What Is Peripheral Neuropathy? [dropcap]P[/dropcap]eripheral neuropathy is a syndrome involving damage to one or more peripheral nerves characterized by impaired nerve transmission. Peripheral nerves are nerves of the body outside the brain and spinal cord. Q:…
[dropcap]M[/dropcap]ultiple sclerosis is an autoimmune disease of the central nervous system characterized by patchy inflammation of the myelin sheath surrounding nerve cells that produces multiple and varied neurologic symptoms and signs due to demyelination.
Q: What does demyelination mean.
A: Demyelination means there is damage to the myelin sheath which is a fatty substance that surrounds and protects nerve cells much like a the covering of a lamp cord keeps the electricity flowing within it from the plug to the light bulb. This damage impairs transmission of nerve impulses between the brain and body.
In the process of demyelination, T-lymphocyte cells that are activated and potentially autoimmune cross the blood-brain barrier and produce inflammatory plaques and axonal tissue loss in the brain, spinal cord or optic (vision) nerves. The end result is the accumulation of gliosis (scarring) and demyelination of areas in the central nervous system.1
The course of multiple sclerosis is unpredictable and slowly progressive, usually with exacerbations (worse symptoms) and remissions (relief of symptoms).
Multiple sclerosis affects about 1 ‰ of the population worldwide.
[dropcap]T[/dropcap]etany is a painful feature of low blood calcium or low blood magnesium causing hyperexcitability of all nerves which in turn stimulates involuntary sudden, intermittent and repetitious tonic spasms of muscles. Tonic spasms are steady rather than jerky.
Causes include low function of the parathyroid glands which regulate calcium blood levels, vitamin D deficiency which inhibits calcium absorption from the gut that leads to calcium deficiency, and alkalosis.
In alkalosis, the chemical pH (acid/alkaline measure) of blood is too high, or alkaline, which inhibits adequate free calcium ions from being available for cell use.
Q: Why do low blood levels of calcium or magnesium cause muscles to spasm?
A: Calcium controls the readiness of muscle to respond to nerve stimulation. In muscle action, calcium and magnesium are minerals that oppose each other. Calcium allows a muscle to contract while magnesium allows it to relax. Inadequate levels of these opposing minerals affect the ability of muscles to properly function.
A simple test for tetany is called Trouseau’s named after the doctor who developed it. A blood pressure cuff is placed on an upper arm as usual and pumped up to a pressure sufficient to stop blood flow. The pressure must be held for 3 minutes. A positive result is shown in the above photo of carpopedal spasm: the wrist and hand flexes inward while the fingers extend (opposite of wrist and hand) and the thumb goes against the palm.
An autoimmune, chronic slowly progressive demyelinating (damage to nerve fibers) disease of the central nervous system characterized by multiple and varied neurologic symptoms and signs such as numbness, muscle weakness and visual disturbances, usually with…