Mutliple SclerosisBy Kayla Morigeau

Learning Objective: Identify the causes, signs, symptoms and treatment of Multiple Sclerosis. Presentation: A 32 year old woman began experiencing double vision along with tingling that began in her toes but eventually traveled to her lower extremities. She wasn’t experiencing any pain so decided not to consult her physician. The symptoms lasted for about 2 weeks and then stopped abruptly. About 2 months later the symptoms returned but now the woman also felt that she was having difficulty keeping her balance while walking. She decided it was time to see her physician. Immediately her doctor ordered an MRI. The MRI came back with noticeable scarring and plaques upon the myelin sheath of her central nervous system. The doctor did not feel that the MRI was enough to make a positive diagnosis for any disease so he scheduled a lumbar puncture, or a spinal tap, for his patient. The lumbar puncture came back positive for immune system proteins in the cerebrospinal fluid that indicated Multiple Sclerosis (MS). Her physician was comfortable enough to diagnose her with MS. Often times, MS is difficult to diagnose because the symptoms vary from person to person. Some may experience tingling or numbness in the limbs, while others may have double vision, fatigue, or loss of balance and coordination. Many do no exhibit symptoms at all, but still may be living with the disease. After the patient’s initial diagnosis, her physician decided to put her on Copaxone, a steroid that stimulates myelin proteins and inhibits plaques from scarring the myelin sheath. It was not known which form of MS the patient has, but the physician thought it best to start her off with medicine prescribed to patients in the relapsing-remitting phase of MS. The patient was also told to eat a healthy diet and exercise daily. She was also given tips about how to keep her stress levels down. The patient has not had any symptoms or episodes since she began her medication. Case Background: MS is thought to be an autoimmune disorder that affects the myelin sheath of the central nervous system, but it is not know for sure whether or not MS is actually an autoimmune disorder. In a person with MS, like the subject, the myelin sheath of the CNS is scarred by inflammation that causes a slowing of signals from the CNS to the rest of the body. This slowing of the signals results in symptoms like double vision, imbalance, loss of coordination, bladder dysfunction, bowel dysfunction, vertigo, and cognitive dysfunction, along with many other symptoms. MS is a degenerative and incurable disease, but one that can be relatively controlled with the proper diet, exercise, and medication. Steroids have proven to be the best medicine in controlling the spread of scarring on the myelin sheath. It is not known why people get MS. Many believe that MS stems from some type of virus, and this virus is what causes the inflammation and the eventual scarring of the myelin sheath. Still there is no definitive answer as to what causes MS, or who gets MS. Woman are significantly more likely than men to get the disease, but it is not known whether the disease is hereditary or not. Some believe that the