Multiple Sclerosis

Multiple sclerosis is a disorder in which the nerves of the eye , brain and spinal cord lose nerve sheath ( myelin ) .

The term is derived from the number of multiple sclerosis regions of scar tissue ( sclerosis ), which represent the various patches of demyelination in the nervous system .
Which may be a sign of neurological symptoms of multiple sclerosis and so diverse that the disease is not diagnosed when symptoms first appear .

After a long time the disease will get worse slowly .
Patients usually experience a symptom-free periods ( remission ) are interspersed with the disease attacks ( exacerbations ) .


OTHER PRIMARY demyelinating disease

Acute disseminated encephalomyelitis ( post- infectious encephalomyelitis ) is a rare type of inflammation , which causes demyelination which usually occurs after a viral infection or vaccination .
Allegedly an immune reaction that is wrong , which is triggered by a virus .
Guillain - Barr syndrome ? is a disease of the peripheral nerves that resembles this disorder .

Adrenoleukodistrofi and Adrenomieloneuropati is a rare hereditary metabolic disorder occurs .
Adrenoleukodistrofi occur in boys ( usually age 7 years ) , but the disease progresses more slowly can be started at the age of 20s .
Adrenomieloneuropati attacking young . Extensive demyelination is accompanied by abnormal function of the adrenal glands . Ultimately mental deterioration occurs and the child becomes rigid and blind .
There is no treatment for this disease .
Food additives such as glycerol trioleate and glycerol trierukat ( Lorenzo's oil ) would improve the composition of fatty acids in the blood , but it has not been shown to improve the disease course .
Bone marrow transplantation is a treatment which is still a test .

Leber hereditary optic atrophy causes demyelination ending with partial blindness .
The disease is more common in men and symptoms usually first appear in late adolescence or early 20s .
This disease seems to come from her mother and passed on through the mitochondria ( the energy source for cells ) .

Myelopathy associated with HTLV is a virus infection of human T-cell limfotrofik , which causes demyelination in the spinal cord .
The disease is often found in certain tropical countries and in some parts of Japan .
After several years , the disease gets worse , resulting in stiffness and weakness of the limbs and impaired function of the gastrointestinal tract and bladder .

CAUSE

The cause is unknown , but suspected a virus or foreign antigens trigger an autoimmune reaction , which usually occurs in the early life of the patient .
Then the body will produce its own antibodies to fight mielinnya , these antibodies cause inflammation and damage to the nerve sheath .

multiple sclerosis

Heredity seems to play a role in multiple sclerosis .
Approximately 5 % of patients have a brother or sister who also suffer from this disease , and approximately 15 % of patients have a close relative who suffers from this disease .

Environmental factors also play a role in the occurrence of this disease .
Multiple sclerosis occurs in 1 of every 2000 people in the first 10 years of his life living in temperate climates , but only 1 of every 10,000 people born in the tropics .
Multiple sclerosis is almost never attack people who live near the equator .
Climate where someone lived the first 10 years of life seems more important than climate in which a person lives after the first 10 years of life .

SYMPTOMS

Symptoms usually appear in 20-40 years of age , is more common in women .
Demyelination can occur in the brain or spinal anywhere, and the symptoms depend on the affected area .

Demyelination of the nerve pathways that carry signals to muscles causing movement disorders ( motor symptoms ) , whereas if it occurs in the nerve pathways to the brain causing abnormal sensation ( sensory symptoms ) .

Initial symptoms often happens is tingling , numbness or odd feeling in the arms , legs , torso or face .
Dexterity and strength can be lost limbs or hands .

Some people only have symptoms in the eye in the form of double vision , partial blindness and pain in one eye , blurred or dim vision , or loss of central vision ( optic neuritis ) .

Early symptoms can also be a change in emotional and intellectual lightweight .
A vague hint of the presence of demyelination in the brain sometimes starts long before the disease is known .

