Multiple Sclerosis

Multiple Sclerosis is a life long condition that affects the brain and spinal cord. It usually diagnosed in people who are in their 20s and 30s.

It is an autoimmune condition, the immune system attacks the brain or spinal cord. In MS the immune system attacks the myelin sheath, a protective coating, around nerve cells. This results in messages transmitted along these nerves being disrupted, slowed and weakened.

Symptoms include:

  • Fatigue
  • Numbness
  • Balance and co-ordination problems
  • Muscle stiffness and spasms
  • Cognitive difficulties
  • Difficulty walking
  • Problems with vision

MS can occur in two ways:

  1. Relapsing-remitting MS

This occurs when symptoms progressively worsen in the span of a few days. The attacks may occur every few years. Although around half of the people with MS of this sort do go on to develop the second type within the next 15-20 years.

2. Primary progressive MS

In this type of MS there are no periods of remission, but instead symptoms progressively worsen.

Treatments include using steroids to treat relapses. Disease-modifying therapies can be used to reduce the frequency of relapses as well as specific treatments focused on alleviating symptoms.  At present, there is no cure for either type of MS and it will progressively get worse. However research is leading to strides in the development of new medication.

 

References:

https://www.nice.org.uk/guidance/cg186

http://www.nhs.uk/conditions/Multiple-sclerosis/Pages/Introduction.aspx

https://www.mssociety.org.uk/what-is-ms

http://www.ms-uk.org/whatisms

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Trigeminal Neuralgia

The trigeminal nerve or fifth cranial nerve is the nerve that sends pain impulses to the brain. When the nerve malfunctions, impulses can be sent at the wrong time, when there is no real pain. However, the sufferer will still feel sharp pain of great intensity. It usually occurs when the protective coating around the trigeminal nerve, the myelin sheath is damaged. High blood pressure, tumours and multiple sclerosis can cause this damage. Rarely, a tangle of arteries and veins called an arteriovenous malformation can also lead to the attack. The attacks can span from a few seconds or to a few minutes, the pain is often unbearable It often only affects one side of the face, usually the right hand side.

The attacks are often brought about by light touching of the face, this can be due to light intensity, wind, air conditioning, eating, washing and even breathing. This means that it is incredibly difficult to control. It usually occurs in those who are over 40 and is more frequent in women than in men.

Treatment can vary but usually:

  1. Anticonvulsant Drugs

Carbamazepine is often used in treatment in order to prevent nerve firing. It slows down nerve impulses, reducing the ability to transmit pain messages. It has to be taken in large doses in order to be effective.

2.  Surgery

Surgery such as nerve replacement therapy can be used in treatment. Through cutting part of the nerve, numbness occurs and the pain is dulled or ceases. However, the nerve may regrow which results in further pain and the need for more surgery and medications.

The National Institute of Neurological Disorders and Stroke (NINDS) is researching the disease. Mice can be used to understand the relationship between the nervous system and the vascular system. Researchers are looking at the role estrogens may play in affecting nerve pain activity, due to the disease being more prevalent in women compared to men.

 

References:

https://www.tna.org.uk/pages/condition.html

https://www.tna.org.uk/pages/condition.html

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet#3236_1

The Liver

The liver is the second largest organ in the body and is responsible for:

  • Detoxification of poisonous substances like alcohol.
  • Producing bile that is used in lipid digestion.
  • Controlling cholesterol levels by breaking down cholesterol through use of HDL’s.
  • Aiding blood clotting.
  • Fighting infections.

Types of liver diseases:

  1. Alcohol-related

Alcohol consumption can lead to a build up of fats within the liver. Fatty liver disease is reversible, if alcohol consumption is reduced drastically for around a month. Alcoholic hepatitis can occur after substance abuse with alcohol and binge drinking. Cirrhosis can also occur when the liver has been scarred. A liver transplant is only required, usually, in the late stages of cirrhosis. However usual treatment is to reduce alcohol consumption drastically after diagnosis and maintaining a balanced life style.

