MS central nervous system disease
Introduction
Controversy, however, exists on the actual biological meaning of Multiple Sclerosis as many biological researchers describe the disease in different versions. According to Polman (292), utilizing various biological frameworks illustrates that Multiple Sclerosis is an immune-mediated process whereby an abnormal response of the immune system is triggered or directed against the central nervous system. Beard (150), on the other hand, drawing upon various biological research explains that the Multiple Sclerosis is a disease that affects the brain, spinal cord as well as the optic nerve and of great importance to note is that the disease differs from one person to another as some can have mild symptoms while others can show serious symptoms. MS is a common disabling neurological disease that affects both young and old adults, but young adults have a higher chance of being infected with this disease.
Brief history
When was the disease discovered? Who discovered the disease?
History shows that MS is a disease that spans more than a century, and it, however, affects the nervous system of people of all ages in spite of the fact that it is mostly skewed towards young people. According to Weinshenker (119), he argues that until the 19 century, most neurologists and physicians relied more on hearsay and superstition as medical ideas such as those of MS were not scientifically tested. Notably, MS was first recognized 20 years after Augustus’ death (the first patient to suffer from MS) in 1848. Augustus, just before his death experienced symptoms such as double vision, weakness in legs as well as bladder and bowel problems, and all this was later linked to MS. It is, however, true that from this period various reports have been brought forward trying to describe the many signs of MS. Among the many reports of individual cases regarding MS that was done in the 18 century, the reports done by Robert Caswell and Jean Cruveilhier in 1838 and 1841 respectively were the most popular. Subsequently, the Parisian neurologist named Martin Charcot in 1868 expanded on his predecessor’s research by attributing the symptoms of MS to impaired conduction in the CS, and he later named or gave a number to this disease. Therefore, with Charcot’s clarification, many cases of MS were reported later in the 19 Century, which therefore showcases that the MS was discovered in 1868 by Martin Charcot.
Clinical symptoms of the disease
According to Ehde, et al. (627) they biologically pinpoint that MS occurs when one’s immune system basically attacks a material called myelin that is tasked to protect the nerve fibres. The absence of this fibres or rather the damage to this outer shell makes the nerves vulnerable. In as much as the patterns of MS are complex, variable, and unpredictable, the disease has the following common clinical symptoms; one is that a person feels numbness and tingling that typically occurs at one side of the lymph. Another clinical symptom is the fact that one may feel an electric shock-wave sensation that that occurs as a result of certain neck movements such as bending forward. Moreover, another symptom is severe pain, which is a result of demyelination or axonal loss. In addition, another symptom is fatigue. Krupp (225) claim that fatigue is the most common and least understood symptom of MS as people often may figure it as laziness. Another symptom of MS is the inflammation of the optic nerve, which is often regarded as optic neuritis. More broadly, another common symptom is that some people can experience double vision. In a nutshell, some other mild symptoms associated with MS include depression, problems associated with bladder or bowel control, sexual problems, and slurred speech in some instances. Notably, it is fundamental to understand that all the symptoms are dependent or anchored on a person’s immune system, which presumably translates that these symptoms vary among individuals.
How is the disease diagnosed?
At present, there are no accurate or reliable means of diagnosing the MS. However, the diagnosis of MS requires the use of both the clinical and paraclinical criteria whereby the paraclinical criteria involves the idea of obtaining information from MRI, Motor-evoked potentials as well as the cerebrospinal fluid tests. The objective of these tests, however, is simply to access the extent of the damage or rather the presence of intrathecal inflammation as well as ruling out other conditions that may mimic demyelinating diseases. In essence, Ebers, George C., and Dessa (117), a group of neurologists’ voice out that the incorporation of MRI as a diagnostic tool has increased the accuracy of diagnosing MS by 90 %. The diagnostic criteria have since evolved over time, and the most used criteria (MacDonald criteria) outlines three basic steps that summarize all the diagnostic criteria and this include; the fact that one should find an “involvement” in the central nervous pathways in more than one location, the disease should show some involvement over time (not a one-time event) as well as the fact that there should be an exclusion of other diseases that look like. Also, many researchers explicitly underscore that there is no single test (either biological or clinical) that can be used to make a clear diagnosis, which means that the diagnosis is a combination of various aspects, but the advancement in technology especially the MRI has facilitated the diagnosis over the years. In general, MS diagnosis is often conferred by any clinician.
