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.
- Balance and co-ordination problems
- Muscle stiffness and spasms
- Cognitive difficulties
- Difficulty walking
- Problems with vision
MS can occur in two ways:
- 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.
Alzheimer’s disease is the most common cause of dementia. It is caused by a build up of protein in the brain to form plaques and tangles. Plaques are clusters of proteins called beta-amyloid that build up between nerve cells. Smaller clumps block signals between nerve cells which leads to damage within the brain. The inflammation caused can trigger the immune system to attack brain cells. Tangles are formed within dying cells and are twists of proteins known as tau. They disintegrate the transport system within cells therefore, depriving cells of their vital nutrients, leading to cell death. The plaques and tangles usually form in the cerebral cortex in areas associated with memory and language. There is also damage to the hippocampus and it often shrinks with Alzheimer’s disease.
- Memory problems.
- Personality changes.
- Problems with speech and language.
Usually, those over 65 are affected by Alzheimer’s, but early onset alzheimer’s can occur in people who are younger. It is very difficult to diagnose alzheimer’s due to the progressive nature of the disease.
There is no cause for Alzheimer’s disease, but symptoms can be treated with medication. In most cases, treatment is used to slow down progression of the disease. Psychological treatments such as cognitive stimulation therapy may be used. It is a life-limiting condition and can lead to other problems such as difficulty swallowing. In many cases, people survive 8-10 years after diagnoses but this can vary from person to person; most people require palliative care.
Dementia is caused by Alzheimer’s disease and is used to describe a wide range of progressive neurological disorders.
- Memory problems.
- Difficulty with concentrating.
- Language problems.
- Spatial Visualisation problems.
- Difficulty reasoning.
Types of dementia:
- Alzheimer’s disease (see above)
- Vascular dementia – Due to a series of small strokes which cause pockets of cell damage in the brain. Memory is less affected, but instead language and speech problems ensue. It is possible to have Alzheimer’s as well as vascular dementia at the same time, this is mixed dementia.
- Frontotemporal dementia – Affects personality and behaviour more than memory. It is known as frontal lobe or Pick’s disease. It can be confused with depression and psychosis.
- Dementia with Lewy Bodies – Movement is affected including motor skills. Tremors are common, similar to those of Parkinson’s disease, in addition, tremors can also occur.
- Early Onset Dementia – Occurs in those below 65 and can be accompanied by depression and anxiety in younger people as well as familial stress.
Dementia can be treated via drug use and the most common form of treatment for Alzheimer’s are three drugs known as donepezil, rivastigmine or galantamine. Memantine can be used to treat a more progressive form of Parkinson’s disease. Those with vascular dementia are treated in order to alleviate symptoms such as high blood pressure and cholesterol. Those with dementia with Lewy bodies are treated with the same drugs as alzheimer’s in order to treat hallucinations.