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Multiple sclerosis (MS) is the most common cause of neurological disability in young adults in the UK. It is variable in presentation and progression. Although there is no cure, there are many symptomatic treatments available. Nurses have a vital role in the ongoing assessment and management of people with MS.
Multiple sclerosis (MS) is the most common cause of disability in young adults; in Canada, it affects 1 in 1,000 people. A chronic and complicated demyelinating autoimmune disorder of the central nervous system, MS has no known cure. Indeed, there has been no effective treatment until recently.
Multiple sclerosis is one of the most common neurologic conditions in Canada. Many individuals with MS eventually develop the progressive form of the disease. The neurologic and psychosocial manifestations of the later stages of MS are numerous. Family physicians ought to have some understanding of patients with advanced MS and some knowledge of how to manage them.
Multiple sclerosis (MS) is a chronic, complex neurologic disease of unknown origin characterized by exacerbations and remissions. This demyelinating disease of the central nervous system primarily affects young adults. Lately, research has provided new and important findings regarding various etiologic possibilities. Knowledge of comprehensive care is necessary not only for acute hospitalizations but also for individualizing daily home activities for MS patients and their families.
Multiple sclerosis is a chronic inflammatory demyelinating condition of the nervous system. Its etiology is obscure. Something in the environment strikes a susceptible host. Somehow the immune system produces central nervous system lesions. Magnetic resonance imaging scans show far greater "lesion" formation in the brain than was expected from clinical exacerbations. White blood cell changes suggest the disease is not entirely localized to the CNS. Some immunomodulatory treatments temporarily slow the rate of deterioration.
Multiple sclerosis (MS) is the most frequent chronic neurological disease affecting young persons in developed countries. MS is, however, considered as a secondary cause, of central origin, for autonomic dysfunction. The most common autonomic symptoms in MS are disorders of micturation, impotence, sudomotor and gastrointestinal disturbances, orthostatic intolerance as well as sleep disorders. The majority of the patients suffer at some period of the disease from lower urinary tract symptoms and sexual dysfunction. Awareness and treatment of these conditions is vital to improving health and quality of life in patients with MS. The increased understanding of the pathophysiological mechanisms in autonomic dysfunction in MS, along with technological and pharmaceutical developments has advanced our ability to treat the multiple aspects complicating autonomic failure in MS.
Multiple sclerosis may ultimately be effectively treated using appropriate immunosuppressive regimens. Both cytotoxic drugs and therapeutic apheresis may constitute important therapeutic options. A number of studies are currently underway which will hopefully clarify the exact role of these treatment modalities in patients at different stages of disease.
Multiple sclerosis (MS) can produce a variety of different respiratory abnormalities because of the multi-focal nature of central nervous system involvement in the disease. This article reviews the different patterns of respiratory involvement in MS and correlates them with the known neuroanatomy of respiratory control. Methods of monitoring pulmonary function in MS are explored, and the treatment of acute ventilatory failure in MS is discussed.
Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. Available treatments (immuno-modulators, immuno-suppressants) limit central nervous system inflammation and are only partially effective. Remyelination of naked axons becomes insufficient in most cases as the disease progresses. The reason for this repair deficit are many, including oligodendroglial, axonal and environmental factors. Understanding why remyelination fails is crucial for devising effective methods by which to enhance it.
Multiple sclerosis (MS) is an autoimmune disease whose features include a massive lymphocyte recruitment into the central nervous system and segmental demyelinization of the white matter. One of the MS development factors is an increase of matrix metalloproteinases (MMPs) activity with a coincidental decrease of tissue inhibitors of MMPs (TIMPs) activity. Investigations of serum, cerebrospinal fluid and brain tissue of patients showed an increase of MMP-1, -2, -3, -7, -9 and MMP-12 activity. MMPs disrupt the blood-brain barrier (BBB), increase lymphocyte migration into the central nervous system and are involved in degradation of myelin proteins. MMPs induce the appearance of an active form of tumor necrosis factor alpha, a strong proinflammatory cytokine. The drugs used in MS treatment decrease MMPs expression. Multiple actions of MMPs prove their involvement in the pathogenesis and treatment of MS.
Multiple sclerosis (MS) is an autoimmune neurological disorder with a complex etiology. Sibling risk, twin, and adoption studies have demonstrated that genes play a vital role in susceptibility to MS. Numerous association and linkage studies have implicated the major histocompatibility complex (MHC) as one component of the genetic etiology, but additional loci remain to be identified. Genomic screens have suggested over 50 regions that might harbor these genes, but there has been little agreement between studies. The one region suggested by all four screens resides within chromosome 19q13. Allelic associations with several markers in this region have also been described. This region has now been examined in detail in an expanded dataset of MS families from the United States. Genetic linkage and association were tested with multiple markers in this region using both parametric and non-parametric analyses. Additional support for an MS susceptibility locus was observed, primarily in families with the MS-associated HLA-DR2 allele. While consistent, this effect appears to be modest with a maximum lambda(s) = 1.47, probably representing no more than 10% of the overall genetic effect in MS.
