Treatment Approaches For The Neurological Progression Of Multiple Sclerosis And Parkinsons Disease
This course provides information on the specific neurological diseases processes of Multiple Sclerosis, Parkinsons and Muscular Dystrophy. Top neurologists specializing in Multiple Sclerosis will share information concerning the results from current research and clinical studies for patients with Multiple Sclerosis. Evidenced based research results will enable the clinician to understand the underlying mechanism of this disease process, diagnostic tools currently being utilized, medications and the importance of therapy and the future of MS treatments. Case presentations of patients diagnosed with Parkinsons, MS and Muscular Dystrophy will provide the clinician with the ability to observe common patterns seen with patients that are characteristic of each of these neurological diseases. The clinician will have the opportunity to get first hand information from the patients on their description of what it is like to be diagnosed with their neurological disease and the limitations and challenges they have encountered. Therapists will identify the appropriate assessment tools and measurement scales utilized for each disease and apply them to their rehab program. This will provide the clinician with the tools needed to effectively develop a program while maximizing the energy efficiency of their patients.
Instructor: Sara Koveleski Kraut, PT, DPT, NCS
Common Misdiagnosis: Multiple Sclerosis
One of the most common answers to the question was multiple sclerosis . Both diagnoses have an effect on the central nervous system. These diagnoses also frequently cause muscle spasms, balance changes, tremor, and impaired memory. However, these are two separate diagnoses.
One difference is that MS is often diagnosed when someone is in their 20s, while most people receive a PD diagnosis in their 60s. Also, MS is an autoimmune disease that over time causes nerve damage. Parkinsons affects the brain. The brain starts producing less and less dopamine, which is responsible for controlling movement.
Yes, with MS which I was worried about for years, but right now I do not know which one is worse. However, my meds are helping a lot. My new saying is It is what it is, aka just live on. My neurologist says that I have stage one mild Parkinson’s disease.
My husband was diagnosed with MS back in 1993 when he had a mini stroke. He was diagnosed with Parkinsons in 2014.
Can You Have Both Parkinsons And Alzheimers
People who already have Parkinsons disease and later develop signs of dementia are diagnosed with Parkinsons dementia.6 However, if you first have Alzheimers disease and develop signs of movement difficulties, you can also have a diagnosis of Parkinsons disease.
Tell us about your experience in the comments below, or with the community.
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Number Of People Affected
Parkinsons disease is thought to affect about 2 percent of Americans over 65. Of those, about 50 to 80 percent will go on to develop Parkinsons-related dementia.1 The Parkinsons Foundation estimates that nearly 1 million Americans will be living with Parkinsons by 2020. The disease affects 1.5 times more men than women.7
Approximately 5.8 million Americans are currently living with Alzheimers disease. That number is expected to increase to 14 million by 2050.8 There is little difference between numbers of men and women who develop Alzheimers, but there are more women with the disease, because women tend to live longer than men.3
What Is Multiple System Atrophy
Multiple system atrophy is a progressive neurodegenerative disorder characterized by a combination of symptoms that affect both the autonomic nervous system and movement. The symptoms reflect the progressive loss of function and death of different types of nerve cells in the brain and spinal cord.
Symptoms of autonomic failure that may be seen in MSA include fainting spells and problems with heart rate, erectile dysfunction, and bladder control. Motor impairments may include tremor, rigidity, and/or loss of muscle coordination as well as difficulties with speech and gait . Some of these features are similar to those seen in Parkinsons disease, and early in the disease course it often may be difficult to distinguish these disorders.
MSA is a rare disease, affecting potentially 15,000 to 50,000 Americans, including men and women and all racial groups. Symptoms tend to appear in a persons 50s and advance rapidly over the course of 5 to 10 years, with progressive loss of motor function and eventual confinement to bed. People with MSA often develop pneumonia in the later stages of the disease and may suddenly die from cardiac or respiratory issues.
While some of the symptoms of MSA can be treated with medications, currently there are no drugs that are able to slow disease progression and there is no cure.
