Published on 03/03/2015 by admin
Filed under Neurology
Last modified 03/03/2015
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Chapter 2
DEFINITIONS
Benign MS
Relapsing remitting MS
Secondary progressive MS
Primary progressive MS
EPIDEMIOLOGY
Prevalence
Age
Gender
Geography
AETIOLOGY
Environmental factors
Viral infection
Vitamin D deficiency
Other factors: environmental
Genetic factors
Familial
Specific genes
PATHOLOGY
The process of demyelination
Axonal loss
OUTCOME AND PROGNOSIS
SIGNS AND SYMPTOMS
Physical
Speech
Swallow
Sensorimotor
Cognitive and perceptual
Secondary complications
Multiple sclerosis (MS) is defined as a chronic, inflammatory, demyelinating auto-immunological disease. The name multiple sclerosis refers to the scars (sclerosis), known as plaques, formed in the nervous system. There are four types of MS classified according to the course/progression of the disease process.
This subgroup is diagnosed retrospectively. These individuals show little or no disease progression.
This is the most common type of MS representing 80% of the people diagnosed with MS. Symptoms occur for a period of time (relapse, exacerbation) and then improve (remission), either partially or completely.
This type is a progression of relapsing remitting MS, when the individual shows a sustained deterioration for at least 6 months. On average, by 15 years, around two-thirds of people with relapsing remitting MS will have developed secondary progressive MS.
This form of MS affects around 10% of the people diagnosed. The course of the disease begins with subtle problems that worsen over time. There is no relapse remitting pattern, their MS is progressive from the beginning.
According to government guidelines, MS is diagnosed in 3.5–6.6 people per 100 000 of the population each year in England and Wales.
MS is usually diagnosed between the ages of 20 and 50 years.
Approximately, the ratio of women to men affected is 2:1.
MS occurs with much greater frequency in areas that are farther away from the equator.
The definitive cause is unknown. However, the evidence suggests that the cause may be a combination of both genetic and environmental factors.
The evidence indicates that a viral infection, produced by a widespread microbe rather than a rare pathogen, could be the origin of the disease. For example, human herpes virus, chicken pox and glandular fever.
Vitamin D deficiency has been linked with a higher risk of MS. This may occur as a result of inadequate intake of the vitamin, coupled with a lack of exposure to sunlight and may explain the geographical distribution of MS in countries further away from the equator.
Neurological Assessment A Clinicians Guide
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