Natural Multiple Sclerosis Treatment Ebook

Reverse MS Now

Heres just a few things youll learn about how to get back into health. and conquer Multiple Sclerosis. Those not-so innocent yet everyday substances that are currently attacking your body, perpetuating and aggravating your Multiple Sclerosis. What to do and what Not to do to overcome your Multiple Sclerosis effectively and permanently. How to create the energy you need to be able to work full time and feel confident you will be able to take care of your loved ones. How the pharmaceutical and food industry are conspiring to poison you and make you sick (Hint: American medical system is now the leading cause of death in the US). Continue reading...

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What is multiple sclerosis

In the classic sense, multiple sclerosis (MS) is a disease of the central nervous system (the brain and spinal cord) that most commonly affects young adults. Sclerosis means hardening MS means that there are multiple areas of hardened tissue in the brain and spinal cord. The word disease means a loss of a feeling of ease (i.e., dis-ease), or otherwise stated, a loss of a sense of well-being. This is a meaningful definition for MS patients faced with a bewildering variety of other specific symptoms. Often, patients afflicted with MS have difficulty describing just how they feel. Although the MS patient appreciates and understands this concept, many healthy persons, including physicians, unfortunately, often do not.

What Is Unlikely To Cause Multiple Sclerosis

Likewise, some medical authors have tried to show that diets rich in animal fats are important in causing and sustaining the disease, but their findings are not based on sound scientific studies. The National Multiple Sclerosis Society (NMSS) recommends the dietary guidelines published by the American Heart Association, in the absence of any compelling evidence linking MS to animal fat in the diet.

Clinical associations with RLS or secondary RLS 61 RLS and multiple sclerosis

After an initial 2002 meeting presentation where data from 100 multiple sclerosis (MS) patients with a prevalence of RLS of 32 was described, Auger et al reported a prevalence of 37.5 in their 200 French-Canadian MS patients meeting the 2003 IRRLSG criteria. Interestingly, in their patient population, more women than men met RLS criteria and 30 of patients reported that RLS symptoms started or worsened during pregnancy. A positive family history for RLS was reported by 36 of these French-Canadian patients meeting RLS criteria. They speculated whether MS plaque formation and involvement in the basal ganglia may be pathogenic for RLS in these patients. This concept may be supported by the therapeutic effect of dopaminergic therapeutic agents. The concept of potential common susceptibility genes for both MS and RLS is raised by the authors (Auger C et al, 2005). The following year, Kilfoyle et al reported a myelin protein zero (MPZ) mutation which was associated in the individuals...

An Overview of Multiple Sclerosis

Partes Medusa

Multiple sclerosis (MS) is a disease of myelin, the insulating cover around the nerves of the central nervous system (CNS brain, optic nerves, and spinal cord) (see Figure 1.1), that becomes damaged in MS. MS most commonly begins in young adulthood and affects about twice as many women as men. Although its initial symptoms vary greatly, certain patterns are typical a previously healthy woman or less frequently, a man, 20 to 30 years old suddenly experiences neurologic symptoms. These symptoms may range from dimming of vision to numbness in the legs or body to dizziness or imbalance. Symptoms of this first attack (or exacerbation) usually remit (clear) or improve. tered throughout the brain and spinal cord. They are located in the white matter, which contains a high percentage of myelin, an insulating material that covers sections of nerve cells that carry electrochemical messages from the nerve cells to action parts of the body, such as the eyes or the muscles in the hands or legs....

Multiple Sclerosis

Multiple sclerosis (MS) and vitamin B12 deficiency share common inflammatory and neurodegenerative characteristics and low or decreased levels of vitamin B12 have been demonstrated in MS patients and may correlate with early onset ( 18 years) (Miller et al 2005). Considering vitamin B12 is a cofactor, and myelin formation has important immunomodulatory and neurotrophic effects (Loder et al 2002, Miller et al 2005, Sandyk & Awerbuch 1993), a theoretical basis exists for its use in MS.

An International Effort To Speed Clinical Trials

Imagine you have just been diagnosed with MS and your doctor says, I see by your clinical profile that you will do well on medication 'X,' you will likely have one exacerbation two years from now, and in 10 years you will still retain your current physical abilities. It is the dream of those involved with the Sylvia Lawry Centre for MS Research (SLCMSR), an international collaboration launched by the Multiple Sclerosis International Federation, that such profiling will become available in the future by amassing and analyzing data from scores of MS clinical trials.

How To Minimize And Manage The Different Types Of Fatigue

What you eat fuels your body with energy stores. It is important for you to eat a well-balanced diet to minimize fatigue and maximize function. Good nutrition will also contribute to your skin integrity, your mood, and elimination patterns. (Nutrition is discussed in detail in Chapter 15, The Role of Nutrition in Multiple Sclerosis. ) Reprinted with permission from Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale applied to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 1989 46 1121-1123.

Maintaining Joint Flexibility and Mobility

The range of motion (or number of degrees of motion) of a joint is determined by the tightness of the ligaments, tendons, muscles, and joint capsule surrounding that joint. The looser or more flexible the structures, the more movement the tighter the structures, the less movement. Generally, a person's everyday movements are enough to keep the joints loose and flexible, but weakness caused by multiple sclerosis (Ms) can interfere with the full range of motion of the joints.

Driving and Other Transportation Issues

Maintaining your independence in mobility and transportation is a basic element to your quality of life. Your ability to walk and drive may change as a result of multiple sclerosis (MS). These changes often require use of a personal modified vehicle, or you may choose to use alternative public or private transportation. Depending on your environment, public transportation may be available for access into your community. Public accessibility for travel options, including plane and train travel, is becoming easier for persons with disabilities. Research in the area of driver's rehabilitation has focused on self-report, comparative motor vehicle records of crashes, and driving behaviors. Maria T. Schultheis, PhD, from the Neuropsychology and Neuroscience Laboratory, Kessler Medical Rehabilitation Research and Education Corporation, reports that there is a significantly higher number of motor vehicle crashes among drivers with MS than among control subjects. The presence of cognitive...

Are there any MS groups that I can look into for additional help

The National Multiple Sclerosis Society (NMSS) chapters and other groups have played an important part in education of patients and their families about MS. The MS Society chapters have regularly supported educational lectures for MS patients and their families. These sessions sometimes double as group therapy. When supervised by a professional, they are of real value to participants. Certainly, meeting other patients and exchanging experiences can help put the disease in perspective. It is important to recognize that the clinical course of illness varies greatly from one person to another. Young people may be intimidated when they meet severely affected individuals, regardless of the age or duration of illness. Therefore, potential participants in these sessions may wish to get more information about who will be present at a particular group session they are considering attending and whether it will be led by a knowledgeable professional.

What Are Economic Consequences

In 1998, Duke University researchers published a comprehensive assessment of the cost of MS in Multiple Sclerosis. Based on a study commissioned by the National Multiple Sclerosis Society (NMSS), these findings substantially support PVA findings. The only exception is that its model included lost wages as a direct cost. The combined costs for MS in this study were 34,103 annually. Adjusted for inflation today, this figure would be about 51,000.

Personal Financial Planning

In 2003, PVA and the NMSS collaborated with the National Endowment for Financial Education (NEFE) to produce the book Adapting Financial Planning for a Life with Multiple Sclerosis. This step-by-step personal financial planning guide is based on much of the preceding discussion. It asks one to identify the direct and indirect costs through a review of personal records or keeping a diary. It suggests ways to maximize a person's understanding of what it costs to live with MS, whether as an individual newly diagnosed or leaving work or retiring. The guide brings together a resource of thoughts and suggestions for organizing finances, building a spending plan, seeking expert assistance, and applying for governmental programs. The guide is not intended to replace expert advice or personal decision making, but it does go a long way toward stating that it's only money, and everyone can gain a measure of mastery over their ability to pursue a lifestyle. You can obtain a copy of Adapting by...

