from solids to mechanically soft or puréed items, even progressing to thick liquids to prevent aspiration” (pg 1094). Additional problems people with MS face are impaired peripheral vision, dysarthria (slurred speech), poor ambulation, all making eating difficult. In these types of situations people rely on prepared, single serving meals or assistance programs such as Meals on Wheels. Some patients may require enteral nutrition support. Bladder issues such as incontinence or UTI’s are common in patients with MS. In this case cranberry supplementation may be recommended. Constipation is also common with MS. A diet high in fiber and adequate fluid intake is recommended (pg 1094). Gaps in Knowledge The etiology of MS has yet to be determined however, there are several studies on going in the areas of immunological, environmental, and genetic. Researchers have been able to identify T Cells (and B cells) as playing a role in the demyelination of myelin. Studies suggest that vitamin D which is known to support immune function and help protect against immune - mediated diseases such as MS. Lastly MS is not classified as hereditary although having a first degree relative such as parents or siblings with MS does increase an individual's risk. Summary Multiple Sclerosis is defined as a progressive disease. However, since the 1800’s to today researchers have been able to categorize three different disease courses, identify the CNS and myelin sheath as being the main components affected, develope fifteen disease modifying therapies, and through numerous clinical trials and studies determine that vitamin D is essential to slowing the progression of the disease.
Mairs’ piece is a careful examination of her experience with MS and her perspective towards her future. In contrast, Soyster writes humorously of a particular incident he had with MS and artfully weaves his ideas about the disease in with his story. In both instances, the authors share the purpose of narrating their encounter with MS to the world to raise awareness.
Multiple sclerosis (MS) is a disease affecting the myelination of the central nervous system, leading to numerous issues regarding muscle strength, coordination, balance, sensation, vision, and even some cognitive defects. Unfortunately, the etiology of MS is not known, however, it is generally thought of and accepted as being an autoimmune disorder inside of the central nervous system (Rietberg, et al. 2004). According to a study (Noonan, et al. 2010) on the prevalence of MS, the disease affects more than 1 million people across the world, and approximately 85% of those that are affected will suffer from unpredictably occurring sessions of exacerbations and remissions. The report (Noonan, et al. 2010) found that the prevalence of MS was much higher in women than in men, and that it was also higher in non-Hispanic whites than in other racial or ethnic groups throughout the 3 regions of the United States that were studied.
So what is happening chemically to the people with MS? The disease is an Autoimmune which this will destroy the cells which are in your body. The immune system is going to attack the tissue which it is going to affect the Myelin. When the Myelin is damaged which is when the T cells over react , and cause them to damaged. That is what happens Chemically with MS people.
Multiple sclerosis (MS) is generally thought to be an autoimmune disease that attacks the myelin sheaths, or oligodendrocytes that cover nerve axons in the central nervous system (PubMed Health 2013). This immune response causes inflammation, which triggers immune cells to destroy axons “along any area of the brain, optic nerve, and spinal cord” (PubMed Health 2013). When the myelin sheath “is damaged, nerve signals slow down or stop” thus hindering the propagation of action potentials and limiting function (PubMed Health 2013).
Multiple sclerosis - is an autoimmune disorder that affects the central nervous system including the spinal cord and brain.
According to National Multiple Sclerosis Society, Multiple Sclerosis (MS) is an unpredictable, often disabling disease of the central nervous system (CNS) that disrupts the flow of information within the brain, and between the brain and body. The central nervous system (CNS) comprises of the brain and the spinal cord. CNS is coated and protected by myelin sheath that is made of fatty tissues (Slomski, 2005). The inflammation and damage of the myelin sheath causing it to form a scar (sclerosis). This results in a number of physical and mental symptoms, including weakness, loss of coordination, and loss of speech and vision. The way the disease affect people is always different; some people experience only a single attack and recover quickly, while others condition degenerate over time (Wexler, 2013). Hence, the diagnosis of MS is mostly done by eliminating the symptoms of other diseases. Multiple sclerosis (MS) affects both men and women, but generally, it is more common in women more than men. The disease is most usually diagnosed between ages 20 and 40, however, it can occur at any age. Someone with a family history of the disease is more likely to suffer from it. Although MS is not
For CSF, 6 of 62 MS patients, and 1 of 40 controls, were positive for ETX immunoreactivity. For the analysis of sera, 6 of 56 MS patients, and 0 of 60 controls were seroreactive to ETX.
