Home › Forums › Other Specialities › Neurology & Neurosurgery › MULTIPLE SCLEROSIS- PATIENT and FAMILY LEAFLET.
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November 6, 2014 at 3:06 pm #2968
Anonymous
InactiveMultiple sclerosis (MS) is a disorder of the brain and spinal cord. It can cause various symptoms.
In most cases, episodes of symptoms come and go at first for several years. In time, some symptoms can become permanent and can cause disability. Although there is no cure for MS, various drugs and therapies may reduce the number of flare-ups and can help to ease symptoms and disability.What is multiple sclerosis?
Multiple sclerosis (MS) is a disease where patches of inflammation occur in parts of the brain and/or spinal cord. This can cause damage to parts of the brain and lead to various symptoms (described below).Understanding the brain, spinal cord, and nerves
Many thousands of nerve fibres transmit tiny electrical impulses (messages) between different parts of the brain and spinal cord. Each nerve fibre in the brain and spinal cord is surrounded by a protective sheath made from a substance called myelin. The myelin sheath acts like the insulation around an electrical wire, and is needed for the electrical impulses to travel correctly along the nerve fibre.Nerves are made up from many nerve fibres. Nerves come out of the brain and spinal cord and take messages to and from muscles, the skin, body organs and tissues.
What causes multiple sclerosis?
MS is thought to be an autoimmune disease. This means that cells of the immune system, which normally attack bacteria, viruses, etc, attack part of the body. When the disease is active, parts of the immune system, mainly cells called T cells, attack the myelin sheath which surrounds the nerve fibres in the brain and spinal cord. This leads to small patches of inflammation.Something may trigger the immune system to act in this way. One theory is that a virus, or another factor in the environment, triggers the immune system in some people with a certain genetic makeup.
The inflammation around the myelin sheath stops the affected nerve fibres from working properly, and symptoms develop. When the inflammation clears, the myelin sheath may heal and repair, and nerve fibres start to work again.
However, the inflammation, or repeated bouts of inflammation, can leave a small scar (sclerosis) which can permanently damage nerve fibres. In a typical person with MS, many (multiple) small areas of scarring (sclerosis) develop in the brain and spinal cord. These scars may also be called plaques.How does multiple sclerosis progress?
Once the disease is triggered, it tends to follow one of the following four patterns.1.Relapsing-remitting form of MS
Nearly 9 in 10 people with MS have the common relapsing-remitting form of the disease. A relapse is when an episode (attack) of symptoms occurs. During a relapse, symptoms develop (described below) and may last for days, but usually last for 2-6 weeks. They sometimes last for several months. Symptoms then ease or go away (remit). You are said to be in remission when symptoms have eased or gone away. Further relapses then occur from time to time.The type and number of symptoms that occur during a relapse vary from person to person, depending on where myelin damage occurs. The frequency of relapses also varies. One or two relapses every two years is fairly typical. However, relapses can occur more or less often than this. When a relapse occurs, previous symptoms may return, or new ones may appear.
This relapsing-remitting pattern tends to last for several years. At first, full recovery from symptoms, or nearly full recovery, is typical following each relapse. In time, in addition to myelin damage, there may also be damage to the nerve fibres themselves.
Eventually, often after 5-15 years, some symptoms usually become permanent. The permanent symptoms are due to accumulation of scar tissue in the brain and to the gradual nerve damage that occurs. The condition typically then slowly becomes worse over time. This is called secondary progressive MS. Typically, about two thirds of people with relapsing-remitting MS will have developed secondary progressive MS after 15 years.
2 .Secondary progressive form of MS
There is a steady worsening of your symptoms (with or without relapses) in this form of MS. Many people with the relapsing-remitting form later develop this type of MS.3 .Primary progressive form of MS
In about 1 in 10 people with MS, there is no initial relapsing-remitting course. The symptoms become gradually worse from the outset, and do not recover. This is called primary progressive MS.4 .Benign MS
In less than 1 in 10 people with MS, there are only a few relapses in a lifetime, and no symptoms remain permanent. This is the least serious form of the disease and is called benign MS.Who gets multiple sclerosis?
About 1 in 1,000 people in the UK develop MS. It can affect anyone at any age, although it is rare in young children. It most commonly first develops around the age of 30. MS is the most common disabling illness of young adults in the UK. It is twice as common in women as in men.MS is not strictly an hereditary disease. However, there is an increased chance of MS developing in close relatives of affected people. For example, a mother, father, brother, or sister of a person with MS has about a 1 in 100 chance of developing MS (compared with about a 1 in 1,000 chance in the general population).
FOR Symptoms,Diagnosis,Treatment,Follow up etc , patient leaflet,-request author.
PRACTICE POINT- Considering the Chronicity , the variable progress in different patients- the Longterm relationship between the patient and the GP, is key for support and management.
Good secondary care( consultant ) help and follow up , with shared care with the General Practitioner needs to be established.
Time to listen, good history taking,and developing Trust ,must be primary aspects to focus on in General Practice.Remember friends,” BUT FOR THE GRACE OF GOD, GO YOU AND I”.
G Mohan.
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