The Encephalomyelitis Disseminate - Essay Example

Multiple Sclerosis Order No. 245848 No. of pages: 5 Premium 6530 Introduction Multiple sclerosis (MS) also known as encephalomyelitis disseminate or disseminated sclerosis is not only a chronic, but crippling and disabling disease that attacks the central nervous system shattering the hopes and dreams of the suffering individual. According to the National Multiple Sclerosis Society, this disease affects around 400,000 individuals in the United States. ‘Multiple sclerosis affects woman more than men. It often begins between the ages of 20 and 40.’ (National Institute of Neurological Disorders and Stroke) The ratio of the disease among women and men stands at 3: 1 and is more often seen among Caucasians than among other races. Though the real cause of this disease is not clearly known, yet researchers are of the opinion that it occurs due to the abnormal response of the immune system in a person’s body and that such an abnormal response is triggered by a virus. According to researchers, the disease is neither contagious nor inherited but definitely genetic susceptibility plays a major role. Besides the virus, the other triggers include heavy metals, trauma and other environmental triggers. ‘There is no cure for MS, but medicines may slow it down and help control symptoms.’ (National Institute of Neurological Disorders and Stroke) To keep this disease under control even Physical therapy or occupational therapy would also help. Autoimmune Disease In individuals suffering from multiple sclerosis, the immune system of the person is attacked by the immune cells that are sent out by the body to fight against bacteria and other viruses that attack the body. The immune cells lymphocytes, T-cells and killer cells, not only attack the myelin and the oligodendrocytes (oligo, few; dendro, branches; cytes, cells, but also destroy them completely. These killer cells not only attack the myelin but also consume it and damaging the myelin sheath, (the fatty insulation that covers the nerve cells in the brain and spinal cord.) The Myelin sheath is responsible for facilitating the smooth transmission of all the high- speed messages that travel between the brain, the spinal cord and the rest of the body. Therefore, when the Myelin sheath is attacked or affected, the messages cannot be sent efficiently and in many cases do not reach their destination. That is why Multiple sclerosis is called an autoimmune disease. Other autoimmune diseases are lupus and Rheumatoid arthritis. The Disease – Multiple Sclerosis In multiple sclerosis, when the Myelin is attacked and destroyed, there is a gradual build up of scar tissue (sclerosis) occurring in multiple places. Hence the name of the disease is multiple sclerosis. These plaques scarred regions, though only a fraction of an inch in diameter, interfere critically with the transmission of signals to the brain and the other parts of the body. The nerves may also get damaged, worsen the symptoms and grossly reduce the degree of recovery. The severity of Multiple sclerosis varies from person to person. In some cases, the symptoms may be very apparent and severe, whereas in some cases there may not be any symptoms at all. The disease breaks out in the form of exacerbations (appearance of new symptoms or the aggravation of old ones) or attacks, if a symptom breaks out and worsens within 24 hours of the attack. These symptoms can last indefinitely for either days, weeks or even months. One of the most common types of Multiple sclerosis is the relapsing-remitting MS, where the cells in the nervous system have their way of compensating partially for the loss of their ability to function. The activity of the disease maintains a rather low level but gradually worsens over time as the axons (signal transmitting portions of the cells) get damaged. Symptoms of Multiple Sclerosis (Mayo Foundation for Medical Education and Research) The symptoms of multiple Sclerosis vary from person to person and the severity of the disease depends on the extent of the disease on the affected nervous system. Though some people may suffer milder attacks, there are others who are completely disabled without being able to even walk or talk properly. In the beginning stages, the individual experiences temporary weakness with some pain or tingling in a limb. They could also experience Ataxia (physical unsteadiness and loss of coordination) Some of the other symptoms of multiple sclerosis are – Degeneration of cognitive functions such as short - term memory, thinking and concentration. In addition to this the person’s reasoning power and judgment may be grossly affected. Blurring of vision or experiencing double vision (diplopia) involuntary rapid eye movement, optic neuritis may occur but rarely a person experiences a total loss of sight. Diminished or loss of coordination between the motor muscles, unstable walking (ataxia) poor balance, and dizziness (vertigo) Poor and slow speech and difficulty in swallowing, (dysphagia) slurring of words and a changing rhythm in speech. Lack of coordination between the limbs and various senses due to spasticity, reduction of good muscle tone producing stiffness in the muscle and spasms which hinders or retards mobility. Poor bowel and bladder control which forces the person to urinate frequently in addition to constipation and inappropriate emptying of bowel. Severe fatigue, loss of strength, and physical exertion and discomfort which is determined through a ‘Fatigue Severity Scale.’ (Johansson S, Ytterberg C, Back B, Holmqvist LW, von Koch L, 2008) Lack of sexual abilities leading to impotency. Also loss of sensation and diminished arousal. Each and every case of Multiple sclerosis is unique and there is nothing like a typical case. Each patient will experience different symptoms and hence have to be treated differently. In individuals suffering from Multiple sclerosis generally are listless because of lack of energy, sleepiness and a total lack of motivation. Treatment of the Disease “Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. [It] means integrating individual clinical experience with the best available external clinical evidence from systematic research.” Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS., 1996) Evidence based medicine is an important guide to the quality of care that can be given to patients with Multiple Sclerosis. It is highly recommended that treatment be started during the early stages of the disease in order to do away with a suboptimal treatment response. An important thing to be kept in mind is that the presently available immunotherapies are not cures in itself but help greatly in controlling the disease. The Treatment making use of Glatiramer acetate, Natalizumab and Mitoxantrone have all shown to not only reduce relapses and MRI lesions but also to retard the worsening or progression of the disease. In comparison to the other drugs, Natalizumab has proved to be on the top of clinical efficacy ‘but the occurrence of 3 cases of progressive multifocal leukoencephalopathy associated with its use has highlighted the importance of safety when using a disease-modifying drug.’ (Hurwitz B. Editorial, 2005) In the case of severe attacks, high doses of corticosteroids like methylprednisolone (US National Library of Medicine (Medline) (2003-04-01) is given intravenously to the patient. Although generally effective in the short term for relieving symptoms, corticosteroid treatments do not appear to have a significant impact on long-term recovery. Brusaferri F, Candelise L (2000). Potential side effects include osteoporosis Dovio A, Perazzolo L, Osella G, et al (2004). and impaired memory, the latter being reversible. Uttner I, Müller S, Zinser C, et al (2005). References Brusaferri F, Candelise L (2000). "Steroids for multiple sclerosis and optic neuritis: a meta-analysis of randomized controlled clinical trials". J. Neurol. 247 (6): 435–42. Dovio A, Perazzolo L, Osella G, et al (2004). "Immediate fall of bone formation and transient increase of bone resorption in the course of high-dose, short-term glucocorticoid therapy in young patients with multiple sclerosis". J. Clin. Endocrinol. Metab. 89 (10): 4923–8. Hurwitz B. Editorial: Licensing and use of new therapies in MS: where are we going? Int MS J. 2005;12:39-41. Mayo Clinic www.mayohealth.org Multiple Sclerosis – Medline Plus www.nlm.nih.gov/medlineplus/multiplesclerosis.html Multiple sclerosis – Research, Diagnosis, Symptoms, Treatment… Johansson S, Ytterberg C, Back B, Holmqvist LW, von Koch L. Journal on The Swedish occupational fatigue inventory in people with multiple sclerosis. Division of Neurology R54, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden. (Published 9 October 2008 in J Rehabil Med, 40(9): 737-43.) www.multiplesclerosis.researchtoday.net Methylprednisolone Oral. US National Library of Medicine (Medline) (2003-04-01). Retrieved on 2007-09-01. Multiple Sclerosis (Symptoms) (Mayo Foundation for Medical Education and Research) www.nlm.nih.gov/medlineplus/multiplesclerosis.html Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isnt. BMJ. 1996;312: 71-72. www.mscare.org/cmsc/Journal-of-MS-Care.html Uttner I, Müller S, Zinser C, et al (2005). "Reversible impaired memory induced by pulsed methylprednisolone in patients with MS". Neurology 64 (11): 1971–3. Read More