Health Insurance Options

For people with a chronic disease or disability such as multiple sclerosis (MS), obtaining and maintaining health insurance coverage is crucial. The quality of one's health coverage determines the quality of one's healthcare, and having the necessary healthcare is a key factor in optimizing function and quality of life.

Can pregnancy in a woman with MS harm the unborn child

There is speculation that fertility is reduced in patients with MS and that the rate of spontaneous abortion is increased in the first trimester of pregnancy. There is no evidence or expectation that MS directly affects the unborn child. However, from the information collected in the North American Research Committee on Multiple Sclerosis (NARCOMS) database, the interferonbeta treatments for MS (Betaseron, Avonex, and Rebif) do pose an increased risk of birth defects in the unborn child.

Other Ways To Feel Safer At Home

Home modifications might also help you feel safer and more independent. Widening doorways, creating an accessible bathroom, building a ramped entrance, and installing a porch lift can often enable someone to stay at home safely and more independently and get out in case of an emergency. A consultation with an occupational therapist, architect, or home modification specialist will help you identify your options. For referrals, contact the National Multiple Sclerosis Society (1-800-FIGHT-MS) or the Paralyzed Veterans of America (800-424-8200).

For Veterans The Department Of Veterans Affairs

Your ability to access benefits and services relating to multiple sclerosis from the Department of Veterans Affairs (VA) is based on whether the diagnosis is considered to be service-connected or not. The U.S. Congress passed legislation defining a diagnosis of multiple sclerosis as service-connected when there is documented evidence that initial signs and symptoms occurred within 7 years of discharge. Because the definition of service-connected multiple sclerosis is based on the evidence of symptoms, it is essential for veterans to have proper documentation in their medical records. Many neurologists within the VA have experience treating people with multiple sclerosis. However, every veteran must question his or her primary care physician to ensure that the referral is to a neurologist with experience in MS. In December 2002, the VA medical system established two Centers of Excellence in research, education, and clinical treatment of multiple sclerosis. These MS Centers of...

Chemical Name Amitriptyline ameetriptileen

Description Amitriptyline is a tricyclic anti-depressant used to treat mental depression. In multiple sclerosis, it is frequently used to treat painful paresthesias in the arms and legs (e.g., burning sensations, pins and needles, stabbing pains) caused by damage to the pain regulating pathways of the brain and spinal cord. by spasticity in multiple sclerosis. Description Baclofen acts on the central nervous system to relieve spasms, cramping, and tightness of muscles caused by spastic-ity in multiple sclerosis. Intrathecal baclofen therapy (ITB) consists of long-term delivery of baclofen to the intrathecal space in the spinal column. It is used in MS for those individuals with severe spasticity whose symptoms are not sufficiently relieved with oral baclofen and other oral medications. Because ITB is administered directly into the intrathecal space, it provides better spas-ticity reduction at lower doses than can be achieved with oral medications that, at higher doses, can produce...

Chemical Name Nortriptyline nortnptileen

Description Nortriptyline is a tricyclic anti-depressant used to treat mental depression. In multiple sclerosis, it is frequently used to treat painful parsthesias in the arms and legs (e.g., burning sensations, pins and needles, stabbing pains) caused by damage to the pain regulating pathways of the brain and spinal cord.

Stress Demon Of The Modern

Many people believe that stress plays an important role either in precipitating the onset of multiple sclerosis (MS) or in triggering exacerbations. Anecdotes abound of people who had their first attack right after a major emotional trauma. Many studies have investigated this possible link, with mixed results. It is therefore unclear whether stress plays a major role in MS disease activity.

Chemical Name Amantadine amantadeen

Description Amantadine is an antiviral medication used to prevent or treat certain influenza infections it is also given as an adjunct for the treatment of Parkinson's disease. It has been demonstrated that this medication, through some unknown mechanism, is sometimes effective in relieving fatigue in multiple sclerosis.

Chemical Name Imipramine imzprameen

Description Imipramine is a tricyclic anti-depressant used to treat mental depression. Its primary use in multiple sclerosis is to treat bladder symptoms, including urinary frequency and incontinence. Imipramine is also prescribed occasionally for the management of neurologic pain in MS.

Exercise Options and Wellness Programs

Exercise is often the focal point of a comprehensive wellness program. Recent research projects have examined the effects of exercise and broader based wellness programs on people with multiple sclerosis (MS). Prior to this research, it was thought that exercise and wellness programs were either inappropriate or futile. It was thought that exercise may actually increase the disease process of MS. Wellness programs were thought to be either complementary or alternative and therefore not relevant to a person with a chronic disease such as MS. Now we are learning the importance of exercise and wellness programs in improving or maintaining overall physical and psychological health.

Other Types Of Exercise

Yoga has become a very popular activity for many people. Yoga for people with MS can be beneficial in improving overall flexibility and body awareness. In addition, yoga is performed at the level of the participant, so fatigue and balance problems can be minimized. Yoga can be performed through organized classes or by using video tapes to guide you through the different poses. When researching yoga classes, discuss with the instructor any limitations you may have and how they will be accommodated during the class. Many MS clinics and local chapters of the National Multiple Sclerosis Society offer yoga classes specifically for people with MS.

Hope through Research

Progress in multiple sclerosis (MS) research is being made at a remarkable rate. Twenty years ago, very little was known about the regulation of the immune system, and before the approval of Betaseron in 1993, no therapy had ever proved capable of changing the underlying course of MS. Now five approved, disease-modifying drugs are available to treat individuals with Ms. But the work in Ms research is not over. scientists are closer than ever to understanding the underlying cause of Ms, and finding additional treatments for all forms of Ms. Research efforts sponsored by the National Multiple Sclerosis Society (NMSS), the National Institutes of Health (NIH), private drug and biotechnology companies, and other Ms agencies around the world are contributing to this progress.

June Halper Mscn Anp Faan

Some health issues affect all women and men, whether or not they have multiple sclerosis (MS), but are of particular concern when they may add to the symptoms or functional impairment brought about by a disabling condition. Therefore, health maintenance is extremely important in MS. Be aware that not all symptoms are related to MS. General healthcare should include regular general checkups by your primary care physician, with assessments appropriate for your age and current symptoms and concerns. Assessment of current symptoms and problems, blood pressure assessment, Pap smears, prostate examination, and tests and examinations appropriate for the person's age are indicated. Table 12.1 summarizes the National Multiple Sclerosis Society's preventive care recommendations for adults with MS.

Fitness and Recreation

There is a belief among many experts in fitness and recreation that participating in physical activity is a close second in terms of its importance to eating and breathing. What would your life be like if you weren't able to participate in all sorts of leisure, fitness, and recreational activities In a society filled with many stressful events, the need to release by moving in any way, shape, or form that is comfortable and enjoyable to you is critical for maintaining overall balance in your daily life. For some people, yoga, meditation, and relaxation exercises fit the bill. Others must hop on a stationary bike or go for a jog to feel invigorated. No matter what type of multiple sclerosis (MS) you have or how much you're able to move, exercise, recreation, and physical activity can be adapted to meet your needs. Don't ever underestimate what you're capable of doing. Many experts in engineering, technology, and exercise have found ways to adapt all kinds of physical activity to meet...

Adjusting to Changes in Sexual Function in MS

Normal sexual function changes throughout one's lifetime, but having multiple sclerosis (MS) can profoundly affect an individual's sexual experience in a variety of ways. The most frequently reported change in men is diminished capacity to obtain or maintain an erection (impotence), while the most frequent change reported by women is partial or total loss of libido (sexual desire).

Addressing Cognitive Problems

Multiple sclerosis (MS) is a disease that affects both the body and the mind. It causes damage to tissue in both the brain and the spinal cord. When it affects the brain, MS is highly likely to affect cognition. Cognition includes high-level functions carried out by the human brain, including comprehension and use of speech, visual perception and construction, calculation ability, attention (information processing), memory, and executive functions such as planning, problem-solving, and self-monitoring.


Pamela Cavallo (1947-2001) was the former Director of the Clinical Programs Department of the National Multiple Sclerosis Society. Her entire career focused on ways to help people with MS and their families have better quality of life. She implemented her vision with programs aimed at people with MS and their families to end the devastating effects of this disease.