Multiple sclerosis frequently results in a wide range of symptoms which often coexist, creating a complex pattern of disability. Chief among these symptoms, both in relation to their frequency and their impact on the patient, are spasticity, ataxia and fatigue. This chapter discusses the pathological basis and current treatment of these symptoms and stresses the importance of a multidisciplinary approach to their management, producing a comprehensive care plan which incorporates these and any other coexisting problems.
Multiple sclerosis (MS), the principal inflammatory demyelinating disease of the central nervous system (CNS), is believed to have an immunopathological etiology arising from gene-environment interactions. In this study, we examined the effect of sex, age, and season at immunization on the susceptibility of (B10.S x SJL/J) F(2) intercross mice to experimental allergic encephalomyelitis (EAE), the foremost animal model of MS. Results of logistic regression analyses suggest that female mice were more likely to exhibit CNS lesions than male mice [odds ratio (OR) = 2.28 for brain lesions; OR = 2.37 for spinal cord (SC) lesions]. Although statistically significant associations were seen between brain and SC lesions and age at the time of injection or month of injection when examined separately; these associations disappeared when controlling for sex in multiple logistic regression analyses. These results suggest that the sex of the mouse is more important in influencing the development of brain and SC lesions than was either age or month of immunization. When examining clinical disease as the endpoint, the OR for the age at immunization is 1.04, indicating that the odds of being affected increase by 4% for each increasing week of age. When controlled for age, the OR for injection in the summer months (July through September) is 1.90, suggesting that the odds of being clinically affected are 90% greater for F(2) intercross animals injected in the summercompared to those injected in the winter to spring months (February through May). In contrast to CNS lesions, the age and season at immunization significantly and independently influenced susceptibility to clinical EAE and did so equally in both males and females. Linkage analysis to eae5, the H2-linked locus controlling susceptibility to clinical disease, was performed using 6- to 12- and >12-week-old cohorts as well as summer and winter/spring cohorts of F(2) mice. Significant linkage of clinical EAE to eae5 was observed with the 6- to 12-week-old and summer populations. In contrast, linkage of clinical EAE to eae5 was not detected with the >12-week-old and winter/spring populations. These results indicate that age and seasonal effects are capable of overriding eae5-dependent genetic control of susceptibility to clinical EAE and have significant implications for the genetics of MS.
Multiple sclerosis (MS) is a chronic debilitating disease with no cure. There has been increasing interest in the use of alternative therapies in combination with or in place of traditional therapies. Nurses and other health care professionals must become more aware of reasons persons with MS are using alternative therapies and identify any risks or potential benefits. The role of the health care professional is to educate persons with MS on contemporary research, cost and regulation of these therapies.
Multiple sclerosis patients may present with clinical data suggestive of cerebral tumor, however, most of the lesions do not show expansive signs in computerized tomography of brain or magnetic resonance imaging. We report in this paper, 2 patients who had shown expansive radiological signs suggestive of neoplasm. Cerebral biopsy was an important diagnostic procedure in these 2 cases which revealed the diagnosis of demyelinating disease.
Multiple sclerosis is a demyelinating central nervous system disorder that affects young, otherwise healthy people. Presenting symptoms can be variable; the complaints are often vague and suggestive of a functional disorder. Diagnosis is based mainly on the clinical triad of young age, involvement of two or more areas within the central nervous system, and history characterized by exacerbations and remissions. In selected cases, the diagnosis is aided by cerebrospinal fluid examination, evoked potentials and computed tomographic scanning.
Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system, especially young adults. Although MS is usually looked on as a disorder of the sensory and motor systems it can also be associated with emotional dysfunctions and changes in personality. The depression, bipolar disorders, euphoria, and pathological laughing and crying are most frequently associated with the disease. Authors present a review of current opinions on pathogenesis, diagnostic criteria and treatment of emotional problems in MS patients.
Multiple sclerosis is a complex disease which presents a unique challenge in clinical management. This decade has seen the advent of new therapies which are partially effective in modifying the disease course. However, current therapies have no impact on existing neurological deficits and so supportive measures, symptomatic treatment and comprehensive rehabilitation remain at the core of management. Historically clinical practice has often been empirical but management should now be evidence-based and guided by consensus opinion if improvements in care are to be made.