Understanding The Visualizations Of The Neuromuscular System Serves As A Conduit For Effective Interventions For The Patients Functional Improvement

IMPRESSION: This patient has a long history of low back pain which seems to have become radicular in January of this year. She did have a CT scan that showed what appeared to be a small disk herniation at L5-S1. She also has a considerable amount of facet arthropathy. I’m not 100% certain that what we see on the CT scan is the etiology of her present symptoms. I would like to have a myelogram prior recommending surgical intervention.

MRI of the lumbar spine performed on 10/30/14 demonstrated mild anterolisthesis and prominent degenerative changes at L4-5, resulting in contact and possible impingement upon passing L5 nerve roots bilaterally. There is moderate bilateral facet arthropathy at this level. Mild central canal narrowing is seen at L4-5. Mild chronic compression deformity, superior endplate of T12 is seen.

As per medical report dated 4/19/16, a lumbar MRI with and without contrast was requested to evaluate for a discogenic and/or facetogenic etiology for pain. MRI would also allow evaluation of conditions such as spinal stenosis.

Multiple sclerosis, or MS, is a disease of the central nervous system. The central nervous system is made up of the brain and spinal cord. Both have nerve fibers that are wrapped in a myelin sheath. In MS, the myelin sheath becomes inflamed and gradually is destroyed. With the destruction of the myelin sheath comes an array of symptoms that may include numbness or tingling, balance problems, weakness, muscle spasms, and blurred vision.

Multiple Sclerosis, commonly known as MS is an autoimmune disease of the central nervous system. Scientists have been studying MS since the 19th century. In MS, the body’s immune system produces cells and antibodies that attack myelin in your brain which is essential for the nerves in your brain and spinal cord to conduct electricity to perform its function. The attack on myelin results in vison loss, paralysis, numbness, muscle weakness, difficulty walking, stiffness, spasms, and bladder and bowel problems. MS has varying degrees of severity and affects people between the ages of 20-50, mostly women. Although there are treatments, there is no cause and cure yet.

Multiple sclerosis is characterized by inflammation, demyelination, and axonal damage in the brain and spinal cord with a loss of myelin that covers the axons. As the myelin sheath regenerates, scar tissue forms, which looks like plaques on magnetic resonance imaging scans. Multiple sclerosis arises when immune-mediated inflammation activates T cells and causes the T cells and immune mediators to cross the blood-brain barriers into the CNS and attack oligodendrocytes (ie, a type of neuroglial cell with dendritic projections that coil around axons of neural cells). When the oligodendrocytes are attacked, the myelin sheath is replaced by scar tissue, which forms throughout the CNS. As a result of damage to the myelin sheath, the ability to transmit and conduct nerve impulses along the spinal cord and in the brain is interrupted, leading to muscle weakness, fatigue, loss of coordination, balance impairment, and cognitive and visual disturbance (DeLuca & Nocentini, 2011). This disease is characterized by unpredictable remissions that occur over several years. During periods of remission, the myelin sheath usually regenerates and symptoms may resolve, but the myelin cannot be completely repaired. As the disease progresses, the myelin sheath is destroyed and nerve impulses become much slower or absent and symptoms worsen. When degeneration exceeds self-repair ability, permanent disability results. There are four defined clinical types of

Multiple Sclerosis is a neurological disease that affects the central nervous system. The CNS consists of the brain and spinal cord. Myelin sheath, an insulation that covers the nerve fibers, is damaged resulting in multiple patches of scarred tissue called lesions. When the Melin sheath is destroyed, damage to the axon begins and causes a wide variety of symptoms. Axons are the fibers that carry electric impulses away from the nerve cell to different parts of the body. MS eventually causes permanent disability. Depending on the extent of the myelin damaged and the location damaged, determines the severity of the symptoms.

Multiple Sclerosis is a chronic progressive disease involving damage to the myelin sheaths of nerve cells in the brain and spinal cord. The exact cause of multiple sclerosis is unknown but we know that something triggers the immune system to attack the central nervous system (CNS). MS happens when your immune system attacks a fatty material called myelin and without this outer shell, your nerves become damaged. The resulting damage to myelin that insulates wire like nerve fibers is a disruption of signals to and from the brain. This hiatus of communication signals causes unpredictable symptoms such as numbness, tingling, mood changes, memory problems, blindness, paralysis, fatigue and pain. People who have MS experience the disease differently,

