Definition, Main Symptoms and Methods of Treatment of Multiple Sclerosis
Multiple Sclerosis (MS) is a progressive autoimmune inflammatory disorder. (Nociti, Batocchi, Luigetti, Conte, Lorusso, Roiati, & Sabatelli, 2011). An autoimmune disease occurs when the immune system destroys the individual’s tissues (Tortora & Derrickson, 2017).
This disease affects the central nervous system, which includes the brain and the spinal cord (Nociti et al., 2011). Multiple sclerosis causes inflammation, degeneration, and demyelination (Autoimmune Diseases and Disorders, 2015). The severity of this condition varies from individual to individual (Autoimmune Diseases and Disorders, 2015).
Multiple sclerosis is caused by T cells that attack the body’s myelin sheath (Tortora & Derrickson, 2017). The axons of neurons surround the myelin sheath (Tortora & Derrickson, 2017). Multiple sclerosis primarily targets the oligodendrocytes, which are large glial cells in the central nervous system (Compston & Coles, 2002). Oligodendrocytes are responsible for synthesising and maintaining myelin sheaths that are surrounded by nerve axons (Compston & Coles, 2002). Multiple sclerosis alters the central nervous system’s neurons, including those in the brain, spinal cord, and optic nerve (Compston & Coles, 2002).
Demyelination causes many symptoms that occur with multiple sclerosis. Phosphenes and Lhermitte’s symptoms are caused by demyelinating axons, which release voluntary and increased mechanical sensitivity (Compston & Coles, 2002). Phosphenes are flashes of light that occur during eye movement (Compston & Coles, 2002). Lhermitte’s symptom is an electrical sensation which occurs down the spine and legs during neck flexion (Compston & Coles, 2002). Partially demyelinated axons can cause Uhthoff’s phenomenon, an appearance of symptoms after exercising or taking a hot shower because the body cannot sustain membrane capacitance when induced by an increased temperature (Compston & Coles, 2002). Fatigue is prevalent in individuals affected by multiple sclerosis as the body’s physical and cognitive tasks increase fatigue during and after task completion (Compston & Coles, 2002). Movement in the eyes, axial muscles, limbs, and bulbar musculature is disrupted when lesions are present on the brain and cerebellar pathways (Compston, 2002). Abnormalities in the spinal cord due to multiple sclerosis can affect motor, sensory, and autonomic functions (Compston & Coles, 2002).
Patients newly diagnosed with active multiple sclerosis have two approved first-line agents available (Ransohoff, 2007). Some patients diagnosed with multiple sclerosis do not need immediate medical treatment (Ransohoff, 2007). The two available agents used to treat multiple sclerosis are interferon beta and glatiramer acetate (Ransohoff, 2007). These two agents may provide adequate disease control, but if they are ineffective, further evaluation is recommended (Ransohoff, 2007). Alternative agents are available. There are therapeutic options available for patients who have inflammatory relapsing-remitting multiple sclerosis, including the following: immunosuppression with cyclophosphamide or mitoxantrone, scheduled pulse therapy with intravenous corticosteroids, and treatment with natalizumab (Ransohoff, 2007). Natalizumab is not available for patients with newly diagnosed or progressive multiple sclerosis (Ransohoff, 2007).
Several holistic treatments for multiple sclerosis are available. Vitamin D supplementation may be beneficial as an add-on treatment; however, after six months, cell proliferation was found to have decreased (Claflin, Ingrid, & Taylor, 2018). Omega 3 is another supplement worth considering (Claflin et al., 2018). In a study, biotin showed a reduction in the progression of the disease. Ginkgo showed no change in disease progression or improvement, but it was well tolerated (Claflin et al., 2018). Exercise is another option for holistic treatment. Many studies have shown improvements in muscle strength and balance (Claflin et al., 2018). Cannabis extract has been shown to improve symptoms associated with incontinence, spasticity, and pain (Claflin et al., 2018). Psychotherapy is also an available option for discussing how this disease may affect your life.
Adaptive immunity is the body’s ability to defend against specific invading agents, including bacteria, toxins, viruses, and foreign tissues (Tortora & Derrickson, 2017). This process involves B cells and T cells, which are lymphocytes (Thompson, Baranzini, Geurts, Hemmer, & Ciccarelli, 2018). Multiple sclerosis involves inflammation, which affects only the central nervous system (Thompson et al., 2018). This indicates that specific antigens recruit T and B cells within the CNS (Thompson et al., 2018).
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