multiple sclerosis wiki

Atypical Optic Neuritis. Two cases with overlapping features. A slit lamp examination is important for visualization of internal eye structures, notably the optic disc. The most common guidelines used for this are called the McDonald criteria, which define the symptoms of MS and how often they must occur in order to make a diagnosis. The tricyclic antidepressant amitriptyline may help both depression and chronic pain. [28] Multiple sclerosis behaves differently in children, taking more time to reach the progressive stage.

McDonald criteria, which are the ones used today, successfully introduced MRI findings as surrogates for the criterion of dissemination in time and space when clinical data are lacking, thus allowing earlier diagnosis of MS.[29], Animation showing dissemination of brain lesions in time and space as demonstrated by monthly MRI studies along a year, Paul O'Connor, James Marriott, Multiple Sclerosis, Chapter 2, Differential Diagnosis and Diagnostic Criteria for Multiple Sclerosis: Application and Pitfalls, Katarzyna Kotulska-Jóźwiak et al. Britze, J., Pihl-Jensen, G., Frederiksen, J. L, et al. My mother has MS, and my goal for this site is to gather all the info I possibly can in a easy format so I can show it to her. 179-86. In MS patients, inflammation against myelin causes swelling and other harmful effects in the nervous system. Willer CJ, Dyment DA, Risch NJ, Sadovnick AD, Ebers GC; Twin concordance and sibling recurrence rates in multiple sclerosis. As a standard, the subtypes are relapsing-remitting, secondary progressive, primary progressive and progressive relapsing[6]. There is no known definitive cure for multiple sclerosis. HLAs are genetically determined proteins that influence the immune system. However, during the first few months after delivery, the risk for a relapse is increased 20%–40%. World Health Organization (2008). a personal review, https://en.citizendium.org/wiki?title=Multiple_sclerosis&oldid=100799612, Creative Commons-Attribution-ShareAlike 3.0 Unported license.

Brain 2018; 141: 2382–2391. In an atypical presentation of optic neuritis, suspicion for a non-MS cause should prompt additional laboratory testing. Gadolinium contrast is used to demonstrate active plaques on T1-weighted images. The incidence of MS differs geographically, between races, sex and between family members where there is a genetic higher risk of developing MS.

Mixed fatigue and depression may be present, encouraging use of the antidepressants such as fluoxetine, or, in pure depression, sertraline.

This is why some people with MS avoid saunas or even hot showers. [1][5], To diagnose MS, or to tell if a person has it, a doctor will determine what kind of symptoms are present and how often they occur. [5][6] The McDonald criteria, which focus on clinical, laboratory, and radiologic evidence of lesions at different times and in different areas, is the most commonly used method of diagnosis[7] with the Schumacher and Poser criteria being of mostly historical significance.

[5] Nevertheless, they still reach it at a lower average age than adults usually do. Symptoms worsen with increases in body temperature, classically after hot showers (Uhthoff's phenomenon)

Dissemination in space, demonstrated by an additional clinical attack implication a different CNS site or by MRI. OCT of the nerve fiber layer. His symptoms began at age 28 with a sudden transient visual loss after the funeral of a friend. Family history of MS is also relevant as there is a genetic predisposition to the disease. In 75% of patients, the initial presentation of MS involves an isolated complaint—45% are motor or sensory and 20% are visual. [51] Climate, diet, geomagnetism, toxins, sunlight exposure, genetic factors, and infectious diseases have all been discussed as possible reasons for these regional differences. Decline occurs continuously without clear attacks. Proc Natl Acad Sci U S A. Feb 1992. 2005 May.

Testing of cerebrospinal fluid (CSF) can provide evidence of chronic inflammation of the central nervous system. The chronic inflammation, degeneration and demyelination of axons in the CNS lead to the clinical presentation of neurologic dysfunction. Along with other data, these exams can help find the widespread nerve involvement required for a definite diagnosis of MS.[20]. The Massachusetts Eye and Ear Infirmary Illustrated Manual of Ophthalmology. MRI brain with contrast of a patient in her mid-20s with new onset MS. Large lesion in left parietal area.

It is estimated that over 2.3 million people worldwide are affected by MS, with most people being diagnosed between the ages of 20 and 50. Multiple sclerosis. Berger T, Rubner P, Schautzer F, Egg R, Ulmer H, Mayringer I, Dilitz E, Deisenhammer F, Reindl M. Pittock SJ; McClelland RL; Mayr WT; Jorgensen NW; Weinshenker BG; Noseworthy J; Rodriguez M. Sadovnick, AD, Ebers, GC, Dyment, DA, Risch, NJ.

In support of alternative theories is the fact that present therapies have not been as successful as was expected based on the autoimmune theory.[30][31][32].
These brain responses can be examined using visual- and sensory-evoked potentials. Relapsing-remitting describes the initial course of 85% to 90% of individuals with MS.

Heat can transiently increase symptoms, which is known as Uhthoff's phenomenon. Multiple sclerosis can have severe debilitating effects within 20-25 years of onset. [31] There is a 5 to 10 year decrease in life expectancy, and death secondary to cardiovascular disease, infection and suicide is higher in MS compared to the general population.[32]. [45] Nonpharmacologic assistance from social workers, physical therapy and occupational therapy are often extremely helpful. [1][21] Other treatments are used all the time to help make attacks happen less often.

These cases are sometimes referred to as borderline forms of multiple sclerosis and are Neuromyelitis optica (NMO), Balo concentric sclerosis, Schilder's diffuse sclerosis and Marburg multiple sclerosis[7]. [13][14] Fifteen percent of individuals have multiple symptoms when they first seek medical attention.[15]. In individuals with progressive subtypes of MS, particularly the primary progressive subtype, on the other hand, supportive equipment is often needed after only about six to seven years.

Banwell B, Bar-Or A, Arnold DL, et al.

Simpson S Jr., Blizzard L, Otahal P, et al.

[19], Once a person is diagnosed with MS, a doctor can help ease the symptoms. While most of them are still under research, there are some of them already well stablished: Several conditions can mimic MS. In sub-Saharan Africa, MS is extremely rare. They also added modificators for the clinical courses based on a pair of characteristics: Active/non-active and with/without progression. Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system (CNS) that results from the immune-mediated inflammation and demyelination of axons. A double-blind, randomized trial of IV immunoglobulin treatment in acute optic neuritis. CNS Drugs 2013; 27:971–988. [25][26] They include: There is no cure for MS. Management involves pharmacotherapy for immune modulation and symptomatic relief.
Multiple sclerosis is an inflammatory demyelinating disease of the CNS in which activated immune cells invade the central nervous system and cause inflammation, neurodegeneration, and tissue damage. Visual prognosis following the first episode of optic neuritis is typically good with or without the use of corticosteroids. Lancet Neurol.

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