Comp. 2: Academic Research Paper
3 September 2014
Use of Corticosteroid Treatment in Multiple Sclerosis
More than 2.3 million people are diagnosed with Multiple Sclerosis worldwide. There are currently 250,000 to 350,000 people in the United States diagnosed with multiple sclerosis. And about 200 new cases are diagnosed every week (Multiple Sclerosis FAQs). Neurologists prescribe these patients with corticosteroids, either oral or through IV. Although scientists have found no cure to multiple sclerosis, corticosteroids have been used to successfully treat relapses and potentially stop progressive-relapsing and relapsing-remitting multiple sclerosis.
To start off with, multiple sclerosis is a disease of the central nervous system. It damages the protective coating around the nerve fibers that sends messages to all parts of your body controlling muscle and sensory activity. It is an autoimmune disease, this is when your body's own immune system attacks itself. As the damage to protective coating around the nerve fibers increase, it becomes a process known as demyelination where the coating is destroyed.
These nerves then become less and less capable at sending messages. As the messages escape they become weaker, leading to difficulty in controlling muscles in different parts of your body. Even when damage occurs to the myelin, it sometimes repairs through internal body repair devices. Described as inflammation at the site of the damage becomes less over time. The rate at which the myelin is damaged is faster than the rate at which repair happens, so the damage becomes more throughout the central nervous system. This damage is known as lesions that take the form of patchy scarring (Managing Your Ã¢ÂÂ¦). Patients and doctors together recognize what the disease does and how it affects your body; still they acknowledge that corticosteroids treat the inflammation and reduce that inflammation.
Furthermore, there are some patterns, anyone can develop multiple sclerosis. More women than men have multiple sclerosis and the percentage keeps increasing as years go by. There is no direct evidence that multiple sclerosis is inherited. Some studies suggest environmental factors, like low Vitamin D have increased the risk of multiple sclerosis. Multiple sclerosis occurs in all ethnic groups, but is most common in Caucasians of European ancestry. When men and women develop multiple sclerosis it usually takes a long time to diagnose. In the early stages of multiple sclerosis, symptoms multiple sclerosis suggest several diseases of the nervous system. Magnetic resonance imaging help give a definite diagnoses since there is no laboratory test available to diagnose multiple sclerosis (Multiple Sclerosis FAQs). As you can see, this means anyone, even if no one in your family has multiple sclerosis, can develop it.
Secondly, there are several different symptoms multiple sclerosis that develop when you have multiple sclerosis. Symptoms multiple sclerosis are different for every person; usual symptoms multiple sclerosis of relapses include optic neuritis, limb weakness, numbness, imbalance, light-headedness, and loss of facial strength. In more serious multiple sclerosis, such as in progressive-relapsing multiple sclerosis, symptoms multiple sclerosis include fatigue, and depression. Relapses usually range from days to weeks and self-fixed around weeks to months. Neurologists use Corticosteroids for selected relapses that have reoccurring symptoms multiple sclerosis and increasingly get worse through-out the relapse. Around fifty percent of neurologists use them for all relapses (Mechanistic InsightsÃ¢ÂÂ¦). This states that even patient that have the same type of multiple sclerosis as you, you may have different symptoms multiple sclerosis and be given different treatments for your relapses, dependent on how sever they may be.
Finally, steroids in general are found naturally in plants and animals, but corticosteroids are those particular steroids released into the bloodstream by the adrenal gland. People with multiple sclerosis relapses who are being treated with corticosteroids show that the corticosteroids work by decreasing the levels of the depraved immune substances and by making the cell membranes of the white cells more flexible and less sticky. Other evidence suggests that there is also an effect on the way the brain interprets the messages coming to it from the body's nerves. MRI studies also show that corticosteroids significantly decrease the amount of swelling around individual multiple sclerosis lesions, causing better nerve transmission through these affected areas (Steroids). As this states, corticosteroids are found in the human body and advance the relapses quicker and faster to a safer recover time than in other treatments commonly used like placebo.
