صورة اليوم الطبية ( Multiple Sclerosis )

before anything we shud remember that in CNS we have degenrative and demyelinating diseases , this falls in the degenerative category

u know how i remember this disease

?

it has 2 similarities with AIDS

how ?
1.with CD4 and macrophage

AIDS depletes those , while MS increases them causing an autoimmune reaction against body mylein sheath

2.in both the pt has incontenince

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now as regard pathological process

if we look at the name : multi-pl-e sclerosis

see the pl ? so there is pl-aques

active plaque : lots of macrophage , lympocytes ( CD4 ) cuffing of blood vessel and myelin loss

inactive plaque : no inflammatory cells , now its burnt out plaque , i mean gliosis and astrocytes increase

the same as doc. gardeania z saying , just the way to link it with the disease

Effect according to site o injury :

on eye : unilateral impairment -optic nerve neuritis
on brain stem : ataxia and nystagmus
spinal cord : AHC=motor impairment , DRG =sensory imapirment

they usually come with numbness which spreads more by time

demyelinating optic neuritis

these pts after hot baths or exercises usually suffer visual loss , and this is important to remember

( utoff's phenomenon )

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thank u alot doctor , useful pictures , waiting for more

theortically speaking , it is a S/S in both
but maybe clinically its not

if replasing/remittent --- beta interferon injections
if acute attacks ---- immunesuppresant lyk corticosteroids

also symptomatic treatment for other symptoms lyk

spasticity --- muscle relaxant
for incontinence --- Anticholinergics or oxybutynin for ex.
TCA , SSRI -- rebalance chemicals that are disturbed in CNS