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Health and Life
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The principal dilemma in current management of multiple sclerosis is that while early diagnosis enables damage-sparing treatment to begin, diagnosing MS too early increases the likelihood of treating people who don't actually have the disease. Current disease-modifying drugs are all given by injection and cost about $14,000 per year. Apart from being inconvenient and expensive, there is some risk of harm from them which, if the patient doesn't actually have MS, occurs without any offsetting benefit. The dilemma would not be great if multiple sclerosis was easy to diagnose, but unfortunately MS is among the most difficult diagnoses in all of medicine to make, at least while still in its early stages. Early in the course of symptoms, MS can resemble other conditions; moreover, other conditions can resemble MS. Affecting 2.5 million people worldwide and 350,000 people in the U.S. alone, multiple sclerosis is not exactly a rare disease. It affects women at least twice as often as men and begins early in adulthood with most cases starting between the ages of 20 and 40. MS is a so-called autoimmune disease, meaning that a person's immune system--ordinarily useful and essential in fighting off infections--becomes overactive and attacks the individual's own bodily tissues. Rheumatoid arthritis is another example of an autoimmune disease, but in MS the immune attack is not directed against joints as it is in rheumatoid arthritis. Instead, the immune system attacks large clusters of nerve-fibers generally deep within the central nervous system which includes the brain and spinal cord. These attacks can produce a wide variety of symptoms depending on what the usual function was of the nerve-fibers that are under attack. When the attacked nerve-fibers have to do with vision, the symptoms are visual, like loss of visual clarity or even doubling of vision. When the nerve-fibers are involved with the process of bodily sensation, then the symptoms can be numbness or tingling. In fact, visual or sensory symptoms are the most common initial symptoms in multiple sclerosis. But initial symptoms might instead consist of dizziness, weakness, clumsiness or difficulty with urination. The sheer diversity of early symptoms that can be due to multiple sclerosis is one of the chief difficulties in recognizing it for what it is and properly diagnosing it. It's useful in this regard to consider the twin issues of "false-positives" and "false-negatives." In short, every medical test and every diagnosis is subject to these errors. False-positive means that a test or a doctor indicates that a disease is present when it is, in fact, absent. A false-negative error occurs when a test or a doctor indicates that a disease is absent when it is, in fact, present. Despite the increased confidence that expanding medical knowledge and ever-more sophisticated tests provide, false-positives and false-negatives are a fact of life and still apply to every test and every diagnosis. In multiple sclerosis there are three cornerstones to the diagnostic process. In usual descending order of importance they are the clinical evaluation, magnetic resonance imaging (MRI) scanning and examination of the cerebrospinal fluid. Each of these is important in its own way, but one component almost never stands on its own merits, requiring one or both of the other components for corroboration. The clinical evaluation refers to the time-honored process in which the physician elicits the history of the symptoms and performs a physical examination. The physical examination consists mainly of the neurological examination, which is a battery of mini-tests that inventories the performance of different components of the nervous system. Even a test as high-tech and powerful as the MRI scan can lead to diagnostic errors. False-positives often occur when a patient has a scan for a totally unrelated reason--like headaches, for example--and has pockets of increased signal within the brain for which the radiologist raises the possibility of multiple sclerosis. When the abnormal scan leads to consultation with a neurologist, the neurologist often determines that multiple sclerosis is out of the question, and the areas of increased signal are either benign or due to another problem entirely. MRIs less frequently produce false-negatives for multiple sclerosis, but even so, this imaging test is believed to show just the tip of the iceberg in this disease, failing to demonstrate important changes that occur at the microscopic level. Examining the cerebrospinal fluid (CSF) is another valuable tool in diagnosing MS. The CSF bathes the inside and the outside of the brain and the outside of the spinal cord, so its cellular and chemical composition often reflects what's going on within those structures. CSF is obtained by means of lumbar puncture, also known as spinal tap, a safe procedure in which a needle is inserted through the lower back and into the CSF space. The fluid is collected as it drips out the back of the needle. In cases of active MS there are usually abnormal proteins produced by the immune system that can be detected and measured in the CSF. However, here too there are false-positives and false-negatives, so that some people with abnormal proteins don't have MS and other people with normal proteins still do have the disease. So the diagnostic process--including clinical evaluation, MRI scanning and CSF examination--is fraught with the possibility of error at each step of the way. Yet there is considerable incentive to make the diagnosis as early in the disease as possible (which is also when the risk of diagnostic errors is greatest) in order to initiate treatment that tames the out-of-control immune system. Sifting through the diagnostic information to make a timely and accurate diagnosis almost always requires the assistance of a neurologist, and even with the help of these specialists in disorders of the nervous system, sometimes the diagnosis gets revised as time passes and clues become more definite. 2012-01-28