Furthermore, Corticosteroids are proved not to cure multiple sclerosis but to treat mild relapses. The symptoms of multiple sclerosis they can be treat with Corticosteroids usually consist of tingling in the absence of sensory loss. One major study done by N. M. Milligan, a researcher at University Hospital of Wales, stated that, "50 patients received methylprednisolone 500mg intravenously for five days or inactive placeboÃ¢ÂÂ¦.carried out at 1 to 4 weeksÃ¢ÂÂ¦.73 percent of methylprednisolone-treated patients improved compared with 29 percent of methylprednisolone-treated of those on placebo". The group he tested on contained both relapsing-remitting multiple sclerosis and Chronic progressive multiple sclerosis, both these patients benefited from methylprednisolone. This study made neurologists, around the world, to start prescribing intravenously methylprednisolone for relapses. One other slightly major study done by Finn Sellebjerg, a professor of neurology at the University of Copenhagen and chief physician at Danish Multiple Sclerosis Center, gave 51 patients enduring a relapse less than four weeks to receive oral placebo or oral prednisolone (Corticosteroids) 500mg per day for five days. Results of Sellebjerg states "Ã¢ÂÂ¦1, 3, and 8 weeks, 4 percent, 24 percent, and 32 percent in the placebo group and 31 percent, 54 percent, and 65 percent in the prednisolone group improved one point on the Kurtzke Scale score" these patients also stated that their symptoms multiple sclerosis improved much more with the steroids at 3 and 8 weeks (Steroids). This states that in most cases, corticosteroids produce patients with shorter relapses times, no side effects when used short term, and reduces the symptoms effect on the patient's work time, wither they can or cannot work, during the duration of that relapse; compared with placebo, which in most cases, does not have an effect on the patients recovery time, does have miner side effects when even used short term, and does not reduce the symptoms effect on the patient's capability to work during the relapses. As you can see, both of these studies prove that corticosteroids are the best treatment to use during or after to manage a relapse.
All and all, Corticosteroids may not be the cure for multiple sclerosis but it does help the relapses end faster. It makes it so that people can go back to work and ends relapses faster. It also lets patients potentially stop their progressive-relapsing and relapsing-remitting multiple sclerosis. As a daughter of a mother that has multiple sclerosis, I'm asking you to spread the word of corticosteroid treatment to those who have multiple sclerosis.
Krieger, Stephen, et al. "Mechanistic Insights into Corticosteroids in Multiple Sclerosis: War
Horse or Chameleon?" Clinical Neurology and Neurosurgery. 119 (2014): 6-16.
Elservier. Web. 2 September 2014.
In Stephen Krieger's persuasive article "Mechanistic Insights into Corticosteroids in Multiple Sclerosis: War Horse or Chameleon?" he discuss cellular, systemic, and clinical characteristics that might contribute to intended and unintended CS effects when utilizing doses in clinical practice. The goal of this article is to consider recent insights about CS mechanism multiple sclerosis of action in the context of MS. A diversity of mechanism multiple sclerosis drive the heterogeneous clinical response to exogenous Corticosteroids in patients with MS.
Multiple Sclerosis FAQs. National Multiple Sclerosis Society, 2014. Web. 2 September 2014.
In the informative article Multiple Sclerosis FAQS it discussed that multiple sclerosis can cause many symptoms, including blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems multiple sclerosis with memory and concentration, paralysis, and blindness and more. Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves. The goal of this article is to inform patients about the use of corticosteroid in multiple sclerosis and how it can shorten relapses.
Robinson, Ian and F. Clifford Rose "Managing Your Multiple Sclerosis: Practical Advice to
In Ian Robinson's informative e-book "Managing Your Multiple Sclerosis: Practical Advice to Help You Manage Your Multiple Sclerosis" discussed a practical guide to multiple sclerosis's management and can provide you with many information sheets on this subject. This book was written by popular demand from patients, who read their articles before, who wanted to know more about practical steps that they could take in their day-to-day living with multiple sclerosis. The goal for this book is to describe multiple sclerosis causes and diagnosis and what steps you can take for different treatments for relapses.
Steroids. Overcoming Multiple Sclerosis, 2014. Web. 2 September 2014.
In the informative article Steroids, discussed that there is convincing evidence that steroids are useful in improving the recovery after a relapse of multiple sclerosis. For most relapses, there should be no delay in starting a short course of steroids. It is probable that steroids delay the onset of the next episode as well. The goal for this article was to state evidence, studies, done on corticosteroids and how they would be beneficial to use based on that evidence and how they end relapses sooner.