Neurological Disorders: Adult Onset

Lecture #2

Multiple Sclerosis

A chronic autoimmune disease that affects the central nervous system, characterized by inflammation, demyelination, and neurological symptoms such as weakness, vision problems, and coordination issues.

MS Frequency

-1,000,000 Americans (0.3%)

-2.8 million worldwide

-More common in women than men

—3:1

MS Age of Onset

-30’s-50’s

MS Causes

-Autoimmune proccess

-higher prevalence further from equator

-EBV infection increases risk

-Genetic variants in HLA (Human Leukocyte Antigen) region TRIPLES risk

What Happens to the CNS w/MS?

-loss of myelin at multiple sites; replaced with scar tissue —> SCLEROSIS

-uncF

MS: Functions Affected?

-Depends on where myelin is lost (could be sensory, motor, cognitive, affective)

-Increased chance of seizures (plaques may become seizure foci)

—2-3% also have seizure disorderW

What worsens MS symptoms and why?

higher body temperature; causes conduction of nerve impulses to slow even more or FAIL

What are the subtypes of MS?

1. Relapsing-Remitting MS (85%—can transition to…)

2. Secondary Progressive MS

3. Primary Progressive (10%)

4. Progressive-Relapsing (5%)

MS and Pregnancy

-MS occurs in women of child-bearing age

-Pregnancy reduces MS progression due to natural immunosuppressants released during pregnancy

-MS progression increases after pregnancy

MS Cure/Treatment

-No cure

-Interferon/”Avonex”

—Disease modifying medication (slows progression)

—not safe for use during pregnancy or breastfeeding

ALS: Amyotrophic Lateral Sclerosis/”Lou Gehrig’s Disease”

Theme

ALS Incidence & Prevalence

-2/100,000

-11/100,000

---

30,000 in USA

8000 new cases each year

ALS Age of Onset

40s-50s

ALS Cause

90% not known, 10% genetic (familial form)

ALS Functions Affected?

-motor system ONLY

-gradual loss of motor control → leads to death by respiratory failure

-3-5 year survival after diagnosis

ALS Target?

-Upper and lower motoneurons and their axons

Lower/Spinal Motoneurons

-cell bodies in the ventral horn of spinal cord

-their axons innervate muscle fibers and provide “trophic” (nutritive) factors

-when a motoneuron dies, muscles atrophy (die)

Symptom of lowe/spinal motoneuron death?

Fasciculations

-twitches in the muscle fibers as they die

Lateral Sclerosis?

refers to the death of the lateral corticospinal tract

ALS Cure/Treatment

-no cure

-2 medications can slow the progression by MONTHS