Snapshot Of Ms

Multiple sclerosis is a chronic disease affecting the central nervous system (CNS the brain, spinal cord, and optic nerves). it is not contagious, and it is rarely fatal, but it is unpredictable. The term multiple sclerosis literally means many scars, referring to the hardened scars, or plaques, this disease leaves in many parts of the CNS tissue after damage has occurred. Multiple sclerosis can attack at any age, but it most often strikes adults in the prime of life, between the ages of 20 and 50. For reasons that are not yet clear, women develop MS at a rate two to three times that of men. Worldwide, an estimated 2 million people have MS.

Disease Management

There are drug treatments that reduce both the severity and duration of relapses in multiple sclerosis (MS). Three types of medications have this effect steroids, routinely prescribed by some neurologists for acute exacerbations (or relapses) immunomodulators that are approved for relapsing forms of MS, two of which are also approved for progressive disease and immunosuppressants, which are still viewed by some neurologists as experimental, although one is approved by the Food and Drug Administration (FDA) for worsening MS.

Pain Management

Multiple sclerosis (MS) one that many doctors don't associate with the disease. Pain is reported by people with both relapsing and progressive forms of MS. For many patients, pain may be the most debilitating aspect of the disease, affecting their ability to function and, therefore, their overall quality of life. Pain occurs in about 80 percent of those with MS about 20 percent experience significant pain. Up to 15 percent suffer chronic pain and often seek relief from a chiropractor, a physical therapist, or an acupuncturist, in addition to a neurologist. Women are twice as likely to have pain symptoms as men.

Remaining Productive

When frequent and severe exacerbations of MS forced Laura to retire, she offered her services to the National Multiple Sclerosis Society (NMSS). Very quickly, Laura became a vital unpaid staff member for the organization as a speaker at chapter programs, a columnist for the magazine Inside MS, and an advisor on legal issues and independent living. Although Laura is unable to work at times because of MS, she says her status as a volunteer gives her the flexibility to attend to her healthcare needs and the freedom to decide which projects deserve her energy. Laura says that the lack of salary for her work does not diminish the value of her accomplishments and that pursuing her interest in legal issues for people with disabilities is essential to her self-esteem.

Set The Stage

Living with multiple sclerosis (MS), or any chronic health condition, is a lifestyle with direct and indirect costs. But before one enumerates either of the two cost categories, it is essential to make an important distinction. Life has usual and customary costs that every style has to address. Money for food, clothing, and shelter challenge the jester, warrior, magician, and king alike. Now, it is certain that style might dictate differences in the amount of costs, but one can assume that our four lifestyles have at least these costs in common. Living with MS is no different. Food, clothing, and shelter costs must be addressed adequately to provide a secure, if not comfortable, style in which one wishes to live. Living with MS presents some special or incremental costs that might be said to go beyond the basic life costs. For the following discussion, we'll label the MS costs as incremental in that these costs are often specific to the presence of MS in a person's life.


The National Multiple Sclerosis Society (NMSS) Multiple Sclerosis International Federation Multiple Sclerosis Association of America (MSAA) Multiple Sclerosis Foundation Established in 1986, the MSF is a national, service-based, nonprofit organization. Their mission is to ensure quality of life through support, educational programs, research into the cause and cure, and investigation of medical and complementary treatment options. They offer a resource-rich web site, a peer counselor and caseworker staffed tollfree helpline, and a multimedia library in English and Spanish. Address Multiple Sclerosis Foundation 6350 North Andrews Avenue Fort Lauderdale, Florida 33309-2130 USA Toll-free Phone 888-MSFOCUS (673-6287) The Multiple Sclerosis Diet Book (Doubleday Publishers) By Multiple sclerosis A neurologic disease that is characterized by focal demyelination in the central nervous system, lymphocytic infiltration in the brain, with a variably progressive course. Pyramidal...

What is a macrophage

Another drawing by Charcot showing loss of normal myelin around a small blood vessel. This blood vessel is a venule with five or six long, beanlike nuclei oriented more or less vertically in the middle of the drawing. Also seen are spaghetti-like axons without myelin, which appear smaller than the other axons with their myelin intact. This observation led to multiple sclerosis being termed a demyelinating disease. Figure 5. Another drawing by Charcot showing loss of normal myelin around a small blood vessel. This blood vessel is a venule with five or six long, beanlike nuclei oriented more or less vertically in the middle of the drawing. Also seen are spaghetti-like axons without myelin, which appear smaller than the other axons with their myelin intact. This observation led to multiple sclerosis being termed a demyelinating disease.

Mechanisms and models of cancerrelated fatigue

'Known' by this we mean fatigue associated with conditions or diseases where a plausible mechanism can readily be identified based upon the known underlying pathophysiology. In this category would be included fatigue associated with exercise, myasthenia gravis, multiple sclerosis, cardiac disease, chronic lung disease, severe anaemia, hypothyroidism, polio, and steroid myopathy.

Contraindications And Precautions

Commission E warns against using echinacea in cases of autoimmune disorders, such as multiple sclerosis, SLE and RA, as well as tuberculosis or leukocytosis (Blumenthal et al 2000). This is based on theoretical considerations and has not been tested in controlled trials. In practice, echinacea has been successfully used by herbalists in autoimmune disease without mishap (Mills & Bone 2005). Duration of use Based on evidence that parenterally administered echinacea reversibly depresses immune parameters, Commission E has recommended that echinacea should not be used for more than 8 weeks. However, in a study in which it was taken orally for up to 6 months, no changes in immune parameters were detected (Vonau et al 2001). As such, no conclusive evidence demonstrates that long-term use is detrimental.

Clergy and religious community

We belong to a religious study group that has met weekly for eight years. In our group during that time there have been three cancer diagnoses and one of multiple sclerosis. We have all become an incredibly supportive family, and we share the burdens. I cannot begin to list the many wonderful things these people have done for us. They consistently put their lives on hold to help. They fill the freezer, clean the house, support us financially, parent our children. They do the laundry covered with vomit. They quietly appear, help, then disappear. I can call any one of them at 3 00 A.M. in the depths of despair and find comfort.

Dichotic Listening And Aging

If the structural model of dichotic-listening effects is valid, then a less severe impediment to interhemispheric transfer than total commissurotomy would also be expected to interfere with left-ear recall. Reinvang, Bakke, Hugdahl, Karlsen, and Sundet (1994) tested this prediction among multiple sclerosis patients for whom there was MRI evidence of callosal thinning. These authors reported findings broadly consistent with the structural model, as have others (Pelletier, Habib, Lyon-Caen, Salamon, Poncet, & Khalil, 1993 Rao, Bernardin, Ellington, Ryan, & Burg, 1989 Rubens, Froehling, Slater, & Anderson, 1985).

Immunomodula Tion

According to in vitro data quercetin induces Th1 -derived cytokines (promoting cellular immunity) and inhibits Th2-derived cytokines, which exert negative effects on cellular immunity (Nair et al 2002). An excess of Th2 cytokines has also been implicated in allergic tendencies, which provides a theoretical basis for the use of quercetin as an anti-allergic substance. Conversely animal studies have demonstrated that quercetin is able to inhibit Th1 differentiation and signalling of IL-12 (Muthian & Bright 2004). As this occurred in the presence of a Th1 cell-mediated inflammatory demyelinating autoimmune disease model of multiple sclerosis suggestive of Th1 excess, a possibility exists that quercetin actually exerts an immunomodulatory effect on these cells. Further trials are required to elucidate the exact effects of quercetin under different conditions.

