Pathophysiology Neurologic System

Question :

What is the effect of the demyelization on the nerves of an individual who has Multiple Sclerosis?

Why are the medications appropriate?

Why do you think females are at greater risk for MS?

Answer :

Myelination is the cell process that sends messages to & from the brain. When a person is suffering from MS demyelination, the immune system attacks the myelin sheath or the cells that produce & maintain it. This will cause injury & inflammation to the sheath & the ultimately nerve fibers surrounding it. Upon the damage of these cells, the nerve will get exposed & the brain will have difficulty in sending & receiving signals to the rest of the body. Females are at a greater risk for MS as MS produces a higher level of blood vessel receptor S1PR2 protein than males & this protein causes more damages in brain area during MS.

We conducted a case study for MS, in which we took myrtle & newly diagnosed 25 years old patient. He was unemployed, homeless, single with Nonsmoker & not addicted to illicit drugs or ETOH (otherwise known as ethyl alcohol). 

In 2006, the patient was having blurred & double vision (diplopia) which is a very common & first symptom that people usually notice (Jopson & Moss-Morris, 2003). 

In 2013, the symptoms increased along with double vision, the bladder problem, & poor attention can be seen in the patient. 

In the year of 2012, the patient showed the problem of numbness in both the legs which is a clear sign of nerve damage from MS. 

After this, the patient has diagnosed with Relapse-Remitting Multiple Sclerosis. 

Twice episodes of neurological symptoms referred to the CNS are separated by space & time. The data of memory problems in the past 6 months with fatigue, heat intolerance, & the problem with balance is recorded (Schwid et al, 1997). 

They are having a memory of only 40% with only 10% of verbal fluency. The patient is prevalence by cognitive domains with 35% of Information processing & 20% of problem-solving ability. The attention/concentration is only 30% with 20% visuospatial abilities & multiple domains with 22% average. 

Supporting the Diagnosis:

we observed during a case study are described below.

When tracking an object to the left or right, paired movements of the eyes. Usually, the INO is mostly marked as the eye damage; i.e, during a to see an object, the left to cross the midline on the opposite side of the body & the right vertical nystagmus (an involuntary, to-and-fro oscillation of the eyes repeatedly) (Jain et al, 2003). It can be physiological, pathological,& congenital, Right Ptosis, MRI brain, & T-spine. When MRI scan recorded it showed a High T2 signal is found in the right optic nerve with Band notes in the area of CSF & not in the serum. There are multiple enhancing white matter lesions & rim enhancing lesions at T6-7CSF.

From concluding the above report, medications like Gabapentin 300mg tid, Oxybutynin Chloride 5mg tid, IM Interferon beta-1a, can be suggested for the patient. Mostly medications are appropriate for the MS as it can be injected into the muscle of skin that can ultimately reduce the frequency & severity of relapses. Medicines help to reduce the severe RRMS attacks & how frequently you have them. It also delays or reduces disability. 

References

Lucchinetti, C., Brück, W., Parisi, J., Scheithauer, B., Rodriguez, M., & Lassmann, H. (2000). Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 47(6), 707-717.

Jain, S., Proudlock, F., Constantinescu, C. S., & Gottlob, I. (2002). Combined pharmacologic and surgical approach to acquired nystagmus due to multiple sclerosis. American journal of ophthalmology, 134(5), 780-782.

Jopson, N. M., & Moss-Morris, R. (2003). The role of illness severity and illness representations in adjusting to multiple sclerosis. Journal of psychosomatic research, 54(6), 503-511.

Schwid, S. R., Goodman, A. D., & Mattson, D. H. (1997). Autoimmune hyperthyroidism in patients with multiple sclerosis treated with interferon beta-1b. Archives of neurology, 54(9), 1169-1170.