Is it genetic? Individuals at risk,
According to Ebers, George C., and Dessa (1), they explain that the risk of developing MS disease is slightly higher if a close relative, say, for example, a parent or sibling has the disease. As of the National Multiple Sclerosis society, they pointed out that the odds of getting the MS disease given that one’s relative has this disease is approximately 2.5. In a nutshell, reliable evidence points towards the presence of genetic susceptibility to MS. Individuals of all ages are at risk of the diseases; however, the prevalence of this disease is skewed or rather seems to be high on young adults. Moreover, a clear pattern of latitudinal variation exists where Epidemiological studies point towards a high prevalence in Northern Europe. People of all races are also at risk of this disease, although there is a high prevalence of MS in white races, and there is less indicative evidence of it affecting the black immigrants from African countries. Besides, sex and ethnicity also play a role in regard to individuals at risk of this disease. Notably, women are two to three times at risk of developing RRMS than men. Besides, people from northern Europe have a higher chance of developing this disease compared to other locations.
Clinical treatment of the disease
It is no exaggeration that there is no cure or rather specific tests for MS, and the treatment of these diseases often relies on ruling out other conditions that have similar signs. Yamout et al. (611) explicitly illustrate that the treatment of MS entails a number of drugs that act through different mechanisms, and it specifically depends on both the clinical course and the form of the disease. No therapy has been proven, and for the primary progressive form, a lot of drugs are available that ameliorate the secondary progressive forms, which goes a long way on modifying the activity of the diseases when it is dominated by the relapsing-remitting course. Further, the treatment of this disease depends majorly on the specific symptoms that a person has, and they include; treating relapses of MS symptoms, treating specific symptoms with respect to MS as well as treatments aimed at reducing the number of relapses. The treatment of MS symptoms is often done individually. Fatigue, for example, is treated by taking prescribed amantadine or undertaking normal exercises. For MS relapses, treatment is often done through taking a prescribed five-day steroid tablet that is taken at home. For treatments aimed at reducing the number of relapses, one will be given the “disease-modifying therapies, which helps in reducing the number of lapses. This will consequently reduce the level of damage to the myelin sheath.
According to Miller et al. (281), the prognosis of longevity for all the patients that have been diagnosed with the MS diseases is generally good on average. While some people with severe MS often lose their ability to walk, others may experience remissions without symptoms for a long time. The present treatment ways may help speed up the recovery process as well as modifying the course of the disease.
Recent research
Previous research has done a lot in a bid to give an in-depth analysis as well as new insights in regard to the general information of the MS disease. Recent research has focused mainly on efforts that look to enhance the lives and health of people that have this disease. The recent research report that was done by both the American Academy of Neurology (AAN) (CMSC) in 2019, focused mainly on various approaches that range from the diet, stress management as well as approved investigational DMTs. In a nutshell, recent research outlines the efforts and activities that have been developed in a bid to promote the fight against MS.
Conclusion
In light of the above discussions, MS disease is an unpredictable disease that may cause neurological disability if not detected early. It is, therefore, necessary to offer support and the necessary information for all patients suffering from this disease. In a bid to contain this disease, the government should offer support by channeling funds towards various MS disease research programs in the country. However, healthcare services, on the other hand, should be responsive and flexible, given the unpredictable nature of this disease.
Work Cited
Polman, Chris H., et al. “Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.” Annals of Neurology 69.2 (2011): 292-302.
Beard, S. M., Amanda Hunn, and Jeremy Wight. “Treatments for spasticity and pain in multiple sclerosis: a systematic review.” (2003): 150-200
Weinshenker, Brian G. “The natural history of multiple sclerosis.” Neurologic clinics 13.1 (2005): 119-146.
Krupp, Lauren B. “Fatigue in multiple sclerosis.” CNS drugs 17.4 (2003): 225-234.
Ehde, D. M., Osborne, T. L., Hanley, M. A., Jensen, M. P., & Kraft, G. H. (2006). The scope and nature of pain in persons with multiple sclerosis. Multiple Sclerosis Journal, 12(5), 629-638.
Ebers, George C., and A. Dessa Sadovnick. “Association studies in multiple sclerosis.” Journal of neuroimmunology 53.2 (2004): 117-122.
Ebers, George C., and A. Dessa Sadovnick. “The role of genetic factors in multiple sclerosis susceptibility.” Journal of neuroimmunology 54.1-2 (1994): 1-17.
Miller, David, et al. “Clinically isolated syndromes suggestive of multiple sclerosis, part I: natural history, pathogenesis, diagnosis, and prognosis.” The Lancet Neurology 4.5 (2005): 281-288.
Yamout, B., et al. “Consensus guidelines for the diagnosis and treatment of multiple sclerosis.” Current medical research and opinion 29.6 (2013): 611-621.