多发性硬化英文VIP免费

多发性硬化英文ppt课件“Multiple”-multipleareasoflostmyelin“Sclerosis”-ScarringMSisachronicautoimmuneinflammatorydiseaseAffectsCentralNervousSystem(brain,spinalchordandopticnerves)MultipleSclerosisInternationalJournalofMSCareMultipleSclerosisSymptomsofMSMuscleweaknessVisualsymptoms•Blurryvision•DoublevisionUnsteadygait/balanceissuesPain/ParesthesiasEmotional/Cognitivedisturbances•Shorttermmemoryloss•InabilitytoconcentrateFatigueSexualDysfunctionSpeechSwallowingAbnormalsensations•Tingling•NumbnessSensitivitytoheatBladderandbowelproblems•Frequency•LossofcontrolMultipleSclerosisKurtzkedisabilitystatusscale1Nodisability&minimalneurologicsign2Minimaldisability-slightweaknessorstiffness,milddisturbanceofgaitormildvisualdisturbance3Moderatedisability-monoparesis(partialorincompleteparalysisaffectingoneorpartofoneextremity)mildhemiparesis(slightparalysisaffectingonesideofbody)moderateataxia,disturbingsensoryloss,prominenturinaryoreyesymptom,oracombinationoflesserdysfunction4Relativelyseveredisability,butfullyambulatorywithoutaid,selfsufficientandabletobeupandabout12hoursaday,doesnotpreventtheabilitytoworkorcarryonnormallivingactivities,excludingsexualdysfunction5Disabilityissevereenoughtoprecludeworking,maximalmotorfunctioninvolveswalkingunaidedupto500meters6Needsassistancewalking,forexampleacane,crutches,orbraces7Essentiallyrestrictedtoawheelchairbutabletowheeloneselfandenterandleavethechairwithoutassistance8Essentiallyrestrictedtobedorachair,retainsmanyselfcarefunctionsandhaseffectiveuseofarms9Helplessandbedridden10DeathduetoMS-resultsfromrespiratoryparalysis,comaofuncertainorigin,orfollowingrepeatedorprolongedepilepticseizuresDiagnosingMSAdiagnosisbyexclusioneliminateotherdiseasestatesthatmayexplainsymptomsbeforesuggestingMSPatientsundergoclinical,laboratory(hematologyandCSFpanels),andimagingstudiestoconfirmdiagnosisDiagnosisbyPoserCriteriaClinicallydefiniteMS•2attacksandclinicalevidenceof2separatelesionsLaboratorysupportedDefiniteMS•2attacks,eitherclinicalorparaclinicalevidenceof1lesion,andCSFimmunologicabnormalities•1attack,clinicalevidenceof2separatelesions&CSFabnormalities1attack,•clinicalevidenceof1andparaclinicalevidenceofanotherseparatelesion,&CSFabnormalitiesMRIMRIfindingsthatstronglysuggestiveofMS•4ormorewhitematterlesions(each>3mm)•3whitematterlesions,1periventricularLesions6mmdiameterorgreater•Ovoidlesions,orientedperpendiculartoventricles•CorpuscallosumlesionsBrainstemlesions•OpenringappearanceofgadoliniumenhancementTheaxialT2WIshowsperi-ventricularflame-shapedhyperintenseareasMRIImagingNormalBrainPatientwithMSMSLesions“Dawson’sFingers”MSLesionsinSpineCerebralSpinalFluidStudiesStronglysuggestiveofMS•NormalRedBloodCellsandglucose•Normalormildlyelevatedprotein5-20mononuclearcells/ul•IntrathecalIgGsynthesis•IncreasedIgGindexor24hoursynthesisrateIncreasedfreekappalightchains•OligoclonalbandsRelapsing-RemittingMS(RRMS)•Mostcommon,affecting85%ofpatients.•Patientsexperienceworseningofpre-existingsymptomsoronsetofnewsymptomsforperiodsofgreaterthan48hourswithoutconcomitantfever,knownasrelapses,flare-ups,orexacerbations,ofMS.•Contrastedbysymptom-freeperiods,knownasremissions,wherethepatient’ssymptomspartiallyorcompletelydisappear.Secondary-ProgressiveMS(SPMS)AprogressionofRRMS•Morecommonbeforeadventofdisease-modifyingmedications•Approxima...