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Discuss, in depth Multiple sclerosis, the following
-Pathophysiology of disease
-clinical manifestations
-Evaluation (diagnostics)
-Treatment (pharmacological and non-pharmacological) +300 words
Multiple sclerosis (MS) is a disorder of the central nervous system that results in inflammation, demyelination and axonal damage. It affects both white and gray matter of the brain, spinal cord, optic nerves and cerebellum. This can cause serious disability due to its effect on movement, sensation and cognition. It is one of the most common causes of neurological disability in young adults between 20-40 years old.
Pathophysiology
The exact cause of MS is unknown; however, it appears to involve an autoimmune attack by T-cells against myelin basic protein (MBP). In response to this attack inflammatory mediators such as cytokines are released causing further damage to myelin sheath surrounding axons which disrupts nerve impulses conduction resulting in neurological symptoms. The disruption can be focal or diffuse involving white and gray matter thus creating lesions that lead to long term neurologic deficits if untreated. Additionally impaired blood brain barrier has been reported as another factor leading to inflammation and damage contributing for development of MS symptoms.
Clinical Manifestations:
Patients with multiple sclerosis present with various signs and symptoms related to inflammation in CNS tissue including motor weakness, numbness or paresthesia along with pain due to involvement of almost all nervous tissues including brain stem nuclei responsible for autonomic functions such as urinary retention or incontinence , constipation etc., Optic neuritis causing vision loss or diplopia, vertigo also occurs commonly along with cognitive defects especially difficulty remembering new information episodes termed Cognitive fatigue .Psychological disturbances like depression may also be seen occasionally.
Evaluation/Diagnosis: Magnetic Resonance Imaging (MRI) is the gold standard tool used for diagnosis due to its ability detecting lesions in either grey or white matter along with other supportive tests such as Lumbar Puncture (LP )for assessing cerebrospinal fluid composition using Oligoclonal band test(OCB). Neurological evaluations including visual testing ,strength test ,reflexes evaluation etc., should also be performed prior starting treatment..
Treatment: Treatment options include pharmacologic therapy like Disease Modifying Drugs (DMDs) which reduce relapses rate if given early enough before permanent neuronal degradation occurs . Nonpharmacological therapies such as physical rehabilitation programmes , occupational therapy , nutritional supplementation are essential part management plan helping patient maintain physical capabilities over time . Nutritional intervention plans contain vitamins B12 & D3 supplementation specially important vitamin D3 shown beneficial reducing relapse rates . Additionally psychological interventions should be included since often patients struggle dealing with daily life activities caused by disease limitations thus requiring continuous support from family members health professionals during course their illness manage better emotionally support positively affecting outcomes overall principles follow holistic approach while treating Multiple Sclerosis Patients