الفهرس 
Chapter (I): Multiple sclerosisOnly 14 pages are availabe for public view
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Abstract
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS). The study of risk factors may provide a clue to the etiology of multiple sclerosis (MS), which is still unknown. In this disease, the underlying pathology is consistent with an autoimmune response to some components of myelin, but itis not clear which factors trigger the immune reaction against myelin. Epidemiological studies have suggested a role for genetic and non-genetic risk factors in the etiology of MS. Among non-genetic factors, exposure to infections or chemical and physical agents, vaccinations, hormonal factors, nutritional habits, physical trauma and psychological stress are the most studied.
Among the central nervous system (CNS) demyelinating disorders, multiple sclerosis (MS) is a chronic inflammatory disease which is the most common form of neurologic impairments in young adults. Motor nerve conduction examinations have been performed on a mixed nerve with motor and sensory axons. Osteopenia (OPN) plays a role in the pathogenesis of MS Its expression is increased in the sera of patients with several autoimmune diseases, including MS, and it may. influence the development of autoimmunity through its immunoregulatory and proinflammatory effects. The OPN transcript is abundant in plaques dissected from the brains of MS patients, whereas it is absent in control brain tissue.
Therefore, the current study aimed to assess peripheral demyelination in patients with multiple sclerosis and its affection on patient’s disability. Also, to detect the level of anti Osteopontin antibody in serum of Multiple sclerosis patients & if there is a relation between it and peripheral demyelination. This case control study was conducted on 50 patients with diagnosed with MS patients diagnosed based on revised Mcdonald criteria 2017, who admitted to Menoufia University and 50 volunteers healthy subjects matched age and sex as the control group along two years (2019 - 2020) duration.
All patients were selected according to the inclusion and exclusion criteria.
Inclusion criteria included: MS patients diagnosed by revised Mcdonald criteria 2017.
Exclusion criteria included: Patients with comorbid medical cause of peripheral neuropathy (diabetes mellitus, thyroid disturbance, etc.….) and patients who refused to be involved in the study.
Patients of both groups were subjected to the following: Full neurological history and examination, MRI brain and spinal cord, CSF analysis of oligoclonal band (if needed), Nerve conduction study on both upper & lower limps, Anti osteopontin antibody titre in serum by ELISA technique and EDSS, DN4 scales.