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Multiple sclerosis

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15 Aug

Multiple sclerosis

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).

In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerves.

Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.

There’s no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

Symptoms

Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers.

Symptoms often affect movement, such as:

  • Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or your legs and trunk
  • Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
  • Tremor, lack of coordination or unsteady gait

Vision problems are also common, including:

  • Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
  • Prolonged double vision
  • Blurry vision

Multiple sclerosis symptoms may also include:

  • Slurred speech
  • Fatigue
  • Dizziness
  • Tingling or pain in parts of your body
  • Problems with sexual, bowel and bladder function

Disease course

Most people with MS have a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by quiet periods of disease remission that can last months or even years.

Small increases in body temperature can temporarily worsen signs and symptoms of MS, but these aren’t considered true disease relapses.
At least 50% of those with relapsing-remitting MS eventually develop a steady progression of symptoms, with or without periods of remission, within 10 to 20 years from disease onset. This is known as secondary-progressive MS.

The worsening of symptoms usually includes problems with mobility and gait. The rate of disease progression varies greatly among people with secondary-progressive MS.

Some people with MS experience a gradual onset and steady progression of signs and symptoms without any relapses, known as primary-progressive MS.

What causes multiple sclerosis (MS)?

MS is an autoimmune condition. This is when something goes wrong with the immune system and it mistakenly attacks a healthy part of the body – in this case, the brain or spinal cord of the nervous system.

In MS, the immune system attacks the layer that surrounds and protects the nerves called the myelin sheath.

This damages and scars the sheath, and potentially the underlying nerves, meaning that messages travelling along the nerves become slowed or disrupted.

Exactly what causes the immune system to act in this way is unclear, but most experts think a combination of genetic and environmental factors is involved

Physical Therapy Management

Physical therapy – plays an essential role in keeping a patient with MS active and functional within the community

Aims of Physiotherapy

  1. To re-educate and maintain all available voluntary control
  2. Re-educate & maintain postural mechanisms
  3. Incorporate treatment techniques into ways of life by relating to ADLs

Inhibit abnormal tone

  1. Prevent abnormal movement
  2. To stimulate all sensory and perceptual experience

The PT assessment – focus on posture, movement, and function, realise the patient’s performance may be limited by fatigue, pain or other factors. An individualized program can then be set up. This program needs must easily be performed at home, provide written instructions. Education is important to assist patients in managing their programs as independently as possible. Multidisciplinary treatment for MS patients leads to positive effects.

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