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  Multiple sclerosis

Multiple sclerosis (MS) is a chronic sensory and motor disorder of variable presentation due to loss of myelin from the nerve cells in the central nervous system. The cause of multiple sclerosis is patchy deterioration of the myelin sheaths of nerve tracts in the brain and spinal cord and in the optic nerve which leads to the deterioration of nerve function. Other probable causes are: genetic, infectious and autoimmune factors.

Multiple sclerosis Neurological disorder
Multiple sclerosis


Onset is usually between 20 and 40. The incidence is higher in women and in high altitude places. The disease is precipitated by fatigue, emotional stress, pregnancy or viral respiratory infection.

The presenting manifestation is mainly due to irregular, intermittent or progressive impairment of sensory or motor function such as the following: hyperesthesia (increased sensitivity to pain), paresthesias (“pins and needles” sensation or tingling sensation), visual disturbances, dysequilibrium, muscular weakness, spasticity, unsteadiness, tremors, nystagmus (rapid, jerky oscillating rhythmic eye movements), diplopia (double vision) and disturbances of swallowing or bladder function.

Physical examination findings focuses on the neurologic examination which reveals typically diffuse and highly variable hyperesthesia or anesthesia, irregularly distributed muscle weakness with spasticity, hypereflexia or increased in deep tendon reflexes, positive Babinski reflex, impaired or abnormal superficial reflexes, ataxia, uncoordinated speech, tremors, nystagmus, and temporal pallor of the optic disks followed by optic atrophy, visual field defects, and emotional lability.

Diagnostic test include lumbar puncture or spinal tap which may show moderate lymphocytosis and elevation of immune globulins including oligoclonal IgG globulins (antibody to myelin) not found in serum. The electroencephalogram (EEG) may show nonspecific abnormalities. Magnetic resonance imaging (MRI) of the brain and spinal cord shows multiple patchy lesions. Visual evoked potential testing may corroborate the diagnosis.

The disease is highly unpredictable. Four patterns are distinguished: relapsing remitting, primary progressive, secondary progressive and progressive relapsing. Presenting symptoms often remit for months or years. Typically the disease progresses gradually, with remissions and exacerbations and eventually produces some disability. Relapses may be triggered by excessive fatigue.

Treatment management include: increased rest, particularly during periods of heightened symptoms. Adrenocortical steroids often mitigate neurologic impairment particularly during acute relapses. Physical therapy and muscle relaxants are helpful in dealing with muscle weakness and spasm. Immunotherapy, plasmapharesis, and synthetic myelin protein are among the treatments currently being evaluated. Psychotherapy may be necessary.

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Prednisone tablets

Prednisone

Prednisone and other Corticosteroids are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions. They are often used as part of the treatment for a number of different diseases, such as severe more...

Tysabri

Tysabri

Also known as Natalizumab, Tysabri is used in the treatment of the relapsing-remitting form of multiple sclerosis (MS). This medicine may extend the time between relapses. Be sure to tell your doctor of any allergies you have whether it is to medicatio more...

Natalizumab

Natalizumab

Natalizumab is in a class of drug known as monoclonal antibody. This medicine affects the actions of the body's immune system. Natalizumab is used in to treat relapsing forms of multiple sclerosis, a demyelinating neurologic disease. more...

Triamcinolone

Triamcinolone

Triamcinolone is in a class of drugs called steroids. Triamcinolone reduces swelling and decreases the body's immune response. Triamcinolone is used to treat endocrine disorders when the body does not produce enough of its own steroids. I more...


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