MSA includes disorders that historically had been referred to as Shy-Drager syndrome, olivopontocerebellar atrophy, and striatonigral degeneration.
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How Is It Treated
Currently, there are no treatments to delay the progressive neurodegeneration of MSA, and there is no cure. There are treatments to help people cope with the symptoms of MSA.
In some individuals, levodopa may improve motor function however, the benefit may not continue as the disease progresses.
The fainting and lightheadedness from orthostatic hypotension may be treated with simple interventions such as wearing compression stockings, adding extra salt and/or water to the diet, and avoiding heavy meals. The drugs fludrocortisone and midodrine sometimes are prescribed. In 2014, the U.S. Food and Drug Administration approved the medication droxidopa for the treatment of orthostatic hypotension seen in MSA. Dihydroxyphenylserine helps to replace chemical signals called neurotransmitters which are decreased in the autonomic nervous system in MSA. Some medications used to treat orthostatic hypotension can be associated with high blood pressure when lying down, so affected individuals may be advised to sleep with the head of the bed tilted up.
Bladder control problems are treated according to the nature of the problem. Anticholinergic drugs, such as oxybutynin or tolteridine, may help reduce the sudden urge to urinate.
Fixed abnormal muscle postures may be controlled with injections of botulinum toxin.
Sleep problems such as REM sleep behavior disorder can be treated with medicines including clonazepam, melatonin, or some antidepressants.
What Is The Cause Of Multiple Sclerosis Parkinsons Alzheimer’s And Als
Despite the previous decades medical explanation, a description of the real Multiple Sclerosis, Alzheimers, Parkinsons and ALS occurs when the myelin sheath becomes sufficiently damaged from an over-acidic lifestyle and diet that causes decompensated acidosis of the interstitial fluids of the largest organ of the body called the Interstitium, as seen in the above picture.The myelin sheath is an electrically insulating phospholipid layer that surrounds the axons of many neurons. It is kind of like the rubber coating on a power cord that keeps the electricity traveling forward rather then shooting out in all directionsvirtually all over the place.
The main function of a myelin sheath is to increase the speed at which electrical impulses transmit and spread along the myelinated fibers. Along unmyelinated fibers impulses move continuously as waves. But in myelinated fibers, they hop or advance quickly by leaps. Myelin increases resistance across the cell membrane by a factor of 5,000 and decreases the ability to collect a charge of electricity by a factor of 50. Thus, the impulses keep moving and are not absorbed.
Myelination also helps prevent the electrical current from leaving the axon. When a peripheral fiber is severed, the myelin sheath provides a track along which regrowth can occur because it is essential that the body is able to repair itself.
Myelin is composed of about 80% lipid fat and about 20% protein.
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What Is Multiple Sclerosis
Multiple sclerosis is a progressive and debilitating disease of the central nervous system that disables the communication between the brain and other parts of the body. It involves an immune-mediated process in which an abnormal response of the bodys immune system is directed against the central nervous system.
Within the central nervous system , the immune system causes inflammation that damages myelinthe fatty substance that surrounds and insulates the nerve fibersas well as the nerve fibers themselves, and even the specialized cells that make myelin. When the nerve fibers are destroyed, messages within the CNS are altered or halted completely. Then, the damaged areas produce neurological symptoms that can vary among people in type and severity. These areas develop scar tissue, giving the disease its namemultiple areas of scarring or multiple sclerosis.
Incidence And Prevalence: Als Compared With Parkinsons
All neurodegenerative diseases are conditions where there is an impact on the brain and/or the central nervous system.
According to statistics, ALS currently affects around 30,000 people in the USA, with around 6,000 new cases being identified each year.
Parkinsons Disease affects around a million people in America and there are about 60,000 new cases annually.
Famous individuals affected by Parkinsons include Michael J Fox and Scottish comedian Billy Connelly. In terms of ALS, the late Professor Stephen Hawking was one prominent public figure who had been diagnosed with a form of ALS. The late legendary US baseball player Lou Gehrig was also diagnosed with ALS and subsequently the condition has been commonly referred to as Lou Gehrigs disease ever since.