Primarily, the term MS refers to a chronic disorder that attacks the central nervous system (CNS). It is most common in temperate continents such as Europe and Australia with Asiatic and African continents having a lower risk of the disease (Wiley Online Library, 2013). A search organised by the Multiple Sclerosis Society (2013) has estimated that there are 127,000 people living with MS in the United Kingdom. Further research by Chipps, Clanin, and Campbell (1992, pp. 158-167) shows that MS disorder more likely affects women than men with its symptoms occurring between the ages of 20 and 40 in most cases and is quite uncommon in childhood and old age. The nerve cells known as neurons in the brain constantly transmit and receive signals. They invoke emotions, activities and cognition that constitute the day to day experiences of humans. Under normal circumstances, these signals travel on a protected insulation path known as the myelin sheath. This insulation is vital as it enables signals to reach their target. In Multiple Sclerosis, the myelin sheath gets disintegrated causing the nerve fibre to be damaged leading to a disruption in the abili...
Multiple Sclerosis (MS) is a debilitating autoimmune disease. The Central Nervous System (CNS) is attacked by the immune system; creating lesions that interrupt the correct signaling of nerves, spinal cord, and brain (Frankel, & James, 2011). Inhibiting development of this disease is crucial for maintaining quality of life and fatigue for individuals with MS. There has been vast amount of research on the effect of various exercise training programs, and their benefits for MS (Motl, & Gosney, 2008, Krupp, 2003, Chen, Fan, Hu, Yang, & Li, 2013). Balance, aerobic, and strength training have been the main focus of most researchers; causing an interest in what training mode is most effective for improving quality of life and lower fatigue. It is critical to examine and contrast the effectiveness of a variety of exercise programs, because if training is completed effectively it can drastically improve quality of life and fatigue for individuals with MS.
... resulting impairment to the CNS. The first group of mice exhibited a pattern of CNS inflammation that resembled that of the most common subtype of MS, RRMS, with lesions filled with macrophages, a type of immune defender cell. The second group of mice displayed inflammation deep in the CNS tissues and in the optic nerve with lesions filled with neutrophils, another type of immune cell. Both groups of mice were given antibody drugs similar to drugs being developed against MS in humans. The effects were observed over time and results showed that some of the drugs inhibited disease in the first group of mice but did not inhibit disease in the second group. Thus, as Mark Kroenke (2008), the study’s first author and a Ph.D. student in immunology at U-M stated, "That's our proof that these really are different mechanisms of disease" (Kroenke et al., 2008).
Multiple sclerosis, also known as MS, is one of the humankind’s most mysterious diseases. Multiple sclerosis has the ability to affect nearly 3 million people worldwide. This disease tends to be more common in individuals of northern European descent and women are more than twice as likely to develop multiple sclerosis as men are. Of those 3 million people, most of them are between the ages of 20 and 50 years old. Even though multiple sclerosis is a mystery disease, scientists are working to determine the exact cause and treatment.
Multiple Sclerosis (MS) is a complicated chronic deteriorating disease that has an effect on the central nervous system (CNS). This disease causes destruction of the myelin around the nerve fibers. “The exact etiology of Multiple Sclerosis is unknown; however, it is thought to be an immune mediated disease. MS is characterized by CNS inflammation, demyelination, and axonal loss” (Compston & Coles, 2008). Typically, it is described by early relapses and remissions of neurological signs of the CNS. This is known as relapsing-remitting MS (RRMS). MS can be identified by a variety of known risk factors. Multiple Sclerosis can be brought on by a mixture of inherited and environmental risk factors such as smoking or an exposure to a virus like Epstein Barr. The inflammatory process has an interesting role on the central nervous system.
Multiple Sclerosis is a nervous system disease that affects the spinal cord and the brain by damaging the myelin sheaths that protects nerve cells. Destroyed myelin prevents messages from communicating and sending properly from the brain, through the spinal cord, to internal body parts. In the United States, more than 350,000 people are diagnosed with this disease. Anyone can get this disease, but it is more common among Caucasian women. MS symptoms begin between the ages 20-40 and are caused by nerve lesions being present in multiple areas of the Central Nervous System, symptoms differ on the lesion’s location.
The discovery of meningitis dates back to the 1800’s. The first evidence that linked bacterial infection as a cause of meningitis was written by Austrian pathologist Anton Weichselbaum. He was the one to isolate the causative agent of cerebrospinal meningitis. He named this bacterium Diplococcus intracellularis meningitidis.
The nervous system plays a major role in co-ordinating and controlling the body’s activities. It is made up of billions of nerve cells. These cells are linked to form a massive communications network. Nerve cells carry messages in the form of electrical impulses. These impulses are carried at high speed around the body to keep it safe and functioning normally. Multiple sclerosis (MS) is a disease which progressively injures the nerves of the brain and spinal cord. Injury to the nerves in multiple sclerosis may be reflected by alterations of virtually any sensory or motor (muscular) function in the body.