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By Isabella Earle and Allison Delaney

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1 By Isabella Earle and Allison Delaney
Multiple Sclerosis By Isabella Earle and Allison Delaney

2 Description What makes it unique?
If a person has multiple sclerosis, their immune system has some abnormalities. The immune system goes against the central nervous system. An antigen specifically targets immune cells that are sensitized to an attack. This is why it is described as immune-mediated. The immune system keeps attacking the myelin and its inner fibers. The myelin forms scar tissue which gives the name of sclerosis. When parts of the myelin sheath are damaged, the signals that are sent from the CNS or to the CNS will be stopped or distorted. This can produce a wide range of symptoms. It is said to have been triggered by an environmental factor in a genetically susceptible person. This is a chronic disease so needless to say, a person won’t die of this but they will face complications associated with this disease for the rest of their life. As time goes on, it can get worse as well. Different lesions, or scarring, form in the brain.

3 Patient: Gina Casmurf Gina is a 26 year old lady who has never had children but currently lives with her boyfriend. She knows that her aunt has multiple sclerosis, but she believes she won’t receive the gene because she looks nothing like that side of her family. If she did have it, then an environmental factor could switch it on and she would have this disease On September 11th, Gina stayed home from working at the roller derby center on route 11 as a wheel remover. Gina woke up on Saturday September 12th, as she was telling a story about band camp, she had a sudden jerk of motion in her arm and hit the pillow she was sitting near. She almost fell when standing up to pick up the pillow she knocked over, but Jerome, her boyfriend, caught her. As Gina tried to stand back up she had pain and felt weak in her joints. This was accompanied by a sudden tiresome feeling. As Jerome asked if she was alright, she started yelling at him about how her vision was becoming distorted. Jerome, being a great guy, took her to the hospital immediately.

4 Gina’s symptoms Blurry vision Slurred speech Fatigue Dizziness
Problems with bladder Tingling in parts of body/loss of sensation Lack of coordination Numbness in some of her limbs Loss of balance Frequent and inconsistent urination Spasms or cramps

5 Regions of Brain Affected:
Frontal lobe Occipital lobe Cerebellum Virtually all regions of the brain are affected because the neurons are in every part of it as well as all the neurons in the body. Different places have more obvious signs of MS. These are only some of them. Spinal cord

6 How she was diagnosed She was diagnosed through multiple tests by neurologists. These include imaging techniques (MRI &spinal taps), lumbar punctures, and lab analysis of blood samples. MRIs are used to produce images of brain and spinal cord. An MRI doesn't hurt but can be very strange if you don’t know what to expect. If MS is suspected, a special contrast material (gadolinium) is used as the injection for the scan. It reacts to areas of inflammation and will "light up" when a lesion is active. This indicates that demyelination(wearing down of the myelin sheath)is occurring. Lumbar punctures are when a long needle gets inserted into the fluid of your spinal canal. The diagnosis is correct 90-95% of the time.

7 Treatment for MS There is no known cure for Multiple Sclerosis yet.
Medications can ease MS attacks and possibly slow the disease. *there are a number of medications that can alter the activity of the immune system. They don’t cure MS but reduce the frequency of breaking down of the myelin. Deep Brain Stimulation may be used. Deep Brain Stimulation is where a doctor inactivates parts of the brain without destroying the brain. It is less frequently used today due to the risks that it has. Plasma Exchange is another method for helping patients with MS. Plasma Exchange is when the liquid part of your blood gets exchanged with a donors or a plasma substitute. Botulinum Toxin is also another option. It reduces spasticity(involuntary muscle spasms). Ampyra can also be helpful. Ampyra blocks K(potassium) channels. This improves the conduction of impulses between the nerves of the CNS. It is only available by prescription. There are many more treatments for MS. A person’s treatment for MS depends on severity.

8 Prognosis The prognosis is variable. Depending on whether a person has mild or serious MS. The average life expectancy for someone with Multiple Sclerosis is 35 years after severe symptoms are seen. Most people with MS function normally unless they have a severe case of MS. At the beginning, most likely at Gina’s stage now, there are silent legions. These cause no harm yet. There may be a few symptomatic lesions through which would produce symptoms. This is an early stage. Some people can be at this stage for their whole lives. But normally, as time goes by, the symptoms will get worse and there won’t be any remission from the symptoms. This phase is called relapsing-remitting MS (RRMS). It gets continually worse from here. During the second phase of RRMS, there are still inflamatory relapses, but the symptoms are getting worse. The last stage a severe patient could reach is SPMS, where their symtpoms are as bad as they can get yet they will continually get worse. As symptoms get worse, they can be described by using an EDSS scale. As a person starts at the beginning or the lowest numbers of it, they essentially are barely affected by MS. But as there symptoms worsen, they become less and less ambulatory. They may start at just needing a cane or assistance from others. This disease can lead to a full-time wheelchair and then even full-time bed rest.

9 Error in Communication
Within the brain, MS can effect different parts. Then it will affect the rest body because a distorted signal will be sent out or none will be sent out at all. The signals sent from or to the central nervous system which could cause a variety of symptoms. The whole brain is affected because the neurons, found everywhere in the body will have a distorted myelin sheath or none at all. The scar tissue that forms can create lesions, pictured as glowing spots in the image of the brain during an MRI. These legions will affect this area and produce symptoms that would be the tell-tale signs of MS. Specifically these symptoms could be caused by neuron problems in the occipital lobe, frontal lobe & cerebellum among many other brain and body parts that could be affected by the scar tissue on the neurons.

10 Biomedical professionals that worked on her
A physical therapist will work on Gina. They help injured or ill people manage their body especially if that patient has pain in certain areas. They restore function to some patients limbs, improve mobility, relieve pain, and stop or limit lasting physical problems. For MS patients like Gina, physical therapists often help her deal with living with her chronic condition. Moving about and being able to walk can sometimes, for her, be very taxing or she just cant do it. She has to learn to deal with her inability to move around normally. A physical therapy will help her get used to being able to move only in a certain way whether it be with a walker or with a cane among other things. A physical therapist needs to graduate from a physical therapist educational program with a masters or doctoral degree. They take courses including biology, chemistry and physics. The job outlook is very good for physical therapists. A Urologist could work on Gina as well. They analyze and diagnose urinary tract conditions. They use x-ray machines, fluoroscopes, catheters, cystoscopies, and radium emanation tubes among other things. A urologist needs to have completed at least three years of college, then entered medical school. Upon entering medical school, they will have a bachelor degree in biology or chemistry. They then complete residency in their given specialty that lasts at least five years. Then the urologist must pass a certification exam, an oral exam both given by the American Urology Association and complete 16 months of clinical practice. They must continue updating their knowledge with the newest information. They also must get a state license to practice. A urologist will help Gina by way of helping to solve any symptoms of bladder problems she may be having that is caused by the MS. This include, not being able to go to the excrete liquid waste when trying or having to go too many times or too few times. May other symptoms could occur as well, these doctors would either prescribe medicine to fix this or having the patient undergo surgery. If it could be solved by another measure that could solve other problems, this urologist would consult others to fix it.

11 Cited sources Kapram, D. (2011, November 9). MRI Scans Predict Long Term Prognosis in MS Patients. Retrieved November 14, 2014, from prognosis-ms-patients Urol, J. (2006, July 23). Medscape Log In. Retrieved November 14, 2014, from

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