Multiple Sclerosis (MS) is an autoimmune disease causing inflammation, selective demyelination, and gliosis, which manifests through acute and chronic symptoms. When a person with the disorder starts experiencing these symptoms, he or she develops impaired quality and significant disability of life. MS causes an inflammatory reaction in the brain once immune cells attacks the central nervous system, which increases the pressure on nerves and impairs the neural transmission (Bick & Graham, 2013). There is the term called demyelination, which is used to describe a condition which myelin is impaired during autoimmune reaction, which leads to a reduced nerve conduction rate, which makes a nerve cells too tired during their early lifespan period. The third term, gliosis, is used to refer to the fibrotic condition that forms in demyelinated areas, leading to proliferation of neurological tissues and scarring the central nervous system. In brief, this essay will be explaining how the abnormal immune-response causes damage to the central nervous system and treatment methods mostly involve giving patients some drugs for reducing the effect of the immune system on the CNS.
How MS Affects the Central Nervous System
During the course of MS, this disorder affect people differently while in others, it is unpredictable. Nevertheless, symptomatic manifestations of this disorder are usually categorized into four clinical sub-types, each subtype explaining the progress of the disorder as evidenced by clinical experts. The first category is relapsing, which involves a remitting MS which is commonly experienced by more than 85 percent of populations that suffer from MS. People who experience the relapsing-remitting MS (RRMS) mostly suffer from quick attacks to the CNS then complete and partial return to usual functioning. The second category is the secondary-progressive MS (SPMS), which begins by a person first experiencing a remitting-relapsing course and later, the functioning of CNS decline steadily (Bick & Graham, 2013). The third category is called primary-progressive MS (PPMS), where individuals experience a gradual development of the symptoms of the disease and a sudden decline in the CNS function, which signals the start of the manifestation of the disease (Bick & Graham, 2013). The last category is referred to as progressive-relapsing MS (PRMS) where patients experiences symptoms that are almost same those of PPPMS, but only this time, they suffer from additional characteristics of acute attacks.
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What Causes MS
The root of MS is not known but studies have shown that is results from the interaction of various factors, which can be examined to understand the etiology of the disorder. The first factor is the immunological factor, which is the central cause of the disorder where the body’s immune system attacks the CNS and destroys the normal functions of nerves (Cashin, 2010). Researchers have found that the white blood cells attack the nerve cells because they are attracted to myelin. These white blood cells are called the T cells, which somehow become sensitive to proteins which are found in the CNS. When the T cells are released into the CNS, they the cause damaging inflammation to the nerve cells by injuring the myelin protein. Moreover, they release some chemicals which damage nerve fibers which are called axons, and attract more cells to the site of inflammation (Cashin, 2010). There is no explanation at the moment that can explain why T cells become activated but research experts postulate that genetic and environmental factors play a part in the development of the disorder.
Controversies Surrounding the Cause of This Disorder
There have been debates surrounding how environmental factors contribute to the prevalence of the disease. For instance, Kelly and Williams (2015) asserts that the disease is common among people who live farther from the equator in cold climate regions. Some studies show that vitamin D which is sourced from the sun, helps to prevent people from developing the disease. This is because people who live in regions around the equator receive a lot of vitamin D from the sun which boost the immunity and protects the body from autoimmune diseases. There are those who reject the claim that climate change increases the risk for developing the disease and rather assert that some genes cause the disease. For instance, Kelly and Williams (2015) asserts that a first-degree member of a family who has the disorder is likely to transfer it to his or her siblings; however, other clinical doctors disagree with this assertion by claiming that the diseases is not spread through inheritance. As such, studies regarding whether or not the disease is linked to genetic factors are still being done, but not concrete evidence has been presented to prove the claim. Others claim that infectious factor, such as the possibility of a viral infection, can trigger the development of the disease. Some studies suggest that some viruses can trigger immunopathology in MS if they become reactivated after years of latency. This claim has been supported by some experts who have observed that when a person develops the disorder, there is usually an oligoclonal band that persist throughout the lifespan of the person, and it occurs when a person has an infectious disorder (Kelly & Williams (2015). So, if some viruses could cause the band to swell, which include the Epstein Barr Virus, it is likely that it could trigger the development of MS.
Diagnosis of MS
Multiple Sclerosis is diagnosed by conducting a detailed medical history, neurological exam, and by use of supportive laboratory tests. For instance, a Magnetic Resonance Imaging (MRI) is conducted to confirm the presence of MS plaques in the white matter of the brain, although these plaques are common in people with Lupus, diabetes, and migraines (Fotiadis, 2015). Since this does not confirm the actual presence of the disorder, a lumbar puncture (spinal tap), is a needle is inserted in the lumbar spine and the cerebral spinal fluid is extracted for testing of the presence of abnormal proteins, white blood cells, and other defects which are secondary to MS (Fotiadis, 2015). Another test that is carried out is called the evoked potential test, used to detect if there is a presence of a lesion to a nerve, which is indicative that the person has MS.
Treatment of MS
There are various strategies that have been recommended by doctors for treating patients with MS. For instance, there is the acute relapse management, which involves giving patients immunosuppressant and anti-inflammatory drugs in order to reduce CND swelling (Chism, 2015). These drugs include methylprednisolone, the first line of treatment which given intravenously to reduce the inflammation quickly among patients with acute MS. There is also plasmapheresis, a secondary treatment which involves removing potentially harmful components of plasma from blood in order to reduce the severe relapsing forms of MS. Patents are also given physical therapy, which is in fact the current best evidence that focuses on keeping MS patients active in order to delay the negative symptoms of the disease Chism, 2015). Types of physical therapy management for patients with MS include the motor imagery, which is a walking rehabilitation program for MS that helps them to improve motor imagery in walking, speeding, distance perception, and the quality of their lifestyles.
Conclusion
In most of the prevention methods, they aim at improving the speed of the nervous system and damage by the CNS so that a person does not experience impairment. It is believed that the inactivity inside the mitochondrion is responsible for causing the progression of the demylinating disorder. The process of Neuron-degeneration affects the production of energy that is used to transmit nerve impulses, causing a person to experience impairment in normal functions such as walking. There is not cure for MS, but those who have this disorder can manage it by doing exercises which increase motor functions and taking drugs which reduce invasion of T cells on myelin proteins.
References
Bick, D., & Graham, I. D. (2013). Evaluating the impact of implementing evidence-
Based practice . New Jersey: John Wiley & Sons.
Cashin, A. (2010). Evidence-based practice in nursing informatics: Concepts and applications:
Concepts and applications . New York, NY: IGI Global.
Chism, L. A. (2015). The doctor of nursing practice . Burlington: Jones & Bartlett Publishers.
Fotiadis, D. I. (2015). Handbook of Research on Trends in the Diagnosis and Treatment of
Chronic Conditions . Hershey: IGI Global.
Kelly, M., & Williams, C. (2015). BUSN . Belmont: Cengage Learning.