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Multiple sclerosis is an inflammatory neurological disease that can generate a wide range of physical and psychological symptoms. Multiple sclerosis involves the deterioration of myelin, a substance that surrounds the body's nervous cells. Myelin has a very important role in the transmission of nervous impulses, and if this substance is affected, the entire activity of the nervous system is seriously compromised. Although the actual causes of multiple sclerosis remain unknown, there are several hypotheses that present genetic abnormalities as the main factors responsible for causing the disease. Medical scientists believe that multiple sclerosis occurs on the background of inherited genetic predispositions, and environmental factors are suspected to be triggers of the disease. Some hypotheses also introduce viral infections in this scenario, although infections with viruses don't seem to contribute to the development of the disease. Multiple sclerosis can affect the body on different levels. The majority of people with multiple sclerosis suffer from dysfunctions of the muscular system, while others also develop neuropsychological dysfunctions. Multiple sclerosis usually generates a wide range of symptoms: body weakness, pronounced fatigue, muscle numbness, poorly coordinated moves, poor balance. People affected by multiple sclerosis can in time experience decreased visual acuity, mental states of confusion and even short-term memory loss. People with multiple sclerosis can also suffer from depression, which is common in more than 80 percent of patients with the disease. Although there is no cure for multiple sclerosis, most medical treatments can alleviate the symptoms generated by the disease, also preventing their recurrence. However, the majority of medications prescribed in long-term multiple sclerosis treatments (beta interferon, corticosteroids) can generate many side-effects, causing additional damage to the body. Hence, it is best to avoid following long-term treatments with potentially-harmful drugs. In many cases, multiple sclerosis therapies can ameliorate physical symptoms just as well, without using any drugs. Considering the fact that most symptoms generated by the disease are linked to the musculoskeletal system, the majority of multiple sclerosis therapies are focused on improving muscular mobility and tonus through physical exercise. Multiple sclerosis therapy through exercise can help patients regain their strength, coordination and balance, alleviating muscular pain, numbness and stiffness. The majority of multiple sclerosis therapies involve recuperative physical exercises and medical gymnastics. Other forms of multiple sclerosis therapies include recreational physical activities, such as swimming, jogging or the practice of different sports. Most people who have followed such multiple sclerosis therapies have experienced an amelioration of their physical symptoms and have improved their overall health condition. Although medical treatments are required for most patients, people who follow multiple sclerosis therapy need smaller doses of medications. Combined with an appropriate diet and a healthy lifestyle, multiple sclerosis therapy through exercise can be very benefic. 2012-01-26 |
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The symptomatic spectrum of multiple sclerosis can be very diverse, involving different manifestations according to the affected body regions. Multiple sclerosis is an inflammatory neurological disease, causing dysfunctions mainly at the level of the central nervous system. Due to the fact that multiple sclerosis affects the nervous system, people with this form of neurological disease can in time experience symptoms in most innervated regions of the body. An estimated number of over 2 million people worldwide suffer from multiple sclerosis, while in the United States the disease affects around 350.000 people. For some reason, multiple sclerosis predominantly affects the female gender. Although the disease can also be developed by men, multiple sclerosis is very common in women. Another interesting characteristic of multiple sclerosis is that it commonly affects young people. The disease has the highest incidence in people with ages between 20 and 40, rarely affecting the elderly. Multiple sclerosis involves damage of the nervous cells, destroying myelin, a substance that normally covers neurons. Myelin has a vital role in transmitting nervous impulses throughout the entire body, establishing connections between the neighboring nervous cells. When the layers of myelin are affected, nervous impulses travel at reduced speed between neurons and the body is unable to adequately respond to external