Multiple Sclerosis

Multiple Sclerosis (MS) is an inflammatory, often progressive, and potentially disabling disease of the central nervous system. Onset of disease is usually between the ages of 15 and 50, with the incidence nearly twice as high in women. While the cause of MS is still unknown, the predominant theory is that it is an autoimmune disease, triggered by an unknown environmental factor that results in both loss of central nervous system myelin and degeneration of axons and neurons. Although there have been a number of publications addressing different aspects of MS treatment in the neurological literature, there is a dearth of material on MS designed for internists and primary care physicians, who are often the first to see patients presenting with symptoms of MS. Therefore, this concise, clinically focused volume will serve as a valuable resource tailored to the specific needs of internists and primary care physicians. Part of the Oxford Neurology Library, this highly practical pocketbook covers current approaches and new developments in the diagnosis, treatment and management of MS, including both early and advanced stages of the disease. The book offers in-depth coverage of special populations, as well as the more unusual manifestations of MS, which are less familiar to the internal medicine audience. It will also address the role of imaging studies in the diagnosis, differential diagnosis and monitoring of the progression of MS. In addition to providing up-to-date information on pharmacological therapies for MS, the book also describes an array of non-pharmacological treatment options.

Autorentext

Director, Multiple Sclerosis Treatment and Research Center, Minneapolis Clinic of Neurology, Clinical Profesor of Neurology, University of Minnesota School of Medicine, Minneapolis, Minnesota

Inhalt

Introduction 1. A Brief History of Multiple Sclerosis a.Experimental Autoimmune Encephalomyelitis 2. Factors Involved in Causing Multiple Sclerosis a.Epidemiology b.Causes of MS c.Immunology 3. The Patterns and Pathophysiology of Multiple Sclerosis a.Patterns of MS b.Pathophysiology of MS 4. Imaging of the Central Nervous System in Multiple Sclerosis a.Standard X-Ray Imaging of the Skull and Spinal Columns b.Computed Tomography (CT) Imaging of the CNS c.Magnetic Resonance Imaging 5. Making a Diagnosis of Multiple Sclerosis a.Patterns of Disease Presentation b.Demographics c.Genetics of MS d.Initial Clinical Symptoms in Persons with Relapsing-Remitting MS e.Initial Clinical Symptoms of Primary-Progressive MS f.Presenting Signs in MS g.Magnetic Resonance Imaging h.Evoked Responses i.Cerebrospinal Fluid Analysis j.Ruling Out "MS Look-alikes" k.Algorithms for the Diagnosis of MS l.Imparting a Diagnosis of MS 6. Complications and Comorbidities of Multiple Sclerosis a.Loss of Bone Density (Osteopenia or Osteoporosis) b.Sleep Apnea and Other Altered Sleep Patterns c.Mood Disturbances d.Urinary Tract and Other Infections e.Sexual Dysfunction f.Skin Lesions g.Joint Dysfunction h.Obesity 7. Relapses of Multiple Sclerosis and Their Treatment a.What Constitutes a Relapse? b.Conventional Relapse Treatments c.Unconventional Relapse Treatments d.Relapse Prevention 8. Long-Term Disease-Modifying Therapies a.Issues with Long-Term Immune-Modulating Therapies b.Beta-Interferons c.Glatiramer Acetate d.Second-Line Disease-Modifying Therapies e.When Should Long-Term Immune-Modulating Therapy Be Stopped? f.Future Therapies 9. Management of Multiple Sclerosis Symptoms a. Fatigue b.Depression c.Pain d.Spasticity e.Sexual Dysfunction f.Conclusion 10. Complementary Therapies for Multiple Sclerosis a.Physical Therapy b.Exercise Physiologists c.Occupational Therapy d.Psychiatrists, Counselors, and Psychologists e.Neuropsychologists f.Orthotists g.Neuro-Ophthalmologists h.Urologists i.Social Workers j.Diet, Nutrition, and Food Supplements 11. Gender Issues and Special Multiple Sclerosis Populations a.Women b. Men c.Children of Parents with MS d.Pediatric MS 12. Resources a.Web Sites b.Patient Advocacy Organizations c.Sites for Disease-Modifying Therapies d.Site for MR Imaging Protocol for MS e.Patient Books and Materials Index