TABLE OF CONTENT

Title Page    –         –         –         –         –         –         –         –         –         i

Certification –         –         –         –         –         –         –         –         –         ii

Dedication   –         –         –         –         –         –         –         –         –         iii

Acknowledgement –         –         –         –         –         –         –         –         iv

Table of Content    –         –         –         –         –         –         –         –         v

CHAPTER ONE 

1.0 Introduction –         –         –         –         –         –         –         –         1

CHAPTER TWO

2.0 Multiple Sclerosis – –         –         –         –         –         –         4

2.1 Causes of Multiple Sclerosis          –         –         –         –         –         6

2.1.1 Infectious Agents    –         –         –         –         –         –         –         6

2.1.2 Genetic Disorder     –         –         –         –         –         –         –         7

2.1.3 Geographical Location      –         –         –         –         –         –         10

2.2 Health Implication of Multiple Sclerosis  –         –         –         –         11

2.3 Characteristics of Multiple Sclerosis        –         –         –         –         15

2.3.1 Formation of Lesions        –         –         –         –         –         –         16

2.3.2 Inflammation          –         –         –         –         –         –         –         17

2.4 Multiple Sclerosis and Pregnancy  –         –         –         –         –         18

2.5 Types and Variants of Multiple Sclerosis –         –         –         –         21

CHAPTER THREE

3.0 Treatment of Multiple Sclerosis –         –         –         –         –         25

3.1 Diagnosis of Multiple Sclerosis     –         –         –         –         –         25

3.2 Management of Multiple Sclerosis          –         –         –         –         26

3.2.1 Initial Management of Acute Flare        –         –         –         –         27

3.2.2 Chronic Treatment  –         –         –                   –         –         –         28

3.2.3 Non-pharmaceutical          –         –         –         –         –         –         29

3.2.4 Alternative Treatments      –         –         –         –         –         –         30

3.3 Drugs for Treatments of Multiple Sclerosis       –         –         –         31

CHAPTER FOUR        

4.0 SUMMARY AND CONCLUSION

4.1 Summary         –         –         –         –         –         –         –         –         34

4.2 Conclusion       –         –         –         –         –         –         –         –         34

References

CHAPTER ONE

1.0 Introduction

Multiple Sclerosis (MS) is the most common demyelinating disease, (Leray et al., 2016) in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. (Murray et al., 2012) specific symptoms can include double vision, visual loss, muscle weakness and trouble with sensation or coordination. (Rryonesi et al., 2021) Multiple Sclerosis takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). (Baecher-Allan et al., 2018) in the relapsing forms of Multiple Sclerosis between attacks, symptoms may disappear completely although some permanent neurological problems often remain, especially as the disease advances (Lubin and Reingold, 2000).

While the cause is unclear, the un-denying mechanism is thought to be either destruction by the immune system or failure of the myelin-producing cells. Nkahara et al. (2012) proposed causes for this include genetics and environmental factors, such as viral infections (Aloisif, and Cross, 2022).

Multiple Sclerosis is usually diagnosed based on the presenting signs and symptoms and the results of supporting medical tests (Tsang and Maccdonell 2011).

No cure for Multiple Sclerosis is known. (‘NINDS Multiple Sclerosis information Page” 2015) Treatment attempt to improve function after an attack and prevent new attacks (Composition and Coles, 2002) Physical therapy (Alphonsuis et al., 2019) and occupational therapy (Quinn and Hynes, 2021) can help with people’s ability to function. Many people pursue after native treatments, despite lack of evidence of benefit (Huntley, 2006). The long-term outcome is difficult to predict, better outcomes are more often seen in women, those who develop the disease early in life, those with a relapsing course, and those who initially experienced few attacks. (Weinshenker, 2000).

Multiple Sclerosis is the most common immune-mediated disorder affecting the central nervous system. (Bererk, and Krishnamoorthy, 2014) Nearly one million people have MS in the United State in 2022, (Mcginley et al., 2021) and in 2020; about 2.8 million people were affected globally with rates varying widely in different regions and among different populations. (Lane et al., 2022) the disease usually begins between the ages of 20 and 50 and is twice as comm0on in women as in men. (Milo and Kahana, 2010) MS was first described in 1868 by French neurologist Jean-martin Charcot (Clanet, 2008). The name “Multiple Sclerosis” is short for multiple cerebro- spinal sclerosis, which refers to the numerous glial scars (or Sclerae-essentially plagues or lesions) that develop on the white matter of the brain and spinal cord (Clanet, 2008).