TY  - CHAP
M1  - Book, Section
TI  - Chapter 30. Multiple Sclerosis
A1  - Atchabahian, Arthur
A2  - Atchabahian, Arthur
A2  - Gupta, Ruchir
PY  - 2013
T2  - The Anesthesia Guide
AB  - Autoimmune  disease  characterized  by  antibody-mediated  demyelination  in  central  nervous  system,  which  leads  to  impaired  nerve  conduction.  Peripheral  nerves  are  not  involvedCombination  of  genetic  and  environmental  factors2F/1MAge  of  onset  usually  20–40,  but  can  be  seen  at  any  ageSigns  and  symptoms  related  to  site  of  CNS  affected  by  demyelinationBroad  spectrum—relapses  and  remissions,  or  chronic  and  progressiveVariety  of  triggers,  such  as  stress  and  heat  (fever)Many  signs  and  symptoms  are  possible,  but  more  commonly  seen  are  visual  symptoms  from  optic  nerve  involvement,  skeletal  muscle/spasms  from  spinal  cord  involvement,  bowel/bladder  dysfunction,  lack  of  coordination,  paresthesias,  seizures,  depression,  autonomic  disturbances  in  advanced  disease.  Lower  extremities  more  frequently  involved  than  upper  extremitiesDiagnosis  usually  based  on  cerebrospinal  fluid  antibodies  or  magnetic  resonance  imagingMS  patients  can  be  treated  with  a  wide  variety  of  medications,  some  targeting  the  disease  and  some  targeting  specific  symptoms:Treatment  with  corticosteroids,  interferons  (Avonex,  Betaseron,  Rebif),  glatiramer  (Copaxone),  azathioprine  (Imuran),  mitoxantrone  (Novantrone;  cardiotoxic),  natalizumab  (Tysabri),  cyclophosphamide  (Cytoxan),  and  methotrexateSymptomatic  treatment  with  baclofen  (lioresal),  tizanidine  (Zanaflex)  for  muscle  spasms,  cholinergic  medications  for  urinary  symptoms,  or  antidepressants  for  mood  disturbances  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=57260701
ER  -