Multiple Sclerosis - A Practical Guide to Rehabilitation - 4

AIMS

A PRACTICAL GUIDE TO IDIOPATHIC PULMONARY FIBROSIS

Introduction
THE MS DISEASE COURSE
Multiple sclerosis (MS) is a chronic autoimmune
disorder that affects the central nervous system
(CNS). More than 2.3 million people worldwide,
including nearly 1 million people in the United
States, have a diagnosis of MS.2,3 The disease is
associated with numerous symptoms including
visual disturbances, spasticity, weakness,
impairment in walking, coordination difficulties,
balance problems, tremor, ataxia, sensory
problems, and bladder dysfunction.2 Various
"invisible symptoms"-such as fatigue,
depression, and cognitive changes-are also
common in MS.

Key features of MS pathology include
demyelination, oligodendrocyte loss, and
axonal/neuronal injury and loss. While complete
understanding of MS disease mechanisms
continues to evolve, it is clear that an
immune-mediated, inflammatory process
involving activated T-cells, B-cells, and
antigen-presenting cells contributes to the CNS
damage observed. Activated T-cells in the
periphery (reactive to CNS proteins, particularly
myelin), along with other immune cells, cross a
"leaky" blood brain barrier. In the CNS, amplified
immune responses attack myelin and
oligodendrocytes, causing axonal injury. Resulting
lesions in the brain, spinal cord, and optic nerves
contribute to the clinical features of MS (Table 1).

Table 1: MS Lesion Sites and Clinical Features of MS5
Lesion Site

Cerebrum; cortex

*
*
*
*

Optic nerve

* Optic neuritis

Cerebellum

*
*
*
*

Postural and action tremor
Limb incoordination
Gait instability
Ataxia

*
*
*
*

Diplopia
Vertigo
Impaired speech and swallowing
Paroxysmal symptoms

*
*
*
*
*
*

Weakness
Spasticity
Diminished dexterity
Autonomic disturbances (sexual, bladder, bowel)
Pain
Nerve disorders/neuropathic pain

Brainstem

Spinal cord

Other

4

Clinical Symptoms
Cognitive deficits
Psychiatric features
Hemiparesis, monoparesis, paraparesis, quadriparesis
Motor impairments, spasticity

* Fatigue
* Temperature sensitivity

Introduction



Multiple Sclerosis - A Practical Guide to Rehabilitation

Table of Contents for the Digital Edition of Multiple Sclerosis - A Practical Guide to Rehabilitation

Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 1
Multiple Sclerosis - A Practical Guide to Rehabilitation - 2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 3
Multiple Sclerosis - A Practical Guide to Rehabilitation - 4
Multiple Sclerosis - A Practical Guide to Rehabilitation - 5
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Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover3
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover4
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