Parkinsons is perhaps a much more well known condition, due to its increased prevalence throughout the world, however ALS has received a lot more attention and awareness since the Ice Bucket Challenge which went viral on social media during the summer of 2014.
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Sonda Identifies Oculomotor Abnormalities In Multiple Sclerosis
The parameters of the main-sequencessaccadic amplitude and saccadic peak velocityof MS patients showed an almost identical distribution to those of the controls . This is consistent with the literature, which indicates that most CNS lesions of this disease have not been associated with unique identifiable clinical symptoms in eye-movements . Thus far, the majority of the studies on oculomotor abnormalities in MS patients focused on the detection of internuclear ophthalmoplegia . This disorder may be present in ~30% of MS patients and is usually identified by measuring the versional dysconjugacy index , which is the ratio between abducting and adducting eye saccadic dynamics . However, despite that relying on the main-sequence parameters alone is insufficient, standardized screening tests capable of detecting other manifestations of oculomotor abnormalities in MS do not exist.
With our novel SONDA approach introduced in this study, in MS we found preserved smooth pursuit responses and two abnormal features in the saccadic pursuit condition . This is consistent with the notion that the most common saccadic issue in MS is saccadic dysmetria , present especially in patients with demyelination affecting the cerebellar peduncles . However, given the relatively small sample the significant difference seems to be driven mostly by a few severely impaired patients, rather than a general decrease in performance.
Data Synthesis And Analysis
Given the heterogeneity in populations, outcomes and analyses, the findings of included reviews were primarily summarised using a narrative synthesis with the quantitative tabulation of results as appropriate. The primary analyses for this umbrella review were centred on type of neurological condition and type of intervention. Following this, cross-comparison of similarities and differences in the effect of different interventions between the three conditions were reported and discussed. The outcomes of each included systematic review were considered and discussed in the context of their methodological quality, as determined by the AMSTAR 2 and the GRADE algorithm.
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Key Difference Ms Vs Parkinsons
MS and Parkinsons disease are two diseases affecting the central nervous system. Multiple Sclerosis is a chronic autoimmune, T-cell mediated inflammatory disease affecting the central nervous system. On the other hand, Parkinsons disease is a movement disorder characterized by a decline in the dopamine level of the brain. Although MS is an autoimmune disorder, there is no immune component in the pathogenesis of Parkinsons disease. This is the key difference between MS and Parkinsons.
Conversion And Psychogenic Disorders
People suffering from these disorders typically translate emotional and mental issues, including stress, into physical pain of some kind. Symptoms are often similar to MS, such as general pain, difficulty with mobility, blindness, and weakness. However, multiple sclerosis presents with very tangible damage to the central nervous system, whereas the average patient with a conversion or psychogenic disorder doesnt have a physical ailment that explains the symptoms. Based on a study, about eleven percent of patients diagnosed with MS actually had one of these disorders rather than MS.
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Multicomponent And Multifactorial Interventions
Multicomponent interventions were investigated for people with MS and PD in one systematic review each . No significant effect of multicomponent interventions was identified for people with MS or PD on number of fallers. However, there was moderate evidence identified for the effectiveness of a multicomponent intervention comprising of physiotherapy and falls-self management education at reducing falls rate among people with PD .
Two systematic reviews for people with stroke included a multifactorial intervention , however, this intervention was primarily comprised of exercises and so was included in the analyses for exercise-based interventions in these reviews.
How Is Msa Diagnosed
Making a diagnosis of MSA can be difficult, particularly in the early stages, in part because many of the features are similar to those observed in Parkinsons disease.
After taking a clinical history and performing a brief neurological examination, a doctor may order a number of tests to help make the diagnosis. These tests might include autonomic testing , assessment of bladder function, and/or neuroimaging such as an MRI or PET scan. An MRI of the brain may identify changes which might suggest MSA or rule out other causes of the observed symptoms.
