By Charles M. Poser
This illustrated pocketbook offers an simply obtainable precis of key matters with regards to diagnosing a number of sclerosis and handling sufferers at diversified phases of the disease.
summary: This illustrated pocketbook provides an simply available precis of key matters with regards to diagnosing a number of sclerosis and dealing with sufferers at varied phases of the disorder
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Extra info for An illustrated pocketbook of multiple sclerosis
0 µm) Selected by Professor Ingrid Allen and Dr John Kirk, Queen’s University of Belfast and the Royal Victoria Hospital, Belfast, Northern Ireland. Courtesy of Dr John Kirk (g, h) Physiology Normal motor and sensory function is dependent upon the rapid propagation of the nerve impulse along myelinated nerve fibers; this time is measured in milliseconds. The myelin sheath is interrupted at regular intervals by nodes of Ranvier, where the axon is denuded. Because the axon has a high resistance to the electrical impulse and the speed of conduction is too slow, there is an alternative mechanism called ‘saltatory conduction’.
While enhancement, which reflects the inflammatory reaction, and blood-brain barrier alteration, are often considered to be a sign of activity of the disease, its actuality is deceptive: blood-brain barrier alterations may have been present for 3 months or longer. Variations in imaging protocols can help to distinguish separate components of the underlying pathological process (Figure 44). In addition to inflammation, demyelination (magnetization transfer ratio), gliosis (T2-weighting reflecting increased water content), and axonal damage (reduction in diffusion tensor imaging AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 55 56 AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 57 Figure 37 T2-weighted (upper) and gadolinium-EDTA-enhanced (lower) axial MRIs showing a number of ovoid lesions.
Because the axon has a high resistance to the electrical impulse and the speed of conduction is too slow, there is an alternative mechanism called ‘saltatory conduction’. This is where the electrical impulse jumps from one node of Ranvier to the next, while achieving the required conduction velocity. However, if the distance between the available nodes is too great because of destruction of myelin segments, the impulse cannot bridge the gap and saltatory conduction is either impaired or abolished.
An illustrated pocketbook of multiple sclerosis by Charles M. Poser