Medical Assignment: An Overview Of Multiple Sclerosis

Question

Task: Your medical assignment should be completed in MLA style, typed in double space, font size 12 and should be exactly 3 solid pages long. Work cited must be provided on a separate page (4th page), there is no need to insert references in the text. The Topic of the assignment is over ''Multiple Sclerosis''.

Students are expected to use published information, reliable websites sources and textbooks.
i. Brief description of the disease disorder
ii. The anatomical and physiological implications (i.e. anatomical structure affected and how it impairs body functions)
iii. Signs and symptoms
iv. Method of diagnosis
v. Factors that influence the disease disorder (environmental factors, deficiencies, genetics, lifestyle etc.)
vi. Habits that reduce the disorder
vii. Available treatments.
viii. References

Answer

Multiple Sclerosis- Brief
Multiple sclerosis is an inflammatory disease that affects the central nervous system. The disease focused in this medical assignmentis an autoimmune disease and can lead to neurological problems as well as cognitive and physical disability. The lesions formed due to CNS plaques formation, oligodendrocyte death, and multifocal zones of inflammation. Inflammation is caused due to attack on the myelin sheath, protecting and surrounding the nerve fibers. Such lesions can cause neurological dysfunctions and hamper the proper nerve impulse transmission.

There are four subtypes and stages of multiple sclerosis namely: Clinically isolated syndrome is the first stage of MS. If the symptoms last longer than 24hours the doctor might go for relapse remitting MS. Patients are usually diagnosed with MS in this stage. The third stage of MS is primary progressive MS, progressive increase of symptoms, without early relapse or remissions. The last stage of MS is secondary progressive MS. In this stage, the disease progresses steadily and there is a chance of relapse and remission.

Anatomical and physiological implications
Multiple sclerosis impacts the myelin sheath that covers and protects the nerve cells. Due to MS, the myelin sheath is damaged due to scarring and inflammation. Multiple sclerosis has several impacts on our anatomy as well as physiology. Certain implications that cause long term impacts on patients are interruptions in brain functionality, difficulty in swallowing, difficulty in breathing, poor bladder control, sexual dysfunction, problems in balance and coordination, weakened muscles, vision problems, and weakening of immune system, increased cardiovascular risk, and brittle bones.

Signs and symptoms
The actions in the body are controlled by the central nervous system. Multiple sclerosis affects the CNS and thus impacts the body's functions and control. The common symptoms seen in multiple sclerosis are listed below:
1. Weakening of muscles: There is a poor stimulation or lack of use due to damage in the nerve and thus causing muscle weakness.
2. Tingling and numbness: An early symptom of multiple sclerosis is pin and needle type sensation. Tingling and numbness can affect the legs, arms, or face.
3. Lhermitte’s sign: It is a sensation of electric shock while the movement of the neck. Such experience is known as Lhermitte’s sign.
4. Problems in the bladder: An early sign of multiple sclerosis is loss of control of the bladder. A person infected with multiple sclerosis might feel incontinence. They might feel problems in urinating or emptying their bladder.
5. Bowel incontinence: Bowel problems are often seen in people with multiple sclerosis. It causes fecal impaction due to constipation.
6. Fatigue: Tremor, muscle spasms and spasticity, sexual dysfunction, dizziness, and vertigo are the symptoms associated with multiple sclerosis. People may experience imbalance and poor coordination. Muscle spasms are frequently observed in patients due to damage in the spinal cord and brain nerve fibres. Involuntary quivering movements are experienced by people with multiple sclerosis.
7. Vision problems: An early sign of MS is vision problems. It usually causes optic nerve inflammation, total or partial vision loss, blurred or double vision.
8. Emotional changes and depression are experienced due to damaged nerve fibre or demyelination.
9. Memory loss or learning disabilities is often experienced which makes it difficult for the patient to multitask, learn, and concentrate.
10. Stiffness of muscles, mobility and gait changes and neuropathic pain is other common symptom of MS.