Applications To Health Promotion And Disease Prevention

Include multiple sclerosis, rheumatoid arthritis, asthma, arteriosclerosis, etc. Those pathologies indicate a critical role for tissue infiltration by leukocytes in inflammatory disease pathogenesis. For immigration of circulating leukocytes into tissues, transmigration through the vascular endothelial layer involves two independently regulated events binding to vessel endothelium, followed by diapedesis. For this purpose, cell arrest is mediated by activation of adhesion receptors on the moving cell, followed by attachment to counter-receptors on other cells or endothelial cells, leading to an immobilized cell. Furthermore, the inflammatory response is mediated by a broad spectrum of mediators able to promote vascular events, edema, and, finally, the recruitment of inflammatory cells (Friedl & Weigelin 2008).

Surgical Complications

Surgical complications are those that occur within 30 days of surgery. These complications are typical of those seen with other intracranial stereotactic procedures and generally occur in less than 5 of the patients. These complications include hemorrhage, ischemic lesions, seizures, infections, and misplaced leads. Several studies have focused on the examination of surgical complications related to DBS. Beric et al. (46) reported 86 patients who received 149 DBS implants in the VIM nucleus of the thalamus, GPi or STN for PD, essential tremor, multiple sclerosis, or dystonia. In this cohort, 2.3 (n 2) of the patients had a hemorrhage, 2.3 (n 2) had seizures, 1.2 (n 1) had a delayed hematoma two months after surgery, and 4.7 (n 4) had postsurgical confusion. Umemura et al. (47) reported surgical complications in 109 patients receiving DBS of the VIM nucleus of the thalamus, GPi, STN, or anterior nucleus of the thalamus for PD, essential tremor, epilepsy, or dystonia. They reported two...

Aetiology of mental fatigue

Interleukin-1 (IL-1) crosses the blood-brain barrier, with the highest rate of entry occurring in the hypothalamus (Dantzer et al. 1992). The hypothalamus has rich connections with the brainstem, frontal cortex, and limbic system. IL-1 and its receptors are found in many areas of the brain. IL-1 messenger RNA is found in abundance in the hippocampus (Dantzer et al. 1992), a critical structure for memory processes. IL-1P depresses the influx of calcium into hippocampus neurons, which may explain the preponderance of memory impairment in patients with IL-1-associated toxicity (Plata-Salaman and Ffrench-Mullen 1992). TNF is also neurotoxic, and is associated with demyelination in the brain (Ellison and Merchant 1991). TNF and IL-1 are synergisti-cally toxic (Waage and Espevik 1988) and are associated with the development of multiple sclerosis plaques and gliosis (Wollman et al. 1992). Patients with Alzheimer's disease have elevated levels of IL-6 (Huberman et al. 1995). We have found...

Samantha S Soldan and Steven Jacobson

Ldlr Pathway

Etiology of Multiple Sclerosis III. Viruses in Multiple Sclerosis A. Viruses Associated with Multiple Sclerosis B. Potential Mechanisms of Virus-Induced Demyelination in Multiple Sclerosis D. Human Herpes Virus-6 and Multiple Sclerosis E. Multiple Infectious Triggers in Multiple Sclerosis Multiple sclerosis (MS) is the most prevalent demyelinating disease of young adults, affecting an estimated 300,000 individuals in the United States alone. The natural history of the disease is unpredictable. The majority of affected individuals have a relapsing-remitting course, while a smaller subset have a more chronic-progressive presentation. Women are affected more often than men, a phenomenon associated with a number of autoimmune diseases. Although the etiology of MS is unknown, it is generally believed that genetic, immunologic, and environmental factors are involved. This chapter will highlight these issues as they suggest that exogenous factors are associated with the patho-genesis of...

Focal Central Nervous System Disorders

Sjogren Brain Mri

Spinal cord syndromes reported in pSS include transverse myelitis and progressive myelopathy, resembling primary progressive multiple sclerosis.4,5,41 Both isolated optic neuritis and myelopathy have been described in pSS patients who are seroneg-ative.42 Case reports of pSS presenting with isolated optic neuropathy suggest consideration of pSS in the differential diagnosis of optic neuropathy.43,44 Neuromyelitis optica (NMO, also known as Devic's syndrome) is an inflammatory neurologic disease characterized by recurrent episodes of myelitis and optic neuritis. NMO has been reported in association both with SLE and with pSS (Fig. 1), but it is unclear whether the association is beyond that expected by chance. A recent report described two cases of pSS among 153 consecutive patients with confirmed or suspected NMO, a prevalence (1.3 ) marginally higher than that of pSS in the general population.45 However, the cases of pSS were identified by prior diagnosis rather than prospective...

Neurovirulence of murine oncornaviruses

Retroviruses and Multiple Sclerosis Two neurologic diseases of humans are known to be caused by retroviruses human immunodeficiency virus (HlV)-associated dementia, and tropical spastic paraparesis caused by HTLV-1. Evidence of the involvement of retroviruses in other diseases of the nervous system is loose at best. The most recent example is the suggested link between the expression of an endogenous virus belonging to the HERV-W family (Komurian-Pradel et al., 1999) and multiple sclerosis (Perron et al., 1997). Viral RNA was identified by RT-PCR in culture supernatants of Our thinking about the function of microglial cells is currently in a state of flux. While it is clear that these cells are the scavengers of the brain and also can act, under certain special situations, as antigen-presenting cells (reviewed in Kreutzberg 1996 ), it now appears that they may play a critical role in the maintenance of immune privilege in the CNS (Bauer et al., 1999 Ford et al., 1996). These newly...

Sleepdisordered breathing disorders in neurological diseases

Generation of respiratory movements (neuromuscular disorders). Vascular damage to the respiratory center may lead to central respiratory disturbances. Neurodegenerative disease can damage the respiratory center (Cormican, 2004), as well as demyelinating lesions (Auer, 1996) located within the respiratory center. Damage of the axons projecting from respiratory center to spinal cord a-motoneurons (cervical spine trauma, demyelinating plaques in multiple sclerosis) can cause respiratory disorders. Damage to the a-motor neurons of the spinal cord (amyotrophic lateral sclerosis, post-polio syndrome) leads to respiratory failure (Aboussouan, 2005). Similarly, peripheral nerve conduction abnormalities (Guillian-Barre syndrome and congenital polyneuropathy) may lead to hypoventilation and respiratory failure. Disorders of the neuromuscular transmission (myasthenia gravis, botulinum toxin poisoning) and primary muscle disorders (myopathies, muscular dystrophy) can cause respiratory disorders....

Medications and Their Effects on Gum Disease

You may be unaware that certain medications can cause changes to your gum tissue and promote gum disease. The most common of these are antiseizure medications taken for epilepsy. Dilantin, for example, is a drug that can create gingival overgrowth, which has the appearance of thickened tissue and loosened gums. Antidepressants such as Paxil, Elavil, and Zoloft create gingival overgrowth and swellings throughout the mouth. Studies have shown that these changes take place on a cellular level and create a more dense tissue. Another drug that causes overgrowth to gum tissue is cyclosporine, used for immunosuppression in people who have had transplants and people with multiple sclerosis.

The Frontal Lobes and Aging

I also mentioned earlier that with aging there is a loss of subcortical white matter. Patients who have diseases that injure their white matter, such as multiple sclerosis or multiple small strokes of the white matter, frequently show evidence of frontal lobe dysfunction and do poorly on tests such as the Wisconsin Card Sorting Test because they get stuck in set.

Pharmacological Uses of Vitamin D

Multiple sclerosis is less common among people living at high altitude, where UV exposure is greater. Patients with multiple sclerosis have poor vitamin D status and low bone density, although this could be a result of the disease rather than a cause. Calcitriol prevents the development of experimental autoimmune encephalomyelitis in mice, a widely accepted model of multiple sclerosis, and it has been suggested that vitamin D supplements may protect genetically susceptible people from developing the disease (Hayes et al., 1997 Hayes, 2000).

