Good morning students, today we discuss about the Multiple Sclerosis. So, read and good luck all of you.

Here we discuss about the Multiple Sclerosis.
Multiple Sclerosis is an autoimmune disease that damage the myelin sheath.

1. MULTIPLE SCLEROSIS Presented by :: Apurba Dandapat

2. INTRODUCTION Multiple sclerosis is the chronic, progressive, degenerative and autoimmune disease that affect central nervous system(CNS)(Brain and Spinal cord). Multiple sclerosis is caused by damage of myelin sheath (demyelination) the protective covering that surrounds nerve cells. When this nerve covering is damaged, transmission of nerve impulses are slow down or impaired.

3. DEFINITION Multiple sclerosis is a chronic demyelinating disease that affects the myelin sheath of neurones in the CNS.

4. TYPES OF MULTIPLE SCLEROSIS Multiple sclerosis is an autoimmune disorder that affect the CNS. There are 4 main types of multiple sclerosis. They are – 1. Clinically isolated syndrome (CIS) 2. Relapsing-remitting MS (RRMS) (Most common types 80-85%) 3. Secondary progressive MS (SPMS) 4. Primary progressive MS (PPMS)

5. CAUSES Exact causes is unknown. Most theories suggest that multiple sclerosis is an autoimmune and viral disease.

6. RISK FACTORS Age (most common affected age is 20 - 40 years) Sex (women are more affected than men) Family history (genetic) Climate (most prevalent in colder climates of North America and Europe) Smoking Stress

7. CLINICAL MANIFESTATIONS Cerebellar Sign – Nystagmus( a vision condition in which the eyes make repetitive, uncontrolled movements.) Ataxia(lose of muscle control in their arms and legs) Dysarthria( slowed speech or Slurred speech) Dysphagia (swallowing difficulty) Motor sign – Weakness Paralysis of limbs, head Diplopia(double vision or seeing double) Scanning speech

8. Sensory sign – Numbness, tingling Patchy blindness ( scotomas ) Blurred vision Vertigo (spinning sensation in the ear) Tinnitus (ringing noises in the ear) Emotional sign – Fatigue Depression

9. DIAGNOSTIC EVOLUTION CT scan – (To detect areas of demyelination) MRI – MRI of brain and spinal cord. To determine the presence of multiple sclerosis plaques ( scarring in damaged area)

10. MANAGEMENT No exact cure. Aim is to prevent the long term disability. Corticosteroid therapy (anti inflammatory and immune suppressive) i.e. Methyl-prednisolone 1gm/ IV or orally Interferon Beta 1a – Avonex given s/c (for treating replacing from of MS) Interferon Beta 1b – Betaseron given s/c (anti viral and immuno-regulatory)