A PET scan is sometimes used to see if metabolic function is reduced in specific parts of the brain. DaTscan can assess the dopamine transporter in a part of the brain called the striatum and can help physicians determine if the condition is caused by a dopamine system disorder however this test cannot differentiate between MSA and Parkinsons disease. Individuals with MSA typically do not have sustained improvement in their symptoms with levodopa , a finding that often supports the diagnosis of MSA.
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Prognosis Of Als Vs Parkinsons
ALS is considered as a fatal disease. The damage and death of neurons begins to spread throughout the body. In the later stages, nerve damage will affect areas like breathing and swallowing.
Parkinsons disease in itself is not considered fatal but people do die from complications relating to the condition.
Link Between Multiple Sclerosis Vs Parkinsons Disease
Researchers have found that nerve pathways in the gut and the brain may be linked to multiple sclerosis and Parkinsons disease. Dr. Anton Emmanuel explained, The gut and brain share the same nerve chemistry and have a dialogue. Thats why when you feel stress and other strong emotions, such as fear, it leads to gastrointestinal symptoms, like rushing to the .
The study suggests that an unhealthy gut can trigger the onset of brain disease as the signals from brain to gut can also travel in the opposite direction from gut to brain. The findings of the study were published in the journal Movement Disorders where researchers found that Parkinsons disease sufferers have a higher prevalence of small intestinal bacterial overgrowth .
The researchers suggest the bacteria produce toxic chemicals affecting the nerves in the gut and this way causing damage to the brain. This can bring about the onset of multiple sclerosis or Parkinsons disease.
Dr. Emmanuel said, We now think that neurological diseases such as MS and Parkinsons are linked to the gut being more leaky, permitting pathogens into the bloodstream and causing an antibody response. Either the pathogens, directly, or the immune response, indirectly, may damage nerve tissue.
Researchers are now exploring bacterial genomes that can help identify the bacteria so that doctors can specifically treat it as a means of preventing Parkinsons disease and multiple sclerosis.
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Genetic Link Discovered Between Immune System Parkinson’s Disease
- Date:
- Scientists have discovered new evidence that Parkinson’s disease may have an infectious or autoimmune origin.
A team of researchers has discovered new evidence that Parkinson’s disease may have an infectious or autoimmune origin.
The study was conducted by the NeuroGenetics Research Consortium, an international team of researchers led by Haydeh Payami, research scientist at the New York State Department of Health Wadsworth Center. The clinical directors for the study were Dr. Cyrus Zabetian, associate professor of neurology at the University of Washington and VA Puget Sound Health Care System, Stewart Factor at Emory University and John Nutt at Oregon Health and Sciences University. The study appears online in Nature Genetics.
The research team studied more than 2,000 Parkinson’s disease patients and 2,000 healthy volunteers from clinics in Oregon, Washington, New York and Georgia, assessing clinical, genetic and environmental factors that might contribute to the development and progression of Parkinson’s disease and its complications. Some of the research subjects were tracked for nearly two decades.
“Over the years, there have been subtle hints that immune function might be linked to Parkinson’s disease” said Zabetian. “But now we have much more convincing evidence of this and a better idea of which parts of the immune system might be involved.”
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Multiple Sclerosis Vs Parkinsons Disease Differences In Symptoms Causes And Treatment
Written byDr. Victor MarchionePublished onJune 10, 2016
Multiple sclerosis is an autoimmune condition that affects the nervous system, while Parkinsons disease is a progressive neurological disorder affecting movement. Symptoms of multiple sclerosis and Parkinsons disease are quite similar at times, but there are distinct differences setting the two conditions apart.
Causes of multiple sclerosis and Parkinsons disease are not well known, although there is some speculation to their roots. We will outline those speculated causes and highlight the symptoms, risk factors, complications, treatment, and therapies for both multiple sclerosis and Parkinsons disease to raise your awareness on each disorder.
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