Malandrinum Homeopathy For Acne Treatment

First-aid uses 271 mountain daisy see Arnica montana mountain laurel see Kalmia latifolia mountain tobacco see Arnica montana mouth, role in digestive system 188 mouth conditions inflammation 104 mouth & throat conditions 85, 92 mouth ulcers 70, 232-33 self-help ailments 232-33 see also individual ailments by name, e.g., gingivitis mugwort see Artemisia vulgaris multiple sclerosis 179 damaged in multiple sclerosis 178, 179 Mygale avicularis mygale see Mygale lasiodora Mygale cubensis see Tarentula cubensis Mygale lasiodora (Mygale las.) 156, 300 Myristica fragrans (Nux mosch.) 156, 301

Stephen D Miller Yael Katz Levy Katherine L Neville and Carol L Vanderlugt

Relevance of Murine TMEV-Induced Demyelinating Disease to Human Multiple Sclerosis Evidence for a viral etiology is particularly extensive for multiple sclerosis (MS) (Challoner et al., 1995 Kurtzke, 1993), a human CD4+ T cell-mediated demyelinating disease associated with antimyelin responses (Bernard and de Rosbo, 1991 Ota et al., 1990). MS is an immune-mediated disease of the central nervous system (CNS) characterized by perivascular CD4+ T cell and mononuclear cell infiltration, with subsequent primary demyelination of axonal tracks, leading to progressive paralysis (Wekerle, 1991). Despite decades of intensive research, the inducing antigen(s) and precise immunologic mechanisms involved in the induction and chronic course of MS are still poorly understood and there are limited therapeutic options for managing this disease. MS is generally considered to involve an autoimmune pathology. Regardless of many reports demonstrating elevated humoral and or T cell-mediated responses...

Related Autoimmune Diseases

In humans, clustering of autoimmune diseases such as SLE, RA, AITD, psoriasis, multiple sclerosis, and SS within families frequently has been documented.18 Autoimmune serologic abnormalities are frequent (up to 55 , depending on the antibody specificity) in otherwise healthy family members.19 Sharing of clinical and serologic features among related diseases also occurs. For example, subsets of patients who have SLE or SS may share similar symptoms (commonly including arthralgias, myalgias, fatigue, rashes, and visceral involvement from vasculitis) or serologic abnormalities, such as antinuclear autoantibodies, anti-Ro SSA, or anti-La SSB autoantibodies.20 Some features of SS are shared more commonly with RA patients, such as arthritis and production of rheumatoid factor antibodies. Furthermore, in studies using high-density gene expression microarrays, the authors and colleagues have identified key disease pathways that are present in multiple disease phenotypes. For example, pathways...

Word from the Author

The information for this book was gathered from two sources (1) interviews with more than 100 people living with Parkinson's disease, people who care for people with PD, and healthcare professionals and (2) my own personal experiences living with multiple sclerosis (MS), which, like Parkinson's disease, is a chronic, degenerative, and incurable illness. Multiple Sclerosis 300 Tips for Making Life Easier (Demos Medical Publishing, 1999, 2005)

What about [Fill in the Blank Other Possible Causes

Attacks the body's own pancreas, killing the cells that produce insulin. The lack of insulin then causes the symptoms of diabetes. Dr. Warren proposed that some autistic children might undergo such an autoimmune process, but that the organ of the body attacked by the immune system in the case of autism is the brain rather than the pancreas. A few studies have found evidence of antibodies (immune proteins usually produced to combat infections) that recognized brain cells as foreign in some children with autism spectrum disorders. One further prediction of the autoimmunity theory is that children with autism should have a higher rate of other autoimmune illnesses, such as asthma, allergies, arthritis, diabetes, multiple sclerosis, and the like. Some studies have indeed found an elevated rate of some of these difficulties in both children with autism spectrum disorders and their family members.

Biological Psychiatry

Bacterial and viral infections, and metabolic illnesses, such as thyroid disease and diabetes, can cause mental dysfunction. So, too, can abused drugs, fever, dehydration, electrolyte imbalances, toxins, or antibiotics. Patients with HIV AIDS often become depressed or demented. Patients with multiple sclerosis or cerebrovascular disease, brain trauma, or brain tumors often have mental disabilities.

Symptoms And Diagnosis

Nonrefreshing sleep or insomnia also can create fatigue in FM. In nonre-freshing sleep, people report they sleep for 10-plus hours but wake up feeling unrefreshed, or as one patient put it, feeling like I've been run over by a Mack truck. Other people with fatigue in FM have insomnia. Insomnia can include difficulty falling asleep, difficulty staying asleep, or early morning waking. All of these sleep disruptions are either caused by, or adversely affect, the body's hormonal and nervous system functioning. Multiple sleep studies consistently have demonstrated abnormalities in the sleep architecture of people with FM. It can be challenging for clinicians to correctly differentiate the fatigue of FM from a diagnosis of general muscle weakness. True muscle weakness appears in neurological diseases such as multiple sclerosis (also called MS, a condition in which the immune system attacks the central nervous system, leading to a loss of normal nerve structure and function). It involves an...

Scientific evaluation of the Intermed

Nurse, based on a review of the medical chart and a patient interview conducted by one in the presence of the other. The two raters showed high agreement, as indicated by a k of 0.85 40 . Temporal stability of the INTERMED was assessed in outpatients who had multiple sclerosis, with an interval of 1 year between the two assessments and without a specific intervention other than care as usual 41 . The correlation between the two assessments was moderate to good (indicated by a k of 0.60) reflecting the fact that the INTERMED is a rather stable measure. Predictive validity, as required for an instrument that should provide clinically meaningful information (clinimetric approach), was studied by selecting relevant outcome variables in several specific patient populations (for a summary, see Table 2). In patients admitted to a general medical ward, those classified by the INTERMED as having a high degree of case complexity were found to have a doubled length of hospital stay and increased...

Chronic Fatigue and Immune Dysfunction Syndrome CFIDS

Overlap between the two shows that 35 to 70 percent of those with CFIDS have FM, whereas 20 to 70 percent of those with FM report an additional diagnosis of CFIDS. Earlier terms for CFIDS included yuppie flu or chronic Epstein-Barr Syndrome. CFIDS is defined by the Centers for Disease Control as a medically unexplained, persistent, or relapsing fatigue that is not substantially alleviated by rest and which is associated with significant functional impairment, including fatigue that occurs concurrently with four of more of the following cognitive dysfunction, sore throat, tender lymph nodes, muscle pain, joint pain without swelling, headaches, lightheadedness, unrefreshing sleep, and postexertional malaise lasting for at least twenty-four hours. These symptoms must persist at least six consecutive months to be diagnosed as CFIDS. As there is no simple test to confirm CFIDS, diagnosis is based on history and physical exam. Tests are often done to rule out other diseases that might mimic...

Beating Fibromyalgia with Botox Injections

Physicians use Botox to treat many different types of medical problems, such as tremors, tics, stroke, cerebral palsy, multiple sclerosis, chronic low-back or neck pain, chronic headaches, and a wide variety of other medical conditions. Some plastic surgeons also use Botox to cosmetically (and temporarily) rid people of their facial wrinkles.

Treatment of Th1Mediated Autoimmune Diseases

We conducted the first anti-IFN-y therapy in Th-1-mediated diseases together with several clinics using a polyclonal anti-IFN-y antibody (both IgG and F(ab')2 antibody fragments) and in some cases, for comparison, a polyclonal anti-TNF-a. The antibodies were given intramuscularly once or twice daily for 5-6 days. Our studies include placebo-controlled, double-blind studies in patients with rheumatoid arthritis unresponsive to standard treatments (Sigidin et al. 2001) and in patients with secondary progressive multiple sclerosis (Skurkovich et al. 2001). In addition, we conducted smaller proof-of-principle studies in patients experiencing corneal transplant rejection (Skurkovich et al. 2002a), in psoriatic arthritis (Skurkovich et al. 1998), type I diabetes (Skurkovich et al. 2003a), uveitis (Skurkovich et al. 2003b), juvenile rheumatoid arthritis, auky-losing spondylitis and in several autoimmune skin diseases (Skurkovich et al. 2002b). 1.2.2 Multiple Sclerosis Anti-IFN-y and...

