Multiple Sclerosis

Multiple sclerosis or MS is a chronic disease. It is most commonly first diagnosed in young adults, although the American Academy of Neurology (AAN) says it can be diagnosed at almost any age. In order to understand this disease, it's first necessary to understand the central nervous system. (Read about "The Brain" "Nervous System")

Ordinarily, electrochemical messages are transmitted between the brain, the spinal cord and the rest of our bodies. These messages help control bodily functions, such as movement, vision, etc.

Nerve cell fibers in the brain and spinal cord are supposed to be insulated by a substance called "myelin." During an MS attack, however, AAN says inflammation or lesions develop in areas of the central nervous system in random patches called plaques. This process is followed by destruction of the myelin. This, in turn, interferes with the transmission of the electrochemical messages. As a result, symptoms of MS develop.

Symptoms

The symptoms of MS can vary from patient to patient in terms of both duration and severity. According to the National Institute of Neurological Disorders and Stroke (NINDS), initial symptoms include:

• blurred or double vision
• red-green color distortion
• potential blindness in one eye (Read about "The Eye")
• muscle weakness in the extremities
• problems with coordination and balance.

Most people with MS also exhibit paresthesias (Read about "Paresthesia"), or transitory and abnormal sensory feelings such as numbness or tingling. Some may experience pain or loss of feeling. (Read about "Chronic Pain") NINDS says about half of the people with MS experience difficulties with concentration, attention, memory and judgment, although generally, MS does not cause severe intellectual impairment.

It's important to remember that many of the above symptoms can also indicate other problems, so anyone experiencing these kinds of symptoms should get medical help as soon as possible.

Types of MS

The National Multiple Sclerosis Society (NMSS) says there are four types of MS. They are:

• relapsing remitting
• primary progressive
• secondary progressive
• progressive relapsing

Relapsing remitting is the most common form of MS, according to NMSS. Some 85 percent of MS patients have this form. It is characterized by periods when the disease is very evident. These periods are called flare-ups, relapses or attacks. After these so-called flare-ups, the disease goes into remission for a period of time.

Primary progressive is a slow progression of the disease. This form is much less common affecting only about 10 percent of patients, according to NMSS. The rate of deterioration will vary depending on the individual, with some improvements occasionally.

Secondary progressive follows a period of relapsing remitting MS. About 50 percent of patients with relapsing remitting MS will progress to secondary progressive MS in 10 years or less. Once it has reached this point, the progression of the disease is relatively steady.

Progressive relapsing is a steady progression of the disease, with periods when the patient suffers acute attacks. Unlike relapsing remitting, there are not periods of recovery when the disease seems to go into remission. NMSS says this is the rarest form of MS, affecting only about 5 percent of patients.

Diagnosis & treatment

Doctors may use several different techniques before determining that symptoms are caused by multiple sclerosis. For example, blood tests may be used to rule out inflammatory diseases or infections that might be producing the symptoms. (Read about "Laboratory Testing") There are also imaging techniques such as MRI. (Read about "MRI - Magnetic Resonance Imaging") This can help doctors see if lesions are present. They also may use MRS (magnetic resonance spectroscopy), to get further information on the brain. According to NINDS, doctors also may study patients' cerebrospinal fluid and an antibody called immunoglobulin G. Since symptoms of MS resemble symptoms of many other diseases and disorders, it's important to see a doctor as soon as you have concerns about this issue.

AAN says the exact cause of MS is unknown. We do know that women are more likely to develop MS than men. In addition, MS is slightly more likely when there is a close relative with the disease. Research has also found evidence that MS is an autoimmune disease, and that attacks may be started or triggered by a virus. (Read about "The Immune System")

Although there's no known cure for MS, there are treatments. The options include:

• corticosteroids - these medications can help ease symptoms and reduce inflammation. Side effects can include weight gain and increased blood pressure.
• beta interferons - these medications can slow progression of the disease. Side effects can include damage to the liver.
• immunosuppressants - these medications help to block the immune system's attack on myelin. Drugs that affect the immune system can lead to a number of different side effects and their use is often monitored carefully.
• synthetic form of myelin basic protein - this type of medication can reduce the rate of relapse.
• plasma exchange (plasmapheresis) - this procedure involves separating and removing plasma from the patient's other blood components, then returning the other blood components.

Medications which can relieve symptoms of progressive MS include corticosteroids, tranquilizers and muscle relaxants. Physical therapy can help patients with all forms of MS as well. (Read about "Rehabilitation") In some extreme cases of tremors, surgery can be an option, according to NINDS. (Read about "Neurosurgery") Patients should also be aware of how their environment affects them. For example, according to NINDS, heat may cause temporary worsening of many MS symptoms. In addition, some studies have shown that MS symptoms stabilize during pregnancy. Because each individual is different, however, it's important to discuss all concerns and treatment options with your doctor.

Related Information:

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