An Illustrated Pocketbook of Multiple Sclerosis by Charles M. Poser

By Charles M. Poser

Because MS impacts women and men of their best time of lifestyles, it's always considered as a devastating ailment that could hardly be taken care of. whereas the efficacy of particular remedies may possibly stay in dispute, there are various measures to be had which can considerably enhance the relaxation and caliber of lifetime of sufferers with MS. This illustrated pocketbook provides an simply obtainable precis of key concerns in terms of diagnosing a number of sclerosis and handling sufferers at diversified phases of the disorder. Designed as a realistic reference for clinicians, it positive factors concise, specialist textual content and gives a richly illustrated advisor to prognosis and treatment.

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Magnetic resonance imaging The introduction of magnetic resonance imaging (MRI) has completely revolutionized the diagnostic process of MS, but has proved to be a mixed blessing. The proliferation of MRI machines has led to their overuse and to misinterpretation of the images. At present, too often the diagnosis of MS has been based exclusively on the presence of areas of increased signal intensity (AISIs), which are most often referred to as ‘lesions’, visualized in the white matter on T2-weighted MRI scans (Figure 36).

This is often followed by the appearance of macrophages containing myelin debris or fragments, abrupt tapering of the myelin sheath, and axonal denudation. Evidence of remyelination may be seen even in the earliest lesions. 26 AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS Figure 18 Axial MRI (upper) and gross appearance (lower) of brain in Baló’s disease. There is concentric demyelination (arrows) and another lesion (indicated by the triangles). , 1994; reproduced with permission of the Radiological Society of America AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 27 Figure 19 Brain section in Baló’s disease showing (upper) concentric demyelination in the right centrum semiovale.

The latter is a common cause of pseudoexacerbations. 1°C may be sufficient to cause such signs and symptoms, which disappear upon cooling. By far the most common cause of these pseudo-exacerbations is an unsuspected urinary tract infection. Clinical aspects Multiple sclerosis most frequently affects the optic nerve and chiasm, brain stem, cerebellum and the cervical spinal cord. The presence of spondylosis often contributes to the formation of plaques in that region. This preferential involvement determines the frequency of the signs and symptoms observed in MS patients (Table 1).

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