Multiple Sclerosis Task

Multiple sclerosis is a disorder that affects the mind, spinal wire, and the optic nerves in the eye. The sickness is long-lasting and causes problems with imaginative and prescient, stability, muscle manipulate, and different primary body features. The disease disrupts the myelin that shields and guards the nerve cells of the spinal nerve and brain cells in a process called demyelination. Ultimately, nerve deteriorates or even is damaged permanently making the brain unable to send signals inside the body correctly. The disease has a different effect on people, whereas in some people there are mild symptoms that need no treatment, some experience difficulty doing day to day tasks. The disease has no cure, but therapy speeds the recovery process from the attacks, change the progress of the disease and cope with the symptoms.

Causes

Multiple sclerosis is considered an autoimmune disease since its reason is still unknown. An autoimmune disease is a disease where the body’s immune attacks its tissues destroying myelin. Myelin is a fatty substance that coats and protects the fibers in the brain and spinal cord. An analogy is used to compare myelin to insulation on an electrical wire (Dendrou et al., 2015). Once, myelin is damaged, the nerve fiber is exposed slowing or blocking the signals being sent along the nerve. Sometimes, the nerve is completely ruined. The development of segregatively in people is not yet apparent, but scientists believe that combination of genetics and environmental factors are responsible for the disease. Some other factors that play a role in the development are immunologic, age, infections, sex, and ethnicity. Researchers believe that bacteria and virus such the measles virus and human herpesvirus-6 may be responsible for the development of MS. Viruses are known to cause demyelination and therefore, could possibly trigger MS. Women are two to three times more likely to develop MS than men. Also, the people who are at the highest of developing MS are those with the northern European descent. 

Discovery

The symptoms of multiple sclerosis have been described as far as the Middle Ages long before it had a name. According to history, a Dutch saint named Lidwina might have the first known case of Ms, the patient died in 1422 (Lublin et al., 2014). It is reported that the Lidwina fell while ice skating and developed symptoms such as excruciating pain, headaches that blinded, a problem when waking and paralysis. With time, her condition got worse, but she remitted later on in life. The grandson, George II, could also be a potential MS patient, with MS symptoms described by the King in his diary in 1848.

 In 1868, Dr. Jean-Martin Charcot became the first person to have identified multiple sclerosis as a disease (Lublin et al., 2014). One of his females suffered a combination of orders, which he tried to treat using the known treatment of neurological disorders such as the electrical simulation and injecting silver into her body without success. A silver injection was a standard treatment that helped alleviate the symptoms of syphilis. According to Lublin et al., (2014) upon the death of the patient, he dissected the brain and found lesions in the brain. He then called the disease sclerose en plaques. Shortly later, myelin was discovered despite the fact that its significance was not known precisely. 

With the advancement of microscopes, the understanding of the disease was enhanced. In 1916, James Dawson, a Scottish doctor identified inflammation and demyelination of the brain cells of patients with MS using a microscope. With the discovery, doctors suggested the various cause of the disease despite lack of proof. Some suggested that the reason was due to toxins or virus while other suggested immune systems as the cause but none was taken seriously. In 1847, a Columbian researcher found the unusual protein in products in the cerebrospinal fluid which paved the way for the today’s MS testing. The doctors started to believe that the problem was a result of blood and used circulation to treat the disease. The discovery of DNA structure in 1953, paved the way for the development in the 1960s that MS was a disease caused by autoimmunity and use of steroid to counter the disease became widespread.

Epidemiology

Epidemiology is the study of disease in a population (Mahad et al., 2015) . It analyses patterns, the cause and the effect on the health of a disease condition with a population. These studies have aided in identifying factors that might be related to the risk of developing MS. These factors include ‘latitude, migration patterns, genetics, and infectious processes. Reports indicate that they about 2.3 million people in the world who are suffering from MS. However, this number could be more because of the number of people who remain undiagnosed in certain parts of the world.

Although the disease is found in all the parts of the world, its prevalence varies greatly depending on the geographical locations (Fox et al., 2016). According to Fox et al., (2016), the highest number of those with the condition is located in North America and Europe, and the lowest recorded in sub-Saharan Africa and East Asia. In some populations such as the Inuit’s, New Zealand Maoris, and Australian Aborigines there is no reported of this disease. When sex is considered, there is twice as much infection of women than men/, hence a suggestion of the role hormone plays in the disease process. Those most affected by the disease range between the age of 25 and 35, despite a report indicating 3% to 5% of those diagnosed are diagnosed and a possibility of infection in much older adults.

Description (Anatomy and Physiology)

The messages sent by nerves are in form electrical impulses traveling through the boy through nerve cells. Nerve cells are also known as neurons. As insulation, the neurons are protected a thin layer of tissues that cover it known as Myelin sheath. As an insulating material, the myelin ensures that the electrical currents passing through the neurons do not leak away (Lassmann, 2018). MS develops when this myelin sheath covering the neurons in the brain and spinal cord are destructed. The damage to the tissue is caused by inflammation due to the attack of the immune system on the nervous system. According to Lassmann (2018), this inflammation occurs in the areas of the brain, optic nerve, and spinal cord. The cause of this inflammation is still unknown but is commonly suggested to be a resulting defect in genes and virus. 

The effect of this a slow passage of messages through the neurons. With time, the damaged tissues form a scar tissue, known as plaque that reduces the ability of neurons to function normally. The damage to the myelin causes various symptoms. The damage causes lose if the ability to make use of his/her senses such touch and vision. Also, there is the loss of control of muscles because the movement of muscles is caused by the nerves.