stimuli. The symptoms of multiple sclerosis are diversified and they can be perceived in different regions of the body. Most patients have individualized symptoms of multiple sclerosis, and they tend to occur in episodes, or "flares". The evolution of multiple sclerosis is unpredictable, alternating between stages of remission and stages of relapse. Most people with multiple sclerosis experience intermittent, recidivating symptoms which amplify in the stages of recurrence. Considering the fact that the symptoms of multiple sclerosis are various and at certain stages of the disease unspecific, multiple sclerosis can't be diagnosed only upon clinical manifestations. Multiple sclerosis is usually diagnosed upon laboratory tests, blood analyses and elaborate neurological examinations. Common, generalized symptoms of multiple sclerosis are: pronounced fatigue, body weakness, sensations of tingling, burning, pain, itching and numbness of the muscles, loss of dexterity and uncoordinated body movement. Other physical symptoms of multiple sclerosis are: decreased vision, loss of mobility, shaking, spasms, tremors, poor balance, dizziness, vertigo. In later stages of the disease, the symptoms of multiple sclerosis can include partial paralysis, renal and gastrointestinal dysfunctions. Neuropsychological symptoms of multiple sclerosis are: mental confusion; altered, inaccurate perceptions; poor concentration; short-term memory loss; compromised judgment and unpredictable, sudden changes of mood. A symptom of multiple sclerosis that commonly occurs in people with this form of neurological disease is depression. Most people affected by multiple sclerosis eventually become depressed and avoid any kind of interaction with other people. Although many symptoms of multiple sclerosis can be very pronounced at certain stages of the disease, they can be alleviated through the means of medical treatment. Medical treatments available today are able to ease the symptoms of multiple sclerosis in the periods of relapse and in time they can even help the reconstruction of myelin, thus helping patients to recover from the disease. It is important to timely discover the symptoms of multiple sclerosis in order to begin the administration of an appropriate medical treatment before the disease becomes serious. 2012-01-25 |
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Most of the time, when a woman experiences a irregular menstrual period, the causes behind it are completely benign. There are a number of occasions where you may experience an irregular menstrual period, including missing a period, having periods too infrequently, experiencing spotting between periods or experiencing a bout of heavy bleeding and clotting. Most of these irregular menstrual period situations are caused by a hormonal imbalance that is an underlying cause and that can be treated relatively easily. Most of us have had an occasion where we missed a period. Sometimes this leads us to anticipate pregnancy while others only feel anxiety as a result. Some women seem to menstruate just like clockwork while others go their entire lives without ever seeming to have a normal or typical menstrual cycle. There is one thing that is a given, however, and that is that shifts in the balance of our hormones can easily alter our menstrual pattern, causing what we have experienced in the past to no longer be the norm, and making irregular menstrual period situations the norm. Many of these irregular menstrual period experiences are especially common when you reach perimenopause, which is the stage that comes before full blown menopause. So what is an irregular menstrual period?Questions are asked about irregular menstrual periods all the time. A textbook menstrual cycle occurs every 24 to 29 days, but what is a "regular" menstrual period actually covers a much wider range than this. Menstrual cycles that occur between 23 days and 35 days are actually quite common in nature. A woman may only get her period between once and four times every year, or she may even experience periods that occur between two and three times every month, involving an extremely heavy menstrual flow or spotting in between. Alternately, a woman can also have heavy bleeding episodes only every two months to three months. So the truth about what an irregular menstrual period is, is that it is only irregular if it is not the norm for you and your body. For the most part, a single missed period or a couple of missed periods every year is nothing to raise alarms over. There are a wide variety of different factors that are capable of being responsible for irregular menstrual periods. Among them includes significant weight loss or weight gain, exercising too often, poor nutrition, drug use, smoking, too much caffeine, excessive use of alcohol, eating disorders, an increase in stress, Uterine abnormalities such as fibroids, polyps or cysts, certain medications, recently having gone through childbirth, breastfeeding, having a recent miscarriage, premenopausal hormonal imbalance or polycystic ovarian syndrome. As should be evident at this point, there are a number of different causes for an irregular menstrual period in women, and they can occur for a multitude of different reasons. While it can be confusing when you experience a irregular menstrual period, you should only consult a physician if it becomes a regular occurrence. 2012-01-23
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