The common symptoms of multiple sclerosis

Sensory symptoms
(changes in sensation)
symptoms of Motor
(changes in muscle function)

numb
Weakness, clumsiness

pins and needles
Difficulty in walking or maintaining balance

Other abnormal sensations
(disestesia)
Tremor (shaking)

Impaired vision
double vision

Difficult to reach orgasm,
reduced sensation in the vagina,
impotence in men
The problem of controlling the digestive tract or bladder,
constipation

Dizziness or vertigo
Stiffness, instability, extraordinary fatigue

Diagnosis

Allegedly a multiple sclerosis in a young age suddenly became blurred vision , double vision or experience sensory and motor abnormalities in a variety of different body parts .
The diagnosis is confirmed by the pattern of recurrence and repeated healing .

Dilakukanpemeriksaan thoroughly the nervous system as part of a physical examination .

Laboratory tests can distinguish multiple sclerosis with other similar diseases .

At lumbar puncture found that white blood cell count less and a little more protein than normal .
Antibody concentrations can be high and specific types of antibodies and other substances found in 90 % of patients .

MRI can show the brain that has lost daerh mielinnya .
This examination can distinguish jug active area of the region that has experienced demyelinating some time ago .

If the nerve is stimulated , the electrical response in the brain can be recorded via the evoked potential .
Under normal circumstances , the brain responds to light or sound with a distinctive pattern of electrical activity . In patients with multiple sclerosis , the response is slower because there is a disruption in the delivery of signals along the nerve sheath has been lost .

Some diseases that cause symptoms resembling multiple sclerosis :
- Brain infection caused by bacteria or viruses ( Lyme disease , AIDS , syphilis )
- Abnormalities in the structure of the skull base and spine ( severe arthritis of the neck , ruptured spinal discs )
- Tumors or cysts in the brain and spinal cord ( syringomyelia )
- Setbacks and spinocerebellar ataxia hereditary ( a disease where the muscle action is irregular or uncoordinated muscle )
- Minor stroke ( especially in patients with diabetes or hypertension are susceptible to this disease )
- Amyotrophic lateral sclerosis ( Lou Gehrig's disease )
- Inflammation of blood vessels in the brain or spinal cord ( lupus , arteritis ) .

TREATMENT

Beta - interferon injections may reduce the frequency of recurrence .
Other promising treatment and research is still in the other interferons , oral myelin and glatiramer ; which helps prevent the body attacks its own mielinnya .

Advantages of plasmapheresis and intravenous gamma globulin treatment is uncertain and it is not practical for long-term therapy .

The main treatment is to reduce symptoms of acute corticosteroids ( eg, prednisone by mouth or intravenous methylprednisolone ) .
Corticosteroids can shorten the attack , but did not stop the progression of the disease in the long term .
Side effects from long-term use of corticosteroids is susceptible to infection , diabetes , weight gain , fatigue , osteoporosis and ulcers .

Patients are often able to maintain an active lifestyle , although susceptible to fatigue and unable to follow a schedule that has been arranged .
Exercise regularly ( eg static bike , running , swimming or stretching ) can reduce muscle stiffness and help maintain a healthy heart , muscle and psychic .
Physical therapy can help maintain keseimbahan , walking ability and affordability and reduce muscle stiffness and muscle weakness .

Innervation that controls the discharge of urine or gastrointestinal tract may be affected and cause incontinence or urinary or fecal water accumulation .
Patients are taught to put the catheter hose ( to empty the bladder ) or use a stool softener or laxative .

Prognosis

Multiple sclerosis has a variable clinical course and can not be predicted .

In many patients , the disease begins with certain symptoms , which for months or years later showed no further symptoms .
In other patients , the symptoms got worse and more widespread within a few weeks or a few months .
The weather was warm , hot bath or fever may aggravate symptoms .

Recurrence can occur spontaneously or be triggered by infections ( eg influenza ) .
If relapse occurs frequently then semakinmemburuk abnormalities and can be settled .