Multiple sclerosis (MS) is a potentially debilitating disease in which your body’s immune system eats away at the protective sheath that covers your nerves. This interferes with the communication between your brain and the rest of your baody. Ultimately, this may result in deterioration of the nerves themselves, a process that’s not reversibile.
Symptoms vary widely, depending on the amount of damage and which nerves are affected. People with sever cases of MS may lose the ability to walk or speak. MS can be difficult to diagnose early in the course of the disease because symptoms often come and go – sometimes disappearing for months.
There’s no cure for MS. However treatments can help treat attacks, modifiy the course of the disease and treat symptoms.
There’s no cure for MS. However treatments can help treat attacks, modify the course of the disease and treat symptoms.
Signs and symptoms of MS vary widely, depending typically occurs on one side of your bady at aa time or the bottom half of your body.
- Numbness or weakness in one or more limbs, which typically occurs on one side of your body at a time or the bottom half of your body
- Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement (optic neuritis)
- Double vision or blurring of vision
- Tingling or pain in parts of your body
- Electric-shock sensations taht occur with certain head movements
- Tremor, lack of coordination or unsteady gait
Most people with MS, particularly in the beginning stages of the disease, experience relapses of symptoms, which are followed by periods of complete or partial remission. Signs and symptoms of MS often are triggered or worsened by an increase in body temperature.
The cause of MS is unknown. It’s believed to be an autoimmune disease, in which the body’s immune system attacks its own tissues, In MS, this process destroys myelin – the fatty substance that coats and protects nerve fibers in the brain and spinal cord.
Myelin can be compared to the insulation on electrical wires. When myelin is damaged, the messages that travel along that nerve may be slowed or blocked.
Doctors and researchers don’t understand why MS develops in some people an dnot otehrs. A combination of factors, ranging from genetics to childhood infections, may play a role.
These factors may increase your risk of developing MS:
- Being beteween the ages of 20 and 40. MS can occur at any age, but most commonly affects people beteween these ages.
- Being female. Women are about twice as likely as men are to develop MS.
- Having a family history. If one of your parents or siblings has had MS, you have a 1 to 3 percent chance of developing the disease – as compared with the risk in the general population, which is just a tenth of 1 percent. But the experiences of identical twins show that heredity solely by genetics, identical twins would have identical risks. However, an identical twin has only a 30 percent chance of developing MS if his or her twin already has the disease.
- Having certain infections. A variety of viruses have been linked to MