CHRONIC NEUROLOGICAL DISEASES: MULTIPLE SCLEROSIS 7
ChronicNeurological Diseases: Multiple Sclerosis
ChronicNeurological Diseases: Multiple Sclerosis
Theimportance of health and wellbeing of any individual cannot begainsaid as far as the economic capability of any country isconcerned. Indeed, health has always been known to have a bearing onthe overall economic wellbeing of a country, especially consideringthat only individuals who are healthy would have the capacity toundertake wealth building activities. This may explain why a largenumber of countries invest substantial amounts of their money in theprovision of healthcare. However, it is understood that there arevariations in the frequency, magnitude and effects of ailments. Ofcourse, quite substantial amounts of research have been done towardsdetermining the causes, predisposing or risk factors of ailments,proper diagnosis, as well as ways of preventing these ailments. Evenmore important is the cure or treatment for them. This is the casefor chronic neurological ailments, particularly Multiple Sclerosis.
MultipleSclerosis refers to an unpredictable and usually disabling ailmentpertaining to the central nervous system that upsets the flow ofinformation in the brain, as well as between the body and brain (Rog&Robinson, 2010).It may also be described as an ailment in which an individual’simmune system starts attacking the protective sheath (called myelin)covering the nerves. This destruction of myelin would disruptcommunication between the brain and other parts of the body. Ofparticular note is the fact that the nerves themselves may,ultimately deteriorate in a process that is known to be irreversible.
Causesof Multiple Sclerosis
Inspite of the numerous studies and researches that have been doneregarding the causes of multiple sclerosis, there has never been adefinitive determination of this. However, scholars have underlinedthe notion that the ailment occurs as a result of a combination ofgenetics and environmental factors.
First,scholars have underlined that there is a connection between geographyand the occurrence of multiple sclerosis (Rog&Robinson, 2010).It is noted that the ailment is common among individuals livingfarther from the earth’s equator. This may be explained with regardto the fact that such individuals would be facing a reduced exposureto sunlight leading to decreased production of vitamin D. This ideais supported by the fact that there exists a relationship between thetime when an individual is born and the possibility of occurrence ofthe ailment.
Inaddition, scholars have established a link between genetics and theoccurrence of multiple sclerosis (Rog&Robinson, 2010).As much as the ailment is not a hereditary ailment, varied geneticvariations increase the risk. Indeed, it is noted that the closer anindividual is related to an affected person, the higher thelikelihood or risk that one will get affected. Testament to this isthe fact that identical twins stand 30% risk, while non-identicaltwins have 5% risk, and 2.5% in the case of siblings (Weiner&Stankiewicz, 2012).On the same note, individuals whose children suffered the ailmentstand a ten times the risk compared to the general population.Certain genes have been connected to the occurrence of multiplesclerosis including variations in human leukocyte antigen (HLA)system.
Further,some microbes are thought to trigger the ailment although none isconfirmed just yet. Indeed, scholars have stated that relocation fromone place to another in the globe at an early age would modify theindividual’s subsequent risk for the ailment. There are suggestionsthat the increased risk may have resulted from some kind of aninfection emanating from a widespread microbe (Weiner&Stankiewicz, 2012).The evidence that viruses cause this ailment is based on thedemyelination in animals emanating from some viral infections,relationships between varied viruses with the human demyelinationencephalomyelitis, as well as the incidence of oligoclonal bands inthe cerebrospinal fluid and brain of a large number of individualswith the ailment.
Typesof Multiple Sclerosis
Thereare four categories of Multiple sclerosis. The first isprogressive-relapsing multiple sclerosis which is related to a steadydeterioration of the ailment along with frequent flare-ups. There isalso primary-progressive multiple sclerosis, which involves and slowand persistent worsening of the ailment right from the onset (Weiner&Stankiewicz, 2012).Third category is secondary-progressive, which involves an initialrelapsing-remitting ailment followed by minor remissions and steadyworsening (Weiner&Stankiewicz, 2012).The last category is relapse-remitting multiple sclerosis, which isthe most common category and involves flare-ups, where there is theworsening of symptoms for months or weeks, as well as remissions inwhich the symptoms partially or completely improve (Weiner&Stankiewicz, 2012).
Pathophysiologyof Multiple Sclerosis
Thereare three major indications of multiple sclerosis includinginflammation, formation of lesions in an individual’s centralnervous system, as well as the destruction or damaging the myelinsheaths of neurons. The characteristics interact in a sophisticatedand yet to be fully comprehended manner to result in a breakdown ofnerve tissue and, consequently, the symptoms and signs of the ailment(Scolding& Wilkins,2009). The symptoms and signs include bowel constipation, extremetiredness, hearing loss, mental health problems, pain, numbness andtingling feeling, shaking, seizures, difficulty walking, headaches,spinning sensations and dizziness, bladder problems, as well ascognitive problems.
Lesionsusually impact on the white matter in the brain stem spinal cord,basal ganglia, white matter at the optical nerve, or even the whitematter tracts that are close to lateral ventricles. White mattercells are responsible for the ferrying of signals between the greymatter areas in which the processing is carried out and other partsof the body. Rarely is the peripheral nervous system involved MSrevolves around losing oligodendrocytes, which are the cells thatcreate and maintain the fatty layer called myelin sheath whichassists neurons in carrying action potentials (Weiner&Stankiewicz, 2012).The myelin sheath would, consequently be lost resulting in thebreakdown of neurons axons. This impedes the functioning of theneurons. As much as remyelination occurs at the early stages of theailment, the oligodendrocytes are incapable of rebuilding the myelinsheath. Persistent attacks result in successively less effectiveremyelinations to the extent that the damaged axons have scar-likeplaques around them (Jelinek,2009).The scars would be the origin of the signs, with magnetic resonanceimaging indicating over ten new plaques in the course of an attack.This may be an indication of the presence of several lesions belowwhich an individual’s brain would be incapable of self-repairwithout the production of noticeable consequences.
Inflammation,on the other hand, occurs in instances where T cells enter the brainthrough blood-brain barrier disruptions. T cells are lymphocytes thatplay a crucial role in the defense of the body (Scolding& Wilkins,2009). Upon gaining entry, they would recognize the myelin as aforeign body thereby attacking it and triggering the inflammatoryprocess that excites other immune cells, and triggers the release ofsoluble factors such as antibodies and cytokines. Persistentbreakdown of this blood-brain barrier would result in otherdestructive effects such as swelling, macrophages activation andincreased cytokines activation alongside other damaging proteins.
HowMultiple Sclerosis is Diagnosed
Thediagnosis of MS is based on the symptoms and signs alongsidesupporting laboratory testing and medical imaging. However, theailment may be difficult to confirm at the early stages as thesymptoms and signs are similar to those of other medical problems.Nevertheless, the diagnostic tools utilized include neuroimaging, aswell as analysis of evoked potentials and cerebrospinal fluid(Scolding& Wilkins,2009). On the same note, magnetic resonance imaging on one’s spineand brain may indicate portions of demyelination. Analysis ofcerebrospinal fluid derived from lumbar puncture offers evidence ofcentral nervous system’s chronic inflammation. It is noted that thecentral nervous system in multiple sclerosis may respond in a lessactive manner to sensory nerve and optic nerve stimulation as aresult of demyelination of pathways (Scolding& Wilkins,2009).
Multiplesclerosis does not have any known cure. Indeed, treatment usuallyinvolves speeding up the individual recovery from any attacks,management of symptoms, as well as slowing down the ailment’sprogression. One way of treating the attacks may involve plasmaexchange where the liquid part of the blood would be removed andseparated from the blood cells, which are then combined with proteinsolutions and returned to the body. This technique may be used ininstances where the symptoms are severe and the individual isunresponsive to steroids. Signs and symptoms, on the other hand,would be treated through physical therapy, muscle relaxants andmedications that reduce fatigue (Jelinek,2009).On the other hand, progression would be halted or slowed down usingvaried medications such as fingolimod, Beta interferons and copaxoneamong others.
Jelinek,G. (2009). Overcomingmultiple sclerosis: An evidence-based guide to recovery.Crows Nest, N.S.W: Allen & Unwin.
Rog,D., & Robinson, I. (2010). Multiplesclerosis.London: Class Pub.
Scolding,N& Wilkins.A (2009). MultipleSclerosis.Oxford: Oxford University Press
Weiner,H. L., & Stankiewicz, J. M. (2012). Multiplesclerosis: Diagnosis and therapy.Chichester, West Sussex: Wiley-Blackwell.