By Charles M. Poser
This illustrated pocketbook offers an simply available precis of key matters in relation to diagnosing a number of sclerosis and coping with sufferers at assorted phases of the disease.
summary: This illustrated pocketbook offers an simply available precis of key concerns with regards to diagnosing a number of sclerosis and handling sufferers at diverse levels of the affliction
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Extra resources for An illustrated pocketbook of multiple sclerosis
Remyelinated) myelin sheaths; macrophages are numerous but do not contain recent (normal periodicity) myelin debris. 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.
Weigert stain. 0 µm) Selected by Professor Ingrid Allen and Dr John Kirk, Queen’s University of Belfast and the Royal Victoria Hospital, Belfast, Northern Ireland. 5 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 Michael Hutchinson (c, d); from Allen and Kirk. 1992, with permission of Edward Arnold (c, d) (continued) AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 31 Figure 22 Continued Electron micrographs showing (e) an isolated oligodendrocyte and myelin sheath among naked axons (indicated by stars) and astrocytic processes (arrows; bar=20 µm); (f) periaxial segmental demyelination, in which loss of myelin internodal segment has resulted in paranodal axolemmal specialization (between arrows).
The disease process must impair conduction in a critical, minimum number of fibers of motor or sensory tracts before clinical dysfunction occurs. The number of available fibers above this minimum number constitutes the safety factor. If the signs and symptoms are due only to inflammation and edema, they will be reversible. When the safety factor is totally abolished by myelinoclasia, the patient will have permanent signs or symptoms (Figure 23). AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 37 Figure 23 Safety factor in the progression of multiple sclerosis: as long as the required minimum number of nerve fibers remains intact, the patient is asymptomatic.