An Overview of Multiple Sclerosis: Diagnosis and Management Strategies

Kathleen Costello, RN, MS, CRNP, MSCN; Colleen J. Harris, RN, MN, NP, MSCN

Disclosures

Topics in Advanced Practice Nursing eJournal. 2006;6(1) 

In This Article

Pathophysiology

Pathologically, there is damage to the myelin as well as damage to the underlying axon. Although initially thought to occur late in the disease, Trapp and colleagues[7] demonstrated that axonal damage occurs early as well as later in the disease process

Gray matter, once thought to be spared in MS, has also been shown to be damaged in MS. The damage appears to be due to an inflammatory process in which lymphocytes that can react to CNS tissue become activated in the periphery, disrupt the intracellular matrix of the blood brain barrier, and enter the CNS tissue. Once in the CNS, reactivation occurs and various other inflammatory cells are recruited to the area.

Inflammatory cytokines, macrophages, microglia, antibodies, free radicals, and complement may all act to damage myelin and underlying axons. Current treatments, directed at the underlying MS disease process, target this inflammatory response.[8,9,10] Inflammatory changes within the CNS are characteristic of the relapsing-remitting type of MS, while more degenerative changes are characteristic of progressive forms of MS. Large numbers of inflammatory cells are seen in new lesions, but fewer are seen in older, more chronic lesions.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....