There are four forms of MS which are relapsing-remitting, primary-progressive, secondary-progressive, and progressive-relapsing (Ascherio and Munger et al.,2016). All these four forms can be mild, moderate, or severe. 85% of those affected by MS suffer from relapsing-remitting at initial diagnosis. This form of MS causes clearly defined flare-ups in individuals. There is also the stage attributed to acute worsening of neurological function that is followed by episodes where the individual can recover either partially or entirely that are characterized by disease-free progression. Primary-progressive is rare with reports of approximately 10% cases in patients. This form is characterized by slow but continuous worsening of the disease from the start, with no relapses or remissions. However, the rate of progression differ with time, plateaus occasionally, and minor improvements temporarily. Patients suffering from relapsing-remitting MS develop secondary-progressive within ten years of the initial diagnosis and before introducing to disease-modifying drugs. Secondary-progressive MS causes experiences associated with relapsing-remitting MS which then worsens steadily with the probability of occasionally occurring flare-ups, minor remissions, or plateaus. Progressive-relapsing is rare with reported on 5% of the affected patients. The disease progresses between periods of relapses periodically.

Symptoms

The disease attacks different parts of myelin in different individual hence the progression of the symptoms vary in intensity and predictability. With every attack, distinct symptoms emerge and effect on new regions of the nervous system. Although the disease can sometimes progress without any remission periods, the symptoms increasing progressively and episodes lasting days, weeks, or months and alternating with ailment-loose remissions. According to Lassmann (2018), the most common symptoms of MS are:-

- Difficulty in walking, caused by muscles weakness.

- The loss in coordination or balance.

- Fatigue

- Pain

- Tremors

- Loss of bladder or bowel control

- Problems with vision including blurred vision or double vision

- Numbness, feeling of “pins and needles” or other abnormal sensations

Treatments available

There is no permanent cure for multiple sclerosis. The remedy of MS is targeted on speeding up the recuperation from the attacks on myelin, slowing down the fee at which the disease progresses, and coping with the signs of MS. With patients who are experiencing mild symptoms no treatment is needed.

            Treatments to curb MS attacks

- Corticosteroids- medication such as the oral prednisone and intravenous methylprednisolone are prescribed to reduce inflammation of the nerves.

- Plasma exchange- this involves removing the plasma from the blood and separating it from the blood cells. The blood is mixed with albumin and returned to the body. This treatment is used when the symptoms are new, severe or did into responding to steroids.

Treatment to modify progression

- For primary-progressive MS ocrelizumab is prescribed. The therapy is used to slow down the worsening of disability in the patients affecting his form.

- To treat relapsing-remitting MS, there are various options. These options include Beta interferons, Ocrelizumab, Glatiramer acetate, Dimethyl fumarate, Fingolimod, Teriflunomide, Natalizumab, Alemtuzumab, and Mitoxantrone.

Treatment for MS signs and symptoms

- Physical therapy- is used to teach stretching and strengthening exercises. When physical therapy is used with movement aid, it can help manage weak leg spot as well as other gait issues.

- Muscle relaxants- used to reduce muscle stiffness that is painful.

- Medications to reduce fatigue.

- Other medication including that of depression, pain, sexual dysfunction, and bladder control can be prescribed.

Global implications

Since MS affects the quality of life substantially and adversely, it increases the cost of MS patients among the facilities and the society as a whole. According to Hartung et al., (2015), the cost of MS to the community is a critical factor to the policymakers as well as advocacy organizations. Studies to quantify the economic burden of MS is vital when allocating funds for research and services. Over the past ten years, many countries have published the cost of MS, and the finding shows high value on a per person basis.

References

Ascherio, A., & Munger, K. L. (2016, April). Epidemiology of multiple sclerosis: from risk factors to prevention—an update. In Seminars in neurology (Vol. 36, No. 02, pp. 103-114). Thieme Medical Publishers.

Dendrou, C. A., Fugger, L., & Friese, M. A. (2015). Immunopathology of multiple sclerosis. Nature Reviews Immunology, 15(9), 545.

Fox, R. J., Bacon, T. E., Chamot, E., Salter, A. R., Cutter, G. R., Kalina, J. T., & Kister, I. (2016). Prevalence of multiple sclerosis symptoms across lifespan: data from the NARCOMS Registry (vol 5, pg 3, 2015). NEURODEGENERATIVE DISEASE MANAGEMENT, 6(2), 178-178.

Hartung, D. M., Bourdette, D. N., Ahmed, S. M., & Whitham, R. H. (2015). The cost of multiple sclerosis drugs in the US and the pharmaceutical industry Too big to fail?. Neurology, 84(21), 2185-2192.

Heydarpour, P., Khoshkish, S., Abtahi, S., Moradi-Lakeh, M., & Sahraian, M. A. (2015). Multiple sclerosis epidemiology in Middle East and North Africa: a systematic review and meta-analysis. Neuroepidemiology, 44(4), 232-244.

Lassmann, H. (2018). Multiple sclerosis pathology. Cold Spring Harbor Perspectives in Medicine, a028936.

Lublin, F. D., Reingold, S. C., Cohen, J. A., Cutter, G. R., Sørensen, P. S., Thompson, A. J., ... & Bebo, B. (2014). Defining the clinical course of multiple sclerosis The 2013 revisions. Neurology, 83(3), 278-286.

Mahad, D. H., Trapp, B. D., & Lassmann, H. (2015). Pathological mechanisms in progressive multiple sclerosis. The Lancet Neurology, 14(2), 183-193.