Time heals all wounds except relapsing-remitting MS.
And primary-progressive MS.
And secondary-progressive MS.
And whole bunch of other age-related illnesses, like glaucoma, age-related macular degeneration and malignancy.
At least time is good for adhesive capsulitis, alternatively known as frozen shoulder!
MS is a chronic disease involving immune-mediated attacks on the central nervous system. Demyelination causes mayhem.
As a parallel, Guillan-Barre acutely affects the peripheral nervous system. When it’s chronic, it’s called chronic inflammatory demyelinating polymyopathy.
Neurological symptoms ensue after the disease has passed a threshold.
- Optic neuritis, characterised by painful visual loss in an eye
- Numbness, weakness
- Ataxia, spasticity
- Sexual and urinary dysfunction, such as detrusor overactivity causing urgency
Clinically isolated syndrome is a one-off presentation of demyelination that can progress to MS.
MRI can show brain lesions.
CSF analysis can show inflammation.
Evoke potential measurement can show demyelination.
Ongoing: immunotherapy agents.
Acute relapse: high-dose corticosteroids.
Paroxysmal symptoms: carbamazepine
Urinary symptoms: oxybutynin
The risk of MS relapse is lower during pregnancy and higher in the first 3 months after giving birth.
Summary of major demyelinating illnesses
Central nervous system: clinically isolated syndrome (acute), MS (chronic)
Peripheral nervous system: Guillan-Barre (acute), CIDP (chronic)
- MS Australia. (2001). Types of MS | MS Australia. [online] Available at: https://www.msaustralia.org.au/about-ms/types-ms [Accessed 20 Jan. 2018].
- National Multiple Sclerosis Society. (n.d.). Definition of MS. [online] Available at: https://www.nationalmssociety.org/What-is-MS/Definition-of-MS [Accessed 20 Jan. 2018].
- Johns Hopkins Medicine. (n.d.). Guillain-Barre and CIDP. [online] Available at: https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/peripheral_nerve/conditions/guillain_barre_and_cidp.html [Accessed 20 Jan. 2018].
- Multiple sclerosis. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited (eTG November 2017 edition); 2017 Nov.