2. Non-alcoholic fatty liver disease.

This usually occurs in people who are overweight or obese and leads to a build up of fat within the liver. This can lead to fibrosis which causes persistent inflammation that leads to  scar tissue around the liver and nearby blood vessels. This can then later turn into cirrhosis.

3. Hepatitis

This is inflammation of the liver due to a viral infection or damage caused by alcohol. Symptoms include joint pain, high temperature, feeling sick, jaundice and itchy skin to name a few. Types of hepatitis:

  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatitis D
  • Hepatitis E
  • Alcoholic hepatitis
  • Autoimmune hepatitis

4. Haemochromatosis

This is an inherited condition that is due to a slow build up of iron in the body. Symptoms include: weight loss, joint pain, fatigue, weakness etc. Treatments include: phlebotomy: removal of blood to stabilise iron levels and chelation therapy: medication to reduce iron levels. Haemochromatosis is caused by a faulty gene that affects how the body absorbs iron from food.

5. Primary biliary cirrhosis

This occurs when the bile ducts in the liver become damaged. This leads to a build up of bile in the liver that leads to cirrhosis, scarring. The immune system attacks bile ducts, this scars bile ducts making it difficult for bile to move out of the liver. It is a progressive condition that worsens over time.

Liver disease can usually be treated in a variety if ways, but in the worst cases a transplant may be required.

References:

http://www.nhs.uk/conditions/liver-disease/Pages/Introduction.aspx

http://www.medicinenet.com/liver_disease/page3.htm

http://www.nhs.uk/conditions/Liver_disease_(alcoholic)/Pages/Introduction.aspx

http://www.nhs.uk/Conditions/fatty-liver-disease/Pages/Introduction.aspx

http://www.nhs.uk/conditions/Hepatitis/Pages/Introduction.aspx

http://www.webmd.boots.com/a-to-z-guides/digestive-diseases-hepatitis

https://www.britishlivertrust.org.uk/liver-information/liver-conditions/hepatitis-c/

http://www.nhs.uk/conditions/Haemochromatosis/Pages/Introduction.aspx

https://www.britishlivertrust.org.uk/liver-information/liver-conditions/haemochromatosis/

http://haemochromatosis.org.uk/

http://www.nhs.uk/conditions/Primary-biliary-cirrhosis/Pages/Introduction.aspx

http://www.mayoclinic.org/diseases-conditions/primary-biliary-cirrhosis/basics/definition/con-20029377

https://www.britishlivertrust.org.uk/liver-information/liver-conditions/primary-biliary-cirrhosis/

 

Shock

Shock is a life threatening condition that occurs when blood flow is restricted. This means that the cells don’t get enough oxygen to enable them to work properly, which can lead to damage of the vital organs like the brain and the heart. Cells require oxygen and glucose so when deprived of blood, the tissues begin to die.

Recognition:

  • Rapid pulse.
  • Pale, cold, clammy skin.
  • Sweating.

As shock develops symptoms change:

  • Rapid, shallow breathing.
  • Weak, thready pulse.
  • Grey-blue skin, especially inside lips.
  • Weakness
  • Giddiness
  • Nausea
  • Vomiting
  • Thirst

As the brain’s oxygen supply weakens:

  • Restlessness and aggressive behaviour.
  • Gasping for air.
  • Loss of consciousness.

Shock can be caused by any condition that reduces blood flow, including:

  • Heart problems (such as heart attack or heart failure)
  • Low blood volume (as with heavy bleeding or dehydration)
  • Changes in blood vessels (as with infection or severe allergic reactions)
  • Certain medicines that significantly reduce heart function or blood pressure

Treatment:

In first aid, you would have to help the casualty lie down and then raise and support the legs over the level of the casualties heart.

References

http://www.sja.org.uk/sja/first-aid-advice/heart/shock.aspx

https://medlineplus.gov/ency/article/000039.htm

http://www.emedicinehealth.com/shock/article_em.htm