Ordering up a round of lab tests

The pain of fibromyalgia may appear to the doctor to be the beginnings of rheumatoid arthritis or lupus, both very serious and deteriorating arthritic conditions. Another possibility is multiple sclerosis, also a serious disease. In addition, the doctor will often want to verify that you don't have a thyroid disease. Hypothyroidism, or below-normal levels of thyroid hormone, can also cause fatigue and muscle and joint pain. Sometimes these conditions can coexist with fibromyalgia. These diseases are known as autoimmune disorders, or diseases resulting from the body's immune system actually attacking itself. A blood test will reveal if your blood includes a special factor that indicates that you may have rheumatoid arthritis or lupus. If the blood test comes back negative, you're unlikely to have them. A spinal-fluid examination can detect antibodies that are characteristic of multiple sclerosis.

Components of cognitive dysfunction

Although there are few data exploring the relationship between mental fatigue and cognitive dysfunction in cancer patients, there is some information in other disease states. For instance, patients with chronic fatigue syndrome (CFS) have impaired cognitive function that is not highly correlated with mood disturbance (Christodoulou et al. 1998). Patients with multiple sclerosis (MS) manifest worsening scores on cognitive tests after a single continuous 4 h testing session, while healthy control subjects show improvement over the same period of time due to practice (Krupp and Elkins 2000). Both the patients with MS and the control subjects reported subjective physical and mental fatigue over the course of the testing session. Similar findings have been reported in patients with myasthenia gravis (Paul et al. 2000). Even healthy control subjects can develop cognitive impairments as a result of fatigue. The ability to make rapid decisions declines when people are exhausted from exercise...

Cs and Cytokines Cooperate for the Induction of Tregs

The therapeutic use of these IL-10 modulated DCs is under investigation since injection of in vitro-generated, IL-10-modified DCs is able to prevent autoimmunity in a murine model of multiple sclerosis (EAE) and prolonged graft survival significantly in an murine GVHD model (Muller et al. 2002 Sato et al. 2003). Although most of these protocols In this regard, TNFa may play a role, since it has been shown that injection of DCs cultivated in presence of TNFa acted in a tolerogenic fashion (Menges et al. 2002). In these experiments, DCs were able to block autoimmunity in a murine model of multiple sclerosis (EAE). This suppressive effect was mediated by the induction of IL-10-producing regulatory T cells. The subsequent phenotypic analysis revealed that the DCs expressed regular amounts of MHC class II, and T cell costim-ulatory molecules, i.e., according to the authors, these DCs displayed a mature phenotype as judged by their surface marker expression. In contrast, these DCs failed to...

Case examples and scoring sheets

During the admission the following information is obtained. Although the patient is silent during the admission process, she starts to cry when the nurse suggests that she must have been in an awful situation, being so ill at home. She replies, How would you feel I have been ill ever since I was married '' She then tells the nurse that in the beginning the complaints were vague. One doctor had suggested the stress of the marriage as a cause. Later, another doctor suggested the possibility of chronic fatigue. She then visited a neurologist, because a friend suggested that she might suffer from multiple sclerosis. The neurologist, after carefully listening and reviewing the earlier reports, referred her to an internist, suggesting a rheumatic disease. At first the internists, although they found abnormalities in her blood, could not find a diagnosis. Finally the diagnosis of systemic lupus erythema-tosus was made, and treatment with corticosteroids and another drug was started, because...

Chronology of Problems

Arthritis, diabetes, high blood pressure, heart disease, osteoporosis, alcoholism, ulcers, kidney disease, liver disease, migraine, tuberculosis, stroke, psychiatric problems, epilepsy, lung disease, venereal disease, sciatica, drug dependency, thyroid disease, hepatitis, skin disorders, AIDS, fractures, multiple sclerosis, endometriosis, lupus, cancer, heart attack, carpal tunnel, breast implants, irritable bowel, Sjogren's, asthma, posttraumatic stress, sinusitis, vasculitis

Neurological conditions

Symptoms Spasms, trembling, and muscle weakness (see right). The joints may be rigid and, between spasms, movement is slow. If the sensory nervous system is affected, there may be vision disturbances and a loss of feeling, so that external sources of pain, such as the heat of an oven or pin-pricks, are not felt. These symptoms may indicate a progressive neurological disorder such as multiple sclerosis or Parkinson's disease. Symptoms may also occur after a stroke

Hardware Related Complications

Several reports have also focused on hardware complications related to DBS. Beric et al. (46) examined complications for 86 DBS patients and found electrode failure in 3.5 (n 3), extension wire failure in 4.7 (n 4), IPG malfunction in 1.2 (n 1), and pain at the IPG in 1.2 (n 1). Kondziolka et al. (49) examined hardware complications in 66 patients undergoing unilateral thalamic DBS for either essential tremor, parkinsonian tremor, multiple sclerosis, or other forms of tremor. There were a total of 23 hardware-related complications affecting 27 of the patients. Lead breakage occurred in 10 patients (15.2 ), system infection in seven patients (10.6 ), connector erosion in two patients (3.0 ), and cranial lead migration, chronic subdural hematoma, defective IPG, and a defective connector each in one patient (1.5 , each). Oh et al. (50) reported hardware complications for 79 patients who received 124 DBS implants. DBS was done for PD, essential tremor, pain, epilepsy, dystonia, multiple...

TNF Blockade An Inflammatory Issue

Army Leadership Requirements Model

Tumor necrosis factor (TNF), initially discovered as a result of its antitumor activity, has now been shown to mediate tumor initiation, promotion, and metastasis. In addition, dysregulation of TNF has been implicated in a wide variety of inflammatory diseases including rheumatoid arthritis, Crohn's disease, multiple sclerosis, psoriasis, scleroderma, atopic dermatitis, systemic lupus erythematosus, type II diabetes, atherosclerosis, myocardial infarction,

Behavioral health disorders in the medical setting

The frequency with which common psychiatric disorders are encountered in general medical outpatients is even greater than has been reported in community samples 13-20 , especially when patients present with chronic medical conditions 15,21-23 . Furthermore, some medical diseases are associated with a higher incidence of specific psychiatric syndromes than are others. For instance, patients who have respiratory and gastrointestinal illness have a higher rate of anxiety disorders, whereas patients who have back pain, multiple sclerosis, Parkinson's disease, cancer, and stroke are more likely to have depressive disorders. Patients who have some conditions, such as cardiac disease and diabetes mellitus, have a high incidence of both.

Recommended Dietary Intake of Vitamin D

Figure 7 Photoproduction and sources of vitamin D. Vitamin D is metabolized in the liver to 25-hydroxyvitamin D 25(OH)D , which is responsible for maintaining calcium homeostasis. 25(OH)D is also converted to 1,25(OH)2 D in a variety of other cells and tissues for the purpose of regulating cell growth, immune function, as well as a variety of other physiologic processes that are important for the prevention of many chronic diseases. MS, multiple sclerosis RA, rheumatoid arthritis. (Copyright Michael F Holick (2004) Vitamin D Importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. American Journal of Clinical Nutrition 79 362-371, used with permission.)

Nonskeletal Consequences of Vitamin D Deficiency

As early as 1941, it was appreciated that if you lived at higher latitudes in the US you were at higher risk of dying of cancer. A multitude of epidemiologic studies clearly show that if you live at higher latitudes and are more prone to vitamin D deficiency then you are at higher risk of dying of colon, prostate, breast, ovarian, and a variety of other cancers. It is also known that living at higher latitudes increases risk of having high blood pressure and heart disease as well as autoimmune diseases including multiple sclerosis and type I diabetes. 20ngml 1 and preferably 30ngml 1 is necessary for various organs including colon, breast, and prostate to convert it to 1,25(OH)2D, which in turn can help regulate various genes responsible for cell growth and differentiation. This could be the explanation for how vitamin D sufficiency is protective against most common cancers. The immune cells also recognize 1,25(OH)2D3. This may explain why children who at 1 year of age had received...

