Claudia medical history has pointed towards demyelination as a major pathological feature responsible for the listed signs and symptoms said to affect her and made her visit the neurologist. The major initial symptoms noted by Claudia are that of the facial numbness on the chin and lower lip. This later seen to be referred to the upper jaw and then towards the eyes. All these events which occurred over several months and after the usage of certain medication a strong link with a chronic neurological degeneration which was not taking into consideration as earlier as possible in order to address the issue before the development of the various forms of deficiency. The information from the Claudia case pointed to the fact that there’s an extensive neurological damage from the spinal cord to the brain. The information is revealed by the result of the MRI and the Cerebral Spinal fluid analysis result.
The sign and symptoms are related to a state of multiple sclerosis simply because of the damage to the insulating cover of the nerve cells hence affecting the communication that is meant to exist. This result in a prolonged state of various signs and symptoms that tend to relate with the physical, mental, and psychiatric issue. As Claudia noted in the medical history of the condition, there are some state of relapse whereby she will feel that symptoms are subsiding making her feel there is no more problem. Another related factor towards supporting this perception of the fact that the associated signs and symptoms are related to the state of sclerosis is the view of various forms of attacks that are associated with the condition. It should also be noted that signs and symptoms associated with the demyelination usually occur at the region of the lesion. It is usually not a generalized condition. That is why symptoms usually occur independently.
The neurological changes associated with all symptoms are focused upon below. The symptoms noticeable by the woman are feeling of numbness in her chin and lower lip, intense stabbing pulsating pain from the tooth which was referred to the nose, blurry vision occurring several days after initial pain with associated left side, urinary urgency, and parenthesis with trouble keeping appropriate balance. It is important to understand that feeling numbness on the chin is related to the nerve supplying that region of the face which is the mandibular nerve. This nerve also supply the lower jaw teeth hence any problem with the lower mandibular teeth can also be associated with the problem of the jaw because of sensory nature of the nerves that relates to the sensory aspect of the teeth.
For instance, the demyelination associated with this nerve will be related to the nuclei associated with the mandibular nerve and it sensory aspect. The demyelination reduces the spread of information that may be related to the nerve tissue. Mental nerve which is the branch of the mandibular nerve supplying the chin and lower lip is the major branch that is affected. This nerve also supplies the lower front teeth hence any issue with this nerve will be noted on all the part or tissue that is usually supplied. At the neurological level, there is the slowness of the neuronal response which makes it as if the nervous tissues is already anesthetize hence creating the feeling of numbness that is being noted by the patient at that part of the face.
The intense stabbing pulsating pain is an effect that is usually noted on a non-vital tooth with some level of infection and inflammation. Since the nerve supplying the tooth relates with the pulp of the tooth, any problem right from this region can be noted as a pulsating pain that can be referred down to the nose. However, since there is no pathology associated with the implicating teeth, there is likelihood of a problem with the nerve supplying that region of oral tissue. Since the nerve supplying the region is also enclosed by the myelin sheath, a problem with myelin producing cells affects the regeneration of the myelin sheath once destroyed. The rate of destruction can be noted by the laboratory findings showing an increased level in the amount of myelin protein within the cerebral spinal fluid analysis conducted.
The problem with the visual pathway noted by the signs and symptoms could be caused by various forms of problems such as the gliomas, meningioma, aneurysm and demyelinating disorders (Esteban Cheng-chin, Lama Chahine, Eric Baron & Alexander Rae Grant). However, the examination conducted clearly revealed that the lesion affects the optic nerve simply because of the notable signs and symptoms of loss of the pupillary light reflex. The optic neuritis which is the inflammation of the optic nerve is one major neural problem usually linked with the multiple sclerosis and this is one of the problems identified to be present in this patient when the doctor examined her (Esteban Cheng-chin, Lama Chahine, Eric Baron & Alexander Rae Grant). The pathophysiology of this is that which relates to the damage caused by the lesion hence affects the efficient transmission of the nerve impulses simply because it is the myelin sheath that is usually affected (NHS). Apart from in the disturbance of the neural transmission caused by the optic neuritis, this can also result blurred vision occurrence, graying of vision, and blindness in one eye.
Double vision noted in this patient is another sign and symptoms of multiple sclerosis and some other commoner conditions. This problem usually occurs especially when there are problems affecting the neuromuscular junction of some cranial nerves. This is a resultant effect of the lack of efficient neuronal transmission coming from demyelination process of the nerves over certain period of time (Genetic Home Reference). The problem is noted to be towards the right hence showing that one of the optic pathways is already affected hence no full coordination again. This is also noted to affects the sustenance of balance by the affected individual.
There are also peri-ventricular lesions and right parietal lesions noted on the MRI scan. This is a pointer towards the neurodegenerative state of the brain and spinal cord. Since the nervous coordination is mainly from such parts, affectation of such regions can show the degree or level of damage or demyelination caused by the condition (NHS). The associated urinary urgency and noted lower limb paraesthesia which later affected her are another major symptoms which supported the hypothesis of breakage in myelin covering of the nerves. This results from the fact that mid spinal cord play important role in the control of those functions.
Having considering those signs and symptoms that affected Claudia over that period mentioned within her medical health history, we can simply conclude that the condition is that seen with multiple sclerosis hence she can be diagnosed of multiple sclerosis.
Esteban Cheng-chin, Lama Chahine, Eric Baron & Alexander Rae Grant. Comprehensive Review in Clinical Neurology: A multiple choice question book. Wolters Kluer Health.
Genetic Home Reference. What is multiple sclerosis. Multiple sclerosis. conditions. (www.ghr.nlm.nih.gov/condition/multiple sclerosis.)
NHS. Symptoms of multiple sclerosis. Conditions. (www.nhs.uk).