Method of diagnosis
Medical practitioners usually go for a neurological and physical examination to diagnose the disease. It also includes the patient’s medical history as well as the patient’s signs and symptoms. A single parameter or assay cannot confirm a diagnosis. Thus, multiple strategies are used by medical practitioners to confirm the diagnosis. The parameters involved in identification are:
1. Evoked potential test is used by medical practitioners to diagnose MS. It involves the time taken by the brain to respond to certain stimuli through touch, sound, or sight.
2. Spinal fluid analysis: This test helps in the identification of antibodies that may be associated with the previous infection or consistent proteins in the diagnosis of multiple sclerosis.
3. MRI scans: The lesions may be revealed by spinal cord or brain MRI scans.
4. Lumbar puncture: It is not involved in the first-line analysis. It is the procedure of withdrawing cerebrospinal fluid followed by antibodies and protein testing. The lumbar puncture (also known as a spinal tap) technique might play a crucial role in diagnosis in certain patients.
5. Blood tests are usually suggested by medical practitioners to find out other conditions like lupus or Lyme disease.

Factors that influence MS
Certain factors increase the risk of multiple sclerosis. Environmental factors in association with exposure to viral and bacterial agents such as EBV can often lead to MS.
Vitamin D. and Vitamin B12 deficiency elevate the risk of neurological diseases and can impact the functionality of the immune system.
Genetic factors in association with environmental factors can trigger multiple sclerosis.

Other factors that may influence MS are smoking, age, etc.
Habits to reduce MS
Healthy habits that can reduce the risk of multiple sclerosis are:
1. Managing the stress level
2. Proper exercise to boost mood, reduce stiffness, enhance flexibility and strength
3. Quit smoking
4. Proper intake of Vitamin B12 and Vitamin D
5. Avoiding a diet rich in saturated fatty acids

Available treatments
The progression of the disease can be slowed down but it cannot be cured. Certain treatments are available to reduce the symptoms, the severity of the relapses, and decrease the number. Alternative and complementary therapies are there to treat multiple sclerosis. Treatments to slow the progression rate: Several FDA-approved drugs are used in the treatment of MS. It mode of medication can be infused, oral, or injectable. Several disease-modifying therapies are there to change the abnormal immune system functionality. It is suggested to use such drugs in the first stage so that it can reduce the rate of progression. Desired drugs are associated with specific stages. Certain drugs approved by FDA for treating MS are alemtuzumab, teriflunomide, interferon beta- 1a, and 1b. Symptoms are often relieved by the usage of certain drugs. Such medications are advised during a flare and must not be consumed on regular basis. Such drugs contain corticosteroids that can decrease inflammation and suppress the immune system. Other alternative therapies that are involved with MS are acupuncture for gait and pain, healthy diet, stress management, etc.

References
Brazier, Yvette. “Multiple Sclerosis: what you need to know.” Medical news today. 6 June 2021, https://www.medicalnewstoday.com/articles/37556.
Brownlee, Wallace J., et al. "Diagnosis of multiple sclerosis: progress and challenges." The Lancet 389.10076 (2017): 1336-1346.
Dobson, Ruth, and Gavin Giovannoni. "Multiple sclerosis–a review." European journal of neurology 26.1 (2019): 27-40.
Ghasemi, Nazem, Shahnaz Razavi, and Elham Nikzad. "Multiple sclerosis: pathogenesis, symptoms, diagnoses and cell-based therapy." Medical assignmentCell Journal (Yakhteh) 19.1 (2017): 1.
Mandia, Daniele, et al. "Environmental factors and multiple sclerosis severity: a descriptive study." International journal of environmental research and public health 11.6 (2014): 6417-6432.
Sintzel, Martina B., Mark Rametta, and Anthony T. Reder. "Vitamin D and multiple sclerosis: a comprehensive review." Neurology and therapy 7.1 (2018): 59-85.
Vargas, Diana L., and William R. Tyor. "Update on disease-modifying therapies for multiple sclerosis." Journal of Investigative Medicine 65.5 (2017): 883-891.