Of Cholesterol Gallstone Formation

CURCUMIN MODULATES MULTIPLE SCLEROSIS Multiple sclerosis (MS) is an inflammatory disease of the central nervous system (CNS) that afflicts more than 1 million people worldwide. The destruction of oligodendrocytes and myelin sheath in the CNS is the pathological hallmark of MS. MS is an inflammatory autoimmune disease of the CNS resulting from myelin antigen-sensitized T cells in the CNS. Experimental allergic encephalomyelitis (EAE), a CD4 + Th1-cell-mediated inflammatory demyelinating autoimmune disease of the CNS, serves as an animal model for MS. IL-12 plays a crucial proinflammatory role in the induction of neural-antigen-specific Th1 differentiation and pathogenesis of CNS demyelination in EAE and MS.

Other Medical Conditions

Mohr et al. (2000,2001) conducted a series of small treatment trials for depression in patients with multiple sclerosis. In one study, patients were randomly assigned to 8 weeks of telephone-administered CT or to usual care. Posttreatment scores on the Profile of Mood States Depression subscale were significantly lower in the CT group than the control group (Mohr et al., 2000). In another study, patients were randomly assigned to 16 weeks of CT, supportive-expressive group therapy, or sertraline. Patients who had received CT or sertraline were significantly less depressed at the post-treatment assessment than those who had received supportive therapy (Mohr et al., 2001).

Cerebrospinal Fluid Testing

Oligoclonal bands are another finding that suggests irritation of the central nervous system. They are sometimes found in lupus and sometimes in multiple sclerosis, but there may be other causes. If the doctors are worried about infections such as Lyme in the central nervous system, they will measure the concentration of antibodies to Lyme in the CSF and compare it with the concentration in the blood. Higher levels of antibodies in the CSF than in the blood suggest Lyme infection of the central nervous system.

Eventrelated potentials ERPs

ERPs provide more detailed information about the time course of brain activity than do most other techniques, and they have many medical applications (e.g., diagnosis of multiple sclerosis). However, ERPs do not indicate with any precision which regions of the brain are most involved in processing. This is due in part to the fact that the presence of skull and brain tissue distorts the electrical fields emerging from the brain. Furthermore, ERPs are mainly of value when the stimuli are simple and the task involves basic processes (e.g., target detection) occurring at a certain time after stimulus onset. As a result of these constraints (and the necessity of presenting the same stimulus several times) it would not be feasible to study most complex forms of cognition (e.g., problem solving reasoning) with the use of ERPs.

So Many Choices

The water supply in my local municipality has contaminants at the extreme high end of normal. Another local community has a higher-than-normal number of multiple sclerosis cases possibly linked to a toxic source entering the water supply. I also have patients with well water who develop depression and emotional dysfunction. Be aware of your source of drinking and cooking water.

John L Portis

Host Factors and Neuroinvasiveness VI. Viral Envelope Sequences That Determine Neurotoxicity VII. Cell Types Involved in Neurovirulence VIII. Envelope Expression in Microglia IX. Role of Inflammation X. Retroviruses and Multiple Sclerosis XI. Concluding Remarks References


Neuroimaging has provided insight into the pathophysiology and natural history of Parkinson's disease (PD) and has emerged as a tool to monitor disease progression and to assess new potentially neuroprotective or neurorestorative therapies for PD. Diverse imaging methods have been successfully applied to neurological disorders. Although technology such as functional magnetic resonance imaging or magnetic resonance spectroscopy has been especially useful in assessing stroke, multiple sclerosis, and epilepsy (1-3), in vivo neuroreceptor imaging using single photon emission tomography (SPECT) and positron emission tomogrpahy (PET) have so far been most valuable in assessing PD. SPECT and PET use specific radioactively labeled lig-ands to neurochemically tag or mark normal or abnormal brain chemistry. Recent advances in radiopharmaceutical development, imaging detector technologies, and image analysis software have expanded and accelerated the role of imaging in clinical research in PD,...

The Neurologist

A neurologist may be called to rule out other conditions that worry patients. For example, many young women with FM become concerned they actually have multiple sclerosis (MS). A neurologist is adroit at identifying this kind of neu-rodegenerative disease. The more common problem encountered by people with FM that is treatable by a neurologist is chronic headache. Many neurologists have extensive experience diagnosing and managing a variety of headaches. Decreasing the frequency and severity of headaches may not only improve the patient's quality of life but may in turn help reduce the central pain of fibromyal-gia. Some argue that because the brain, spinal cord, and peripheral nerves are adversely affected in FM, neurologists should be the primary providers for people with FM. In reality, there are currently too few neurologists to accept the additional patient load. Primary care is therefore argued to be the best home for fibromyalgia, with continued referral to neurologists to rule...

Peripheral Lymphoid

Myelin basic protein in patients with multiple sclerosis. Science 247 718-721. Barbano, R. L. and Dal Canto, M. C. (1984). Serum and cells from Theiler's virus-infected mice fail to injure myelinating cultures or to produce in vivo transfer of disease. The pathogenesis of Theiler's virus-induced demyelination appears to differ from that of EAE. J. Neurol. Sci. 66 283-293. Begolka, W. S., Vanderlugt, C. L., Rahbe, S. M., and Miller, S. D. (1998). Differential expression of inflammatory cytokines parallels progression of central nervous system pathology in two clinically distinct models of multiple sclerosis. J. Immunol. 161 4437-4446. Bernard, C. C. and de Rosbo, N. K. (1991). Immunopathological recognition of autoantigens in multiple sclerosis. Acta Neurologica 13 171-178. Challoner, P. B., Smith, K. T., Parker, J. D., MacLeod, D. L., Coulter, S. N., Rose, T. M., Shultz, E. R., Bennett, J. L., Garber, R. L., Chang, M., Schad, P. A., Stewart, P. M., Nowinski, R. C., Brown, J. P., and...


However, there is also preliminary evidence that iron may be implicated in the pathogenesis of auto-immune disorders, including SLE, scleroderma, type 1 diabetes, Goodpasture syndrome, multiple sclerosis and RA (Bowlus 2003). Current evidence suggests that moderately elevated iron stores may be associated with an overall increased risk for cancer, especially colorectal cancer (McCarty 2003). Additionally, it has been proposed that iron may increase HIV replication and the rate of progression of HIV infection, although doses of 60 mg of elemental iron twice weekly for 4 months did not appear to affect HIV-1 viral load in clinical studies (Olsen et al


Multiple sclerosis A neurological disease causing unpredictable bouts of paralysis, numbness, and vision loss, once thought to strike only adults but now acknowledged to occur in children. Multiple sclerosis (MS) affects about 350,000 American adults, but experts estimate that as many as 20,000 children in the United States also have the disease yet remain undiagnosed. New medical evidence suggests that the number of pediatric patients is rising, probably because more doctors are considering the diagnosis when they see a child suffering from telltale symptoms such as a sudden visual problem. Multiple sclerosis occurs when the body's immune cells turn and mistakenly attack the thick sheath (myelin) covering the nerve fibers of the brain and spinal cord. When the myelin is destroyed, the underlying nerve can be damaged, triggering a range of symptoms such as tremors or slurred speech.


Chelation is typically used as an intravenous therapy (sometimes oral) to remove a particular substance that is found to occur at a toxic level in the body such as lead, copper, mercury, or arsenic. The amino acid complex, ethylene-diamine-tetra-acetic acid, is the most commonly used chelating agent, though herbs and supplements may sometimes be used. Though there is a higher incidence of PD occurring in persons with chronic exposure to heavy metals such as manganese and copper and also with exposure to pesticides and herbicides, no specific toxic agent directly linked to the cause of PD has ever been identified and it is unclear what one would attempt to chelate out of the body of someone with PD. There is no scientific evidence to support the use of chelation therapy for the treatment of PD. In fact, chela-tion therapy has come under investigation and criticism for making false statements about its curative powers for a number of diseases such as multiple sclerosis, Alzheimer's...

