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Multiple Sclerosis (MS), References - Coggle Diagram

- - - - In the case of Multiple Sclerosis, the body's immune system attacks and destroys the myelin that covers the nerve fibers in the brain and spinal cord.
    - - Damage to myelin sheaths inhibits communication between nerves.
        
        Because of this, Multiple sclerosis can lead to muscle weakness, poor coordination, and in severe cases paralysis.
  - - - -many people initially diagnosed with relapsing MS develop this
        -characterized by a build-up of disability without any periods of relapse
    - - -Symptoms gradually worsen over time, rather than presenting as sudden attacks
        -affects approximately 10-15% of people diagnosed with MS
    - - -Characterized by distinct attacks of symptoms accompanied by periods of stability where symptoms fade completely or partially
        -Approximately 85% of people are diagnosed with this kind of MS
- - - - -Research suggests that this is due to the decreased amount of sunlight in temperate climates
        -Decreased sun exposure can correlate with vitamin D deficiency
    - - Research suggests that Vitamin D deficiency may play a role in immune function and the development of autoimmune disorders
- - - - The National MS society states that nearly 2000 cases of MS are diagnosed each week in the Unites States
        
        Northern States:
        -rates of MS are higher further from the equator
        -The rate of MS in Northern states (above the 37th parallel) is twice as high, at about 110-140 cases per 100,000 people
        
        Southern States:
        -In southern states (below the 37th parallel) the rate of MS is between 57-78 cases per 100,000 people
    - - A 2012 study shows the highest prevalence in people ages 55-64 years old.
      - The onset of MS usually occurs between the ages 20-40, but can technically occur at any point of one's life
      - A 2013 study found that only 4-5% of all diagnosed MS cases are in children.
- - - - Manifestations:
        
        numbness or weakness in limbs that typically occurs on one side of your body at a time
        -electric-shocl sensations that occur with certain neck movements
        -tremor, lack of coordination
        -unsteady gait
- - - - Spinal Tap
        
        -Involves the removal of a small amount of CSF for analysis
        -Can show abnormalities in antibodies associated with MS
      - MRI
        
        -May reveal areas (lesions) of Multiple Sclerosis on your brain and spinal cord
        -May receive an IV injection of contrast to highlight lesions
      - Blood tests
        
        -Help to rule out other disease with symptoms similar to Multiple Sclerosis.
        -Tests that check for biomarkers associated with MS are under development and could potentially aid in diagnosing the disease
      - Evoked potential tests
        
        -Record electrical signals produced by your nervous system in response to stimuli
        -May use visual or electrical stimuli
        -Used to measure how quickly the information travels down nerve pathways
- - - - -Fingolmod
      - Prescribed to reduce the rate of relapses and slow MS progression
    - - Natalizumab (Tysabri)
        
        Designed to block the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord
      - Alemtuzumab (Campath, lemtrada)
        
        Helps to reduce relapses of MS by targeting a protein on the surface of immune cells and depleting white blood cells.
      - Ocrelizumab (Ocrevus)
        
        -Approved to treat both primary and relapsing MS
        -designed to reduce relapse rate and slow progression in both forms
    - - Interferon beta medications
        
        -Commonly prescribed for MS
        -Injected underneath the skin or muscle to help reduce the frequency and severity of relapse
      - Glatiramer acetate
        
        May help to block your immune system's attack on myelin and must be injected beneath the skin
  - - - -prednisone and IV methylprednisone
        -prescribed to reduce nerve inflammation
    - - -plasma is removed and separated from blood cells
        -blood cells are then moxed with albumin and put back into body
        -may be used if your symptoms are new and haven't responded to steroids