Learn to Predict

Once she turned 21, Amanda expected

good times ahead. So why could she
barely manage to climb the two flights
of steps to her chemistry class? When
she started experiencing weakness in
her left hand, Amanda consulted a
physician. After conducting numerous
tests, Amandas physician told her she
had multiple sclerosis (MS), a condition
in which the myelin sheaths of motor
and sensory neurons within the central
nervous system are gradually destroyed.
By combining what you learned about
the histology, physiology, and gross
anatomy of the muscular system in
chapters 9 and 10 with new information
about nervous tissue organization in this
chapter, explain why MS made it difficult
for Amanda to walk up stairs and also
led to her hand weakness. Also, predict
how Amandas condition is likely to
change over the next several years.

Multiple sclerosis, or MS, is a disorder of the CNS that affects 2.5 million people worldwide, and 400,000 in North
America alone. In addition to overt nervous system symptoms, affected individuals experience disability, mood
problems such as depression, and even great fatigue. Four subtypes of MS are recognized, based on the pattern of
symptomatic periods over time. In MS, the myelin coating in various sites through the brain and spinal cord becomes
inflamed due to an immune response and is eventually destroyed, leaving hard scars, called scleroses, that block the
underlying neurons from transmitting messages. Muscles that no longer receive input from motor neurons stop
contracting, and eventually, they atrophy. Symptoms reflect the specific neurons affected. Short circuiting in one part
of the brain may affect fine coordination in one hand; if another part of the brain is affected, vision may be altered as
well. The first signs of MS are often blurred vision and numb legs or arms (like in Amandas case), but because in
many cases these intermittent, diagnosis may take a while. Diagnosis is based on symptoms and repeated MR
scans, which can track development of lesions. MS may develop when certain infections in certain individuals
stimulate T cells in the periphery, which then cross the blood brain barrier. Here the T cells attack myelin producing
cells through a flood of inflammatory molecules and by stimulating other cells to produce antibodies against myelin. A
virus may lie behind the misplaced immune attack that is MS. Evidence includes the observations that viral infection
can cause repeated bouts of symptoms, as can MS, and that MS is much more common in some geographical
regions than in others. Various drugs are used to manage MS. Drugs to decrease bladder spasms, antidepressants,
short-term steroids, muscle relaxers and mitoxantrone. Amandas condition is likely to worsen over the next several
years if she does not take medication and follow doctors orders. Her immune system is going to be weak anyway,
and she has to be very conscious.