Subjective Tinnitus

Acoustic neuromas are well described elsewhere (5). The very common condition of migraine can present with tinnitus. Migraine may be a genetic calcium channel defect of neurons and can present with multiple unusual manifestations (see Chapter 23 for detailed discussion of migraines). Cure (6) gives a report of multiple sclerosis (MS) patients presenting with tinnitus. MS lesions can appear throughout the brain and spinal cord and thus could be expected to affect locations in the auditory system, reduce signal transmission, and activate the compensatory mechanisms that result in tinnitus.

How nerves function

Digital Veins Fingers

All but the smallest nerve fibers are insulated and protected by a fatty substance called myelin, which also helps to conduct nerve impulses quickly along the fibers. Multiple sclerosis is believed to occur because the myelin becomes damaged in some way. The brain and spinal column are protected by delicate membranes called meninges.

Immune Modulators

Several substances produced by animals and fungi have been investigated for immune-modulating effects. Fish oils are the most studied. As a source of n-3 fatty acids, fish oil consumption by humans has been shown to influence the synthesis of inflammatory signaling molecules like prostaglan-dins, leukotrienes, and cytokines. In addition to direct effects on prostanoid synthesis, n-3 fats have also been shown to directly alter the intracel-lular availability of free calcium ions, the function of ion channels, and the activity of protein kinases. Generally administered as nutraceuticals rather than as functional foods, fish oil supplements have demonstrated anti-inflammatory and immune sup-pressive effects in human adults. A high intake of the n-3 fatty acids eicosapentaenoic (20 5n-3) and docosahexaenoic (22 6n-3) acid (DHA) from seafood or fish oil supplements has also been associated with prevention of several types of cancer, myocardial infarction, ventricular arrhythmias, migraine...


Activating protein-1 JNK, c-jun N-terminal kinase MMP, matrix metal-loprotease COX, cyclooxygenase iNOS, inducible nitric oxide synthase PBMC, peripheral blood mononuclear cells VSMC, vascular smooth muscle cells HDL, high-density lipoprotein TBARS, thiobarbituric acid reactive substance LDL, low-density lipoprotein VLDL, very-low density lipoprotein ASA, acetylsalicylic acid PGI2, prostacyclin I2 AA, arachidonic acid GSH, glutathione MDA, malondialdehyde SOD, superoxide dismutase LDH, lactate dehydrogenase ISO, isoproterenol NAG, N-acetyl glucosa-minidase TGF-h1 transforming growth factor beta1 IL, interleukin MS, multiple sclerosis CNS, central nervous system EAE, experimental allergic encephalomyelitis STAT, signal transducers and activators of transcription HIV, human immunodeficiency virus LTR, long terminal repeat LMW proteins, low-molecular-weight proteins NSAIDs, nonsteroidal anti-inflammatory drugs APP, amyloid precursor 4-HNE, 4-hydroxy-2-nonenal GST, gluthathione...


IFN-y is a cytokine released mainly by certain T cells and natural killer cells. It drives the immune response by directing CD4+ T cells toward a Th-1 phenotype, activating macrophages to kill pathogens, enhancing or inducing MHC class I and class II molecules and stimulating B cells to mature and secret antibodies (Snapper 1996). In many autoimmune diseases, IFN-y appears to play a key role in activating autoreactive T cells (Buntinx et al. 2002). Thus different clinical manifestations of these diseases may depend on the cell territory in which these cytokines are hyperproduced (Skurkovich et al. 1994). High levels of IFN-y or IFN-y-producing T cells compared to controls have been found in the disease sites of many Th-1 autoimmune diseases, such as in the synovial fluid in rheumatoid arthritis (Canete et al. 2000), in the cerebrospinal fluid and plaques in multiple sclerosis (Woodroofe and Cuzner 1993 Traugott and Lebon 1988), in the aqueous humor and corneal infiltrating cells in...

Spasms tremors

Symptoms Muscle spasms, tremors, and weakness in the limbs. Spasms may be triggered by the slightest touch, and may be accompanied by fainting or convulsions. These symptoms may be linked to alcoholism, fever, multiple sclerosis, petit mal epilepsy, or even brain damage following a stroke. Symptoms better For fresh air for expelling natural discharges for movement for cold drinks. Symptoms worse For heat for sleep for touch on the left side for the menopause for alcohol or hot drinks.

Conventional care

Diagnosis is aided by evoked response tests on the eyes (measuring the speed of optic nerve impulses), and magnetic resonance imagery (MRI), which can reveal damage to the white matter of the nervous system. Conventional treatment of multiple sclerosis includes sunflower or evening-primrose oil, interferon (protein produced by the body to fight infection and cultured from human cells or synthesized in the laboratory), and potent drugs such as corticosteroids. An amino acid, phenylalanine, is believed to be beneficial, as well as vitamin B, and low doses of antidepressant drugs. Controversy surrounds the use of marijuana to relieve muscle spasms. Physiotherapy may help those affected by multiple sclerosis.

Homeopathic medicine

Homeopathic treatment is largely constitutional after study of the patient's history. This includes emotional factors and, especially in multiple sclerosis, any long-suppressed problems from childhood. Homeopathy attributes this condition to an inherent weakness of the nervous system that is aggravated by trauma, infection, or the effects of toxic metals.

Oxidative Stress

When the critical balance between generation of free radicals and other ROS or RNS and the antioxidant defenses is unfavorable, oxidative damage can accumulate. Oxidative stress is defined as a condition that is characterized by accumulation of non-enzymatic oxidative damage to molecules that threaten the normal function of the cell or the organism (Blomhoff, 2005). Compelling evidence has emerged in the past two decades demonstrating that oxidative stress is intimately involved in the pathophysiology of many seemingly unrelated types of disease. Thus, oxidative stress is now thought to make a significant contribution to all inflammatory diseases (arthritis, vasculitis, glomerulonephritis, lupus erythematosus, adult respiratory distress syndrome), ischemic diseases (heart disease, stroke, intestinal ischemia), cancer, hemochromatosis, acquired immunodeficiency syndrome (AIDS), emphysema, organ transplantation, gastric ulcers, hypertension and pre-eclampsia, neurologic diseases...


In vitro experiments have demonstrated the possible benefits of andrographolide on various cancer cells. The compound has been shown to increase apoptosis of prostate cancer cells (Kim et al 2005), inhibit proliferation of human cancer cells and increase IL-2 induction in human peripheral blood lymphocytes in vitro (Kumar et al 2004, Rajagopal et al 2003). However, contradictory results have been described from a murine model. Andrographolide was found to decrease IFN-gamma and IL-2 production and therefore shown to have an immunosuppressive effect. Burgos et al (2005) concluded that andrographis may be useful for autoimmune disease, especially where high levels of IFN-gamma are present, for example, in multiple sclerosis and RA. In vitro and in vivo data has recently shown that andrographolide has the ability to interfere with T-cell proliferation, cytokine release and maturation of dendritic cells, as well as drastically decreasing the antibody response in delayed-type...

The Hap Map Project

In 2005, the first phase was completed with the identification of 50 disease-associated genes. On October 17, 2007, the second phase linked type 2 diabetes, Crohn's disease, elevated blood cholesterol, rheumatoid arthritis, multiple sclerosis, and prostate cancer to mutated genes. The project has catalogued 2.8 million SNPs in individual human genes.


Psychostimulants are drugs that increase alertness and or motivation. There have been no randomized controlled trials that have specifically assessed the effectiveness of psychostimulants for the management of cancer-related fatigue. However, the effects of some of these drugs have been studied in patients with HIV disease (Breitbart et al. 2001) or multiple sclerosis (Weinshenker et al. 1992 Krupp et al. 1995). Krupp et al. (1995) failed to find any benefit with pemoline in a double-blind randomized placebo-controlled study involving 93 patients with multiple sclerosis. In contrast, Weinshenker's group (Weinshenker et al. 1992) reported that pemoline provided good or excellent relief of fatigue in 46 of patients with multiple sclerosis and fatigue compared with 20 of patients receiving the placebo. Breitbart et al. (2001) undertook a double-blind randomized placebo-controlled study to compare the efficacy of two psychostimulants (methylphenidate and pemoline) for the treatment of...

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