Multiple Sclerosis (MS) is neurodegenerative disorder that affects the central nervous system (brain and spinal cord). The nerves of the central nervous system are typically covered in a fatty sheath called myelin. This sheath improves the conduction of the speed of nerves a generally helps keep them in good health.
In individuals with MS the myelin degrades, slowing electrical impulses and interfering with functions of the central nervous system, such as balance, walking, vision, speech and memory.
Symptoms of MS usually begin in early or middle adulthood, and it is more common in Caucasians and women.
The cause of MS is not know, however, some researchers feel it is an autoimmune disorder or an infection whereby the body’s own immune system attacks the myelin in a process know as demyelination. This leaves scars, or plaques on the nerves that can be identified by MRI and is an important feature in making a diagnosis.
There may be a weak genetic link to MS. One feature of MS is its tendency to have periods of worsening symptoms (exacerbation) and periods remission.
Symptoms can vary significantly in both severity and range of symptoms experienced. Some may include:
- Weakness, numbness and tingling
- Balance and co-ordination problems
- Fatigue, dizziness
- Visual disturbances caused by Inflammation of the optic nerve (optic neuritis)
- Speech disorder
- Cognitive disorder that may include memory loss, impaired judgment and attention deficit
TYPES OF MULTIPLE SCLEROSIS
- Relapsing Remitting MS
- Most MS individuals start with this type of MS. It is characterized by multiple periods of flare-ups followed by partial or complete remission. This stage may last for many years or even decades, often with periods of little or no symptoms.
- Primary Progressive MS
- Some MS individuals start with progressive increase in level of disability from the outset, rather than periods of remission.
- Secondary Progressive MS
- After many years of Relapsing Remitting MS an individual may show a decline with longer periods of flare-ups that do not fully recover between attacks.
It is not unusual for MS to go undiagnosed for many years. Often it is about putting the clinical picture together retrospectively. Other important tests include:
- MRI: to identify plaques
- Evoked Potential Test: which measures the speed of nerve transmission
- Lumbar Puncture: to examine the fluid surrounding the brain and spinal cord (cerebrospinal fluid) for antibodies
Individuals with MS need to be under the care of a neurologist. Medical management is required in advancing stages or during relapsed.
The focus of chiropractic is to support the nervous system and improve muscle balance. The effectiveness of any care may be difficult to monitor due to the episodic nature of the symptoms.
Vit D deficiency is currently being investigated as a possible cause of MS. Other supplements such as Omega 3 fatty acids and anti-oxidants may have a role with MS.
For more information go to www.msaustralia.org.au
The most common form of cranial neuralgia is Trigeminal Neuralgia, which affects the fifth cranial nerve (Trigeminal Nerve). This condition is also known as Tic Douloureux.
The trigeminal nerve is the largest cranial nerve and receives sensation from the entire face as well as controlling motor functions such as biting, chewing and swallowing.
Individuals with Trigeminal neuralgia experience severe electric-shock-like pain that shoots into the face along the distribution of the trigeminal nerve or one of its branches. Pain usually affects one side of the face.
Pain typically lasts for a few seconds or a few minutes, but is usually frequent and re-occurring, and at times constant. Pain is often debilitating and can be bought on by simple activities such as chewing, shaving, brushing teeth or even wind blowing onto face.
Trigeminal neuralgia is often seen in patients with Multiple Sclerosis. Other causes include pressure or irritation to the nerve due to a swollen blood vessel or tumour. However, most commonly there is no clear cause of the neuralgia.
An individual that presents with trigeminal neuralgia will likely need a MRI, CT scan and blood tests to determine the cause of the face pain.
This may include medications such as anti-seizure drugs, muscle relaxants and anti-depressants. Various surgical procedures (depending on the cause of the neuralgia) may also be used.
To date there a no large studies investigating the effectiveness of chiropractic care with trigeminal neuralgia. There are, however, case studies that show chiropractic care may improve outcomes for these patients.1
Often the upper cervical or temporomandibular (jaw) joints show dysfunction that can cause pressure and irritation and act as a trigger for the neuralgia.
It has been our experience that these patients may improve with gentle chiropractic care and TMJ pacification exercise.