Question

Neurologic System: Multiple Sclerosis Discussion Assignment: 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? Case Study: Patient: Myrtle, Newly Diagnosed, (25 years old) Social History: Homeless, Unemployed, Single, Nonsmoker; no ETOH (ETOH is an acronym for ethyl alcohol); no illicit drugs On line college student-struggles to understand material Symptoms 2006: blurred & double vision 2013: Double vision; urinary urgency; poor attention 2012: Numbness in both legs Diagnosis: RRMS - Relapse-Remitting Multiple Sclerosis (2 episodes of neurological symptoms referable to the CNS, separated in space and in time) Memory problems past 6 months; fatigue; heat intolerance; problems with balance Prevalence by Cognitive Domains Memory 40% Information Processing 35% Attention/concentration 30% Problem Solving 20% Visuospastial Abilities 20% Verbal fluency 10% Multiple domains (average) 22% Supporting the Diagnosis: Findings on exam: left INO internuclear ophthalmoplegia abbreviation: INO Loss of the normal paired movements of the eyes when tracking an object to the left or right. An INO is marked by the failure of one eye, e.g., the left, to cross the midline during an attempt to see an object on the opposite side of the body, e.g., the right. vertical nystagmus (a repetitive, involuntary, to-and-fro oscillation of the eyes. It may be physiological or pathological and may be congenital or acquired.), right ptosis, MRI Brain and T spine: Multiple enhancing white matter lesions High T2 signal in the right optic nerve Rim enhancing lesion at T6-7CSF Bands notes in CSF and not in serum Medications IM Interferon beta-1a Gabapentin 300mg tid Oxybutynin Chloride 5mg tid.

Subject: Pathophysiology

Answer 1

Effect of the demyelination on the nerves of an individual who has Multiple Sclerosis

Multiple sclerosis is an autoimmune disorder characterised by chronic, infammatory degeneration of nerve tissue of brain and spinal cord. Myelin is covering the axone of nerve tissue which is made up of fatty substances. In multiple sclerosis, body’s immune system recognize myelin as a forgine body and distroy them(demyelination). This cause sclerosis (hardening, caring and plaque formation in the brain and spinal cord and slow down the conduction of nerve impulses.

Use of Interferon beta-1a Gabapentin and Oxybutynin Chloride in multiple sclerosis

• Interferon beta-1a Gabapentin

In a normal immune response, interferon beta is released at the end of the immune response to stop the immune response by reducing the inflammation. It acts in the same way in multiple sclerosis as it is an autoimmune response. it helps to reduce the symptoms by reducing inflammation and reduce the relapse by preventing certain types of white blood cells entering into the brain and spinal cord which damage the melin.

• Oxybutynin Chloride

Oxybutynin Chloride is used in MS to control over reactive bladder or neurogenic bladder. It is an anticholinergics/ antimuscarinics drug which ac on bladder muscle and reduce frequency of urination.

Females are at greater risk for MS

Studies have shown that female have two to three times more likely chance of affected with Ms than males. it would be probably due to some genetic factors and hormonal variations in women. Some studies shows that there is less difference of chance of getting MS in girls and boys before puberty, but in adolescence and adulthood female shows more chance of disease. In both men and women, the body composition are different. they have difference in hormones, genetics, body built(female body has more fat stores) and body needs. these all factors may contribute to the risk of disease towards Ms in women.