Multiple Sclerosis is an autoimmune disorder affecting movements, sensation and bodily functions. The cause of MS is by the myelin sheath being destroyed in the brain and spinal cord. The immune system attacks myelin sheaths which is a fatty substances that surrounds the nerve axons that makes it possible for the transmission of nerve impulses. When the myelin sheath are destroyed the nerves impulses that are being triggered to the brain and spinal cord get out of disrupted that provoke the messages to become slower and less efficiently. There are four types of MS people could experience which are Relapsing-remitting multiple sclerosis (RRMS), Secondary –progessive multiple sclerosis (SPMS), Progressive-relapsing multiple sclerosis (

The four main types of Multiple Sclerosis are Relapsing-remitting MS, Secondary Progressive MS, Primary Progressive MS, and Progressive Relapsing MS. “Symptoms occur in any area served by the myelinated nerves of the central white matter of the brain, brain stem, and spinal cord” (Murray, 2005). Symptoms include: weakness or sensory changes in the limbs (legs); unsteadiness; difficulty with bladder control; visual changes; vertigo; facial numbness or weakness; or double vision (Murray, 2005). Because different areas of the brain and spinal cord are responsible for different kinds of movements and sensations, the neurologic deficit that results from an area of scarring depends on the exact location of the abnormality (Schapiro, 2007). These abnormalities Schapiro (2007) means are lesions in any part of the Central Nervous System. These symptoms and harshness of the symptoms all vary depending on where that damage in the Central Nervous System has occurred. No case of Multiple Sclerosis is exactly alike from patient to patient and because of that, symptoms vary considerably.

Multiple sclerosis (MS) is an acquired demyelinating disease of the central nervous system (CNS) that typically is diagnosed in the second or third decade of life. Normally, nerves are enclosed in myelin sheaths that help facilitate transmission of nerve impulses within the CNS and the peripheral nervous system throughout the body. In patients with MS, the myelin sheath is damaged and eventually degenerates, causing patches of scar tissue called plaques or lesions to occur anywhere randomly on the myelin sheath (Ruto, 2013). This results in impaired nerve conductivity, which interferes with message transmission between the brain and the other parts of the body. As a result, impulse transmission is altered, distorted, short-circuited, or completely absent. This interference in impulse transmission creates muscle weakness, muscle imbalance, and possibly muscle spasms with partial or complete paralysis. Multiple sclerosis also can result in visual impairment and alteration of cognitive abilities, as well as pain, numbness, or tingling sensations (Ruto, 2013).

Transverse myelitis is a neurological condition that creates inflammation in the spinal cord, usually within the protective covering around the nerve cell fibers called the myelin. This inflammation can cause injury to the spinal cord itself, and it might affect what a patient feels in areas of the body below the injury. Transverse myelitis may also disrupt the transmission of electrical signals to the spinal nerves, leading to various issues with movement and sensory ability.

Multiple sclerosis, or MS, is a disease of the central nervous system. The central nervous system is made up of the brain and spinal cord. Both have nerve fibers that are wrapped in a myelin sheath. In MS, the myelin sheath becomes inflamed and gradually is destroyed. With the destruction of the myelin sheath comes an array of symptoms that may include numbness or tingling, balance problems, weakness, muscle spasms, and blurred vision.

Multiple Sclerosis (MS) is a neurologic disease that affects the Central Nervous System (CNS) through cellular immune response and the demyelination of CNS white matter (McCance et al., 2014, pp. 630–633). The initial causes of MS are unknown however, it is believed that it could possibly be due to an immune response to an initiating infection or an autoimmune response to CNS antigens on the myelin itself (Brück, 2005) (Miljković and Spasojević, 2013). MS is a result of the degradation of the myelin sheath surrounding neurons and therefore disrupts the transmission of action potentials along these cells. MS can display itself in the form of symptoms ranging from muscle weakness to trouble with sensation and coordination (NHS, 2016). The degradation of myelin leads the body to attempt to remyelinate the neurons, a process that in turn leads to the thickening of the cell by glial cells and this causes lesions to form (Chari, 2007). It is this thickening (sclerae) from which the disease gets its name. Sufferers of MS can either have a relapsing type of MS, in which there are episodes that lead to the worsening of symptoms for a period of time, or a progressive type of MS where symptoms gradually progress and worsen (McCance et al., 2014, pp. 630–633).

MS is an inflammatory demyelinating condition. This means it is caused by damage to myelin – a fatty material that insulates nerves, acting much like the covering of an electric wire. Myelin allows a nerve to transmit its impulses rapidly. It is the speed and efficiency with which these impulses are conducted that permits smooth, rapid and coordinated movements to be performed with little conscious effort. (3)