12.2 Nutrition and Long-Term Cardiovascular Illnesses
3 min read•june 18, 2024
Multiple sclerosis is a complex autoimmune disorder that attacks the central nervous system. It causes demyelination, , and axonal damage, leading to a range of neurological symptoms that can significantly impact daily life.
Diagnosis involves a combination of clinical evaluation, MRI scans, and cerebrospinal fluid analysis. Treatment focuses on managing symptoms and slowing disease progression through immunomodulatory therapies, which aim to reduce relapses and disability.
Overview of Multiple Sclerosis
Mechanisms of multiple sclerosis
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Autoimmune disorder involves the immune system mistakenly attacking the central nervous system (CNS)
T-cells, a type of white blood cell, cross the blood-brain barrier and enter the CNS causing damage
Demyelination occurs when T-cells attack and damage the myelin sheath, the protective covering around nerve fibers
Damage to myelin disrupts the transmission of electrical signals along nerve fibers leading to impaired function
Scarring (sclerosis) occurs in multiple areas where myelin is damaged resulting in hardened, scar-like tissue
Axonal damage can occur as the disease progresses, where the nerve fibers (axons) themselves become damaged
Axonal damage leads to permanent neurological deficits and disability due to irreversible nerve damage
Inflammation in the CNS is caused by immune system activation
Inflammatory chemicals contribute to further damage of myelin and nerve fibers exacerbating the condition
Neuroplasticity, the brain's ability to form new neural connections, can help compensate for some damage
Signs and symptoms of multiple sclerosis
Visual disturbances such as optic neuritis, an inflammation of the optic nerve
Blurred vision, double vision, or complete loss of vision in one eye can occur
Sensory symptoms include numbness, tingling, or burning sensations in the face, body, or extremities
Paresthesia, abnormal sensations such as pins and needles, may be experienced
Motor symptoms involve muscle weakness, especially in the legs
Difficulty with coordination and balance can be present
Spasticity, stiffness and involuntary muscle spasms, may occur
Fatigue is an overwhelming tiredness that worsens as the day progresses
May be exacerbated by heat exposure (Uhthoff's phenomenon)
Cognitive changes such as difficulty with attention, concentration, and memory
Slowed information processing speed can be observed
Bowel and bladder dysfunction including urgency, frequency, or incontinence
Constipation may also be experienced
Sexual dysfunction such as decreased libido, erectile dysfunction, or reduced vaginal lubrication
Other symptoms can include vertigo and dizziness
Pain, including trigeminal neuralgia and dysesthetic pain, may be present
Emotional changes, such as depression or mood swings, can occur
Factors and diagnosis of multiple sclerosis
Risk factors for developing MS include genetic susceptibility, where certain genes increase the risk
Environmental factors such as low vitamin D levels, smoking, and Epstein-Barr virus infection may play a role
Geographic location, with higher prevalence in regions farther from the equator, is a contributing factor
Age and gender, typically diagnosed between 20-40 years old and more common in women, are risk factors
Diagnostic methods involve a neurological examination to assess signs and symptoms
Magnetic Resonance Imaging (MRI) detects lesions in the brain and spinal cord and helps rule out other conditions
Cerebrospinal fluid (CSF) analysis, obtained through a lumbar puncture, may show oligoclonal bands and elevated IgG index suggesting MS
Evoked potential tests measure the electrical activity of the brain in response to stimuli and can detect subtle changes in nerve conduction
McDonald Criteria are diagnostic guidelines that combine clinical presentation, MRI findings, and CSF analysis to confirm MS diagnosis and rule out other possible causes
The Expanded Disability Status Scale (EDSS) is used to quantify disability in MS patients and monitor disease progression
Types and Treatment of Multiple Sclerosis
Relapsing-remitting MS is characterized by periods of symptom flare-ups followed by periods of remission
Progressive MS involves steady worsening of neurologic function over time without distinct relapses
Immunomodulatory therapy is a primary treatment approach, using medications to modify the immune system's response
These treatments aim to reduce the frequency and severity of relapses and slow disease progression