Multiple sclerosis is a disorder in which the nerves of the eye , brain and spinal cord lose nerve sheath ( myelin ) .
The term is derived from the number of multiple sclerosis regions of scar tissue ( sclerosis ), which represent the various patches of demyelination in the nervous system .
Which may be a sign of neurological symptoms of multiple sclerosis and so diverse that the disease is not diagnosed when symptoms first appear .
After a long time the disease will get worse slowly .
Patients usually experience a symptom-free periods ( remission ) are interspersed with the disease attacks ( exacerbations ) .
OTHER PRIMARY demyelinating disease
Acute disseminated encephalomyelitis ( post- infectious encephalomyelitis ) is a rare type of inflammation , which causes demyelination which usually occurs after a viral infection or vaccination .
Allegedly an immune reaction that is wrong , which is triggered by a virus .
Guillain - Barr syndrome ? is a disease of the peripheral nerves that resembles this disorder .
Adrenoleukodistrofi and Adrenomieloneuropati is a rare hereditary metabolic disorder occurs .
Adrenoleukodistrofi occur in boys ( usually age 7 years ) , but the disease progresses more slowly can be started at the age of 20s .
Adrenomieloneuropati attacking young . Extensive demyelination is accompanied by abnormal function of the adrenal glands . Ultimately mental deterioration occurs and the child becomes rigid and blind .
There is no treatment for this disease .
Food additives such as glycerol trioleate and glycerol trierukat ( Lorenzo's oil ) would improve the composition of fatty acids in the blood , but it has not been shown to improve the disease course .
Bone marrow transplantation is a treatment which is still a test .
Leber hereditary optic atrophy causes demyelination ending with partial blindness .
The disease is more common in men and symptoms usually first appear in late adolescence or early 20s .
This disease seems to come from her mother and passed on through the mitochondria ( the energy source for cells ) .
Myelopathy associated with HTLV is a virus infection of human T-cell limfotrofik , which causes demyelination in the spinal cord .
The disease is often found in certain tropical countries and in some parts of Japan .
After several years , the disease gets worse , resulting in stiffness and weakness of the limbs and impaired function of the gastrointestinal tract and bladder .
CAUSE
The cause is unknown , but suspected a virus or foreign antigens trigger an autoimmune reaction , which usually occurs in the early life of the patient .
Then the body will produce its own antibodies to fight mielinnya , these antibodies cause inflammation and damage to the nerve sheath .
multiple sclerosis
Heredity seems to play a role in multiple sclerosis .
Approximately 5 % of patients have a brother or sister who also suffer from this disease , and approximately 15 % of patients have a close relative who suffers from this disease .
Environmental factors also play a role in the occurrence of this disease .
Multiple sclerosis occurs in 1 of every 2000 people in the first 10 years of his life living in temperate climates , but only 1 of every 10,000 people born in the tropics .
Multiple sclerosis is almost never attack people who live near the equator .
Climate where someone lived the first 10 years of life seems more important than climate in which a person lives after the first 10 years of life .
SYMPTOMS
Symptoms usually appear in 20-40 years of age , is more common in women .
Demyelination can occur in the brain or spinal anywhere, and the symptoms depend on the affected area .
Demyelination of the nerve pathways that carry signals to muscles causing movement disorders ( motor symptoms ) , whereas if it occurs in the nerve pathways to the brain causing abnormal sensation ( sensory symptoms ) .
Initial symptoms often happens is tingling , numbness or odd feeling in the arms , legs , torso or face .
Dexterity and strength can be lost limbs or hands .
Some people only have symptoms in the eye in the form of double vision , partial blindness and pain in one eye , blurred or dim vision , or loss of central vision ( optic neuritis ) .
Early symptoms can also be a change in emotional and intellectual lightweight .
A vague hint of the presence of demyelination in the brain sometimes starts long before the disease is known .
The common symptoms of multiple sclerosis
Sensory symptoms
(changes in sensation) |
symptoms of Motor
(changes in muscle function) |
numb
|
Weakness, clumsiness
|
pins and needles
|
Difficulty in walking or maintaining balance
|
Other abnormal sensations
(disestesia) |
Tremor (shaking)
|
Impaired vision
|
double vision
|
Difficult to reach orgasm,
reduced sensation in the vagina, impotence in men |
The problem of controlling the digestive tract or bladder,
constipation |
Dizziness or vertigo
|
Stiffness, instability, extraordinary fatigue
|
Diagnosis
Allegedly a multiple sclerosis in a young age suddenly became blurred vision , double vision or experience sensory and motor abnormalities in a variety of different body parts .
The diagnosis is confirmed by the pattern of recurrence and repeated healing .
Dilakukanpemeriksaan thoroughly the nervous system as part of a physical examination .
Laboratory tests can distinguish multiple sclerosis with other similar diseases .
At lumbar puncture found that white blood cell count less and a little more protein than normal .
Antibody concentrations can be high and specific types of antibodies and other substances found in 90 % of patients .
MRI can show the brain that has lost daerh mielinnya .
This examination can distinguish jug active area of the region that has experienced demyelinating some time ago .
If the nerve is stimulated , the electrical response in the brain can be recorded via the evoked potential .
Under normal circumstances , the brain responds to light or sound with a distinctive pattern of electrical activity . In patients with multiple sclerosis , the response is slower because there is a disruption in the delivery of signals along the nerve sheath has been lost .
Some diseases that cause symptoms resembling multiple sclerosis :
- Brain infection caused by bacteria or viruses ( Lyme disease , AIDS , syphilis )
- Abnormalities in the structure of the skull base and spine ( severe arthritis of the neck , ruptured spinal discs )
- Tumors or cysts in the brain and spinal cord ( syringomyelia )
- Setbacks and spinocerebellar ataxia hereditary ( a disease where the muscle action is irregular or uncoordinated muscle )
- Minor stroke ( especially in patients with diabetes or hypertension are susceptible to this disease )
- Amyotrophic lateral sclerosis ( Lou Gehrig's disease )
- Inflammation of blood vessels in the brain or spinal cord ( lupus , arteritis ) .
TREATMENT
Beta - interferon injections may reduce the frequency of recurrence .
Other promising treatment and research is still in the other interferons , oral myelin and glatiramer ; which helps prevent the body attacks its own mielinnya .
Advantages of plasmapheresis and intravenous gamma globulin treatment is uncertain and it is not practical for long-term therapy .
The main treatment is to reduce symptoms of acute corticosteroids ( eg, prednisone by mouth or intravenous methylprednisolone ) .
Corticosteroids can shorten the attack , but did not stop the progression of the disease in the long term .
Side effects from long-term use of corticosteroids is susceptible to infection , diabetes , weight gain , fatigue , osteoporosis and ulcers .
Patients are often able to maintain an active lifestyle , although susceptible to fatigue and unable to follow a schedule that has been arranged .
Exercise regularly ( eg static bike , running , swimming or stretching ) can reduce muscle stiffness and help maintain a healthy heart , muscle and psychic .
Physical therapy can help maintain keseimbahan , walking ability and affordability and reduce muscle stiffness and muscle weakness .
Innervation that controls the discharge of urine or gastrointestinal tract may be affected and cause incontinence or urinary or fecal water accumulation .
Patients are taught to put the catheter hose ( to empty the bladder ) or use a stool softener or laxative .
Prognosis
Multiple sclerosis has a variable clinical course and can not be predicted .
In many patients , the disease begins with certain symptoms , which for months or years later showed no further symptoms .
In other patients , the symptoms got worse and more widespread within a few weeks or a few months .
The weather was warm , hot bath or fever may aggravate symptoms .
Recurrence can occur spontaneously or be triggered by infections ( eg influenza ) .
If relapse occurs frequently then semakinmemburuk abnormalities and can be settled .
