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  • Multiple Sclerosis Pathophysiology

  • PaganJim

    Administrator
    October 17, 2020 at 4:16 pm

    Multiple Sclerosis Pathology

    The first thing I want, or should say “need,”  to do is apologize. There is no way around it in this article but there are going to be a lot of technical/medical terms in this article. I will use them as sparingly as possible, and whenever I can, I will explain the terms that I do use. If I tried to write this without the medical terms, then this article would just be three times as long, at least.

    The first thing I need to define is a word up top, Pathology. As simply as I can put it, pathol0gy is the study of the causes and effects of disease or injury. The word pathology also refers to the study of disease in general, incorporating a wide range of bioscience research fields and medical practices. Even though a part of pathology refers to the causes of disease, we are not going to go there in this post. It is way above what we will be discussing now.

    What is MS?

    Multiple sclerosis (MS) is a chronic neurodegenerative disease, targeting the central nervous system (CNS) and widely believed to be autoimmune in nature. Another quick definition is in order here. The “Central Nervous System” is the brain and spinal cord. The rest of the nerves in the body are considered peripheral nerves. The classic symptoms of MS are brought about by autoreactive lymphocytes that cross the blood-brain barrier (BBB) and enter the CNS where they cause demyelination.  Autoreactive simply means that there is an immune response against the body itself. The lymphocytes, or White Blood Cells, are what are responsible for attacking the myelin sheath around the nerve cells in the CNS. I always compare neurons to electrical wires because most people can understand that better. So you have a speaker wire, for example. that uses electricity to cause the speaker to move. If you strip some of the coating away from the wire, you will start losing part of the signal to the speaker, and something that sounded great yesterday may sound terrible today. This is essentially what the lymphocytes are doing. They are stripping away part of the insulation to the wires, the neurons in our CNS. This has an effect on efficiency for that neuron. This can cause lost or garbled information getting passed from one neuron to the next.

    It is estimated that there are 2.5 million people worldwide with MS.  Of those 2.5 million cases, it is estimated in a recent study launched by the National MS Society over 900, 000 people are living with Multiple Sclerosis in the United States. Most people are diagnosed between the ages of 20 and 40 years old.  However, it is estimated that 3 – 5% of new cases are children under the age of 18.

    The spread along gender lines has been widening. For a long time, it was shown that twice as many women as men would be diagnosed with MS. Now it is approximately 2.5 – 3 women that will receive an MS diagnosis compared to men.

    It is not known why there is an increase in the percentage of women getting MS or why more children are getting MS. These are just two of the questions among what we don’t know about MS.

    How is Multiple Sclerosis Diagnosed?

    It has been said that in order to diagnose MS, you have to rule out every other possible cause of the symptoms that the patient is experiencing. That is why many patients have to wait months of years for a specific diagnosis. Multiple Sclerosis has a wide range of symptoms. That is one reason it is so difficult to diagnose.  Another reason is there are so many diseases that mimic MS symptoms. Just a few of these are Myasthenia Gravis, Lupus, and Lyme disease.

    Part of the confusion is that there is no one test that can diagnose MS. All of the tests that are conducted on patients that are believed to have MS are just a part of the puzzle.  An important thing to remember is the “multiple” part of the name. That means that there is more than one episode that is related to MS. Clinically isolated syndrome (CIS) refers to a first episode of neurologic symptoms that lasts at least 24 hours and is caused by inflammation or demyelination. People may be diagnosed with CIS before being diagnosed with MS if they have had only one episode that is related to MS.

    What Can I Expect with MS?

    This is a question I hear constantly from newly diagnosed people. I always answer with “nothing and everything.” Let me explain. There is no one course for MS. It is as unique to every individual as their fingerprints. I have known people that were diagnosed 20 years ago that have hardly no symptoms. I have known people that were diagnosed 6 months ago that are in wheelchairs.

    There is no way to predict if a patient will take the first course or the latter course or something in between. If you are a normal patient and not one of these extremes. It also depends on what type of MS you are diagnosed with, but we will save all of that for another time. For the sake of this article we will just assume a diagnosis of Relapsing Remitting MS since that is the most common for newly diagnosed people.

    One thing you can exepect is to have an exacerbation, or flare up mostly referred to as simply a flare, from time to time. Again this can be a wide range from a body part, a hand for example, going numb or tingling, to Optic Neuritis (ON) which causes you to lose the vision in one or both eyes temporarily. A note on ON. What started me on my road with MS was ON in my left eye. I completely lost the vision in that eye. I would always describe it as putting a piece of grey poster board in front of that eye because that was all I saw out of that eye. ON usually resolves itself within 6 months. But they cannot predict to what degree you will get the vision back. The ON that I had resolved itself in about 5 months and I had about 90% of my vision return.

    This is already longer than I expected it to be, so I will cut of here for now. I am not sure what the next article will be about exactly but more than likely a continuation of this.

    So everyone stay healthy and safe until the next time.

     

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