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Multiple sclerosis is a disease of the central nervous system consisting of brain , spinal corduroy and ocular nerves . The nerve is surrounded by a roly-poly tissue known as myelin case that protect the face from external damage and helps in electrical impetus conduction . When , this myelin sheath is damaged at multiple locations , leaving behind scar tissue paper known as induration , the conductivity of electric impulse in nerves is often disrupted and unnatural . This unnatural and disrupted conductivity of nerve impulse leads to various symptoms of MS .
Although , the causa of multiple induration is still undecipherable , it is believe to be due to attack of the immune system against the myelin sheath . This autoimmunity is supposed to be triggered by various ingredient , including genetics , infection , smoke , female gender and geographical location aside from equator .
The symptoms experienced in MS are varying in each affected role . These may range from fatigue , pain in the ass , weakness , prickling , visual alteration , delivery mental defectiveness , bowel changes , bladder incontinence , ataxia , abnormal aesthesis , spasms , find out job anddepression .
Can I Still Have MS If My MRI Is Normal?
The diagnosing of MS is not base on any particular imaging or laboratory test . The diagnosis of MS is a compounding of clinical symptoms and signs , MRI , call forth potential and CSF examination for the presence of oligoclonal band .
Magnetic Resonance Imaging (MRI)
MRIis a highly sensitive and specific imaging run for MS . MRI is used to detect the scarring or sclerosis cause by MS in the central nervous system . MRI is superior toCT scanin identifying areas of damage and blanched subject lesions with summate advantage of zero radiation syndrome . However , it is obviate in citizenry with metal implant , aneurism clips and cardiac pacemakers .
About 95 % patient with clinically authoritative MS have an abnormal MRI , but MRI is not a definitive investigation as up to 4 % normal healthy individuals can have periventricular lesion that can not be distinguished from MS . White matter wound can also be found in other consideration , including ischaemic and age concern changes . A soul with an unnatural MRI has about 83 % risk of rise clinically definite MS in 10 yr . When the number of lesion is more in an MRI , the disability will be worse and time of conversion to a clinically definite diagnosis of MS will be relatively earlier to one who has less number of lesions .
On the other hand , a normal MRI does not dominate out the diagnosis of MS . About 5 % mass , who have sustain MS establish on other diagnostic criterion , do not show any brain lesions on MRI . These masses may have lesions elsewhere , such as spinal cord or lesions that are undetectable by MRI . A person with normal MRI has about 11 % peril of develop clinically definite MS in 10 years . Although , the chances are less , a patient can still be irrefutable for MS , even if their MRI is normal . Therefore , MRI alone is not used to name MS , especially in affected role with atypical or non - specific histories . In addition , other diagnostic psychometric test such as CSF exam and evoked potential should also come with MRI before rule out MS and to reach a definitive diagnosis .
Cerebrospinal Fluid (CSF) Exam
CSF examination also has eminent sensitivity and specificity for MS . CSF testing is done to look for specific staining pattern of antibodies known as oligoclonal band ( OCBs ) . About 95 % of patient with clinically definitive MS are positive for CSF oligoclonal bands . Although , OCBs are present in many seditious diseases too , it can also be constitute in patient with non - inflammatory neurologic disease .
Evoked Potential (EP) Test
It is the symptomatic study of electric conduction through nerve that studies the rate of conduction and bountifulness of nerve impetus . ocular evoked potential ( VEPs ) is most conducive for the diagnosis of MS . A holdup in impulse conduction means demyelination and reduction in amplitude means damage to axons or conductivity cylinder block . Although , EP is helpful in identifying the initial block , it is throttle in finding out further damage . Therefore , it is the least efficacious of all three nosology .
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References :
https://msfocusmagazine.org/Magazine/Magazine-Items/5-Things-to-Know-About-MRIs-and-MS
