NEUBRASKA ™ Multiple Sclerosis
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Multiple sclerosis is an immune-mediated inflammatory injury to "white matter myelin sheaths" of the central nervous system (CNS). Focal inflammation with loss of myelin results in focal neurologic disorders including: internuclear ophthalmoplegia, optic neuritis, imbalance, paraparesis, bladder or sexual dysfunction. When cerebral periventricular areas are involved in multiple sclerosis, mental slowness and emotional lability of the patient may be observed.
Age of multiple sclerosis onset is usually between 20 and 40 years of age. Women are affected more commonly than men and Caucasians more than non-Caucasians. The lifetime risk of developing multiple sclerosis is 1 in 1,000. The diagnosis of multiple sclerosis is based on a careful and complete history and physical examination supplemented with tests such as an MRI of the spinal cord and brain. MRI enhancement with gadolinium may be useful to find "newer" lesions. Analysis of the Cerebro-Spinal Fluid for increased CNS immunoglobulin synthesis or oligoclonal bands and Evoked Potential studies may also be ordered.
The differential diagnosis of multiple sclerosis includes: acute disseminated encephalomyelitis (ADEM), Neuromyelitis Optica (Devic's), Collagen Vascular Diseases (Systemic Lupus Erythematosus, Sjogren's Disease/Syndrome, Behcet's Syndrome), Infectious diseases (Lyme disease, syphilis, HIV, HTLV-1, and progressive multifocal leukoencephalopathy), metabolic disorders (Vitamin B12 deficiency), neoplasms of the CNS (Non-Hodgkin's lymphoma), disorders of the spine or vascular malformations.
Acute attacks of multiple sclerosis may be treated with steroids, IVIG or plasma exchange. There are many modalities to treat multiple sclerosis and its symptoms. If you have questions about multiple sclerosis, please contact Byron L. Barksdale, M.D.
500 West Leota Street #200
North Platte, Nebraska 69101
Byron L. Barksdale, M.D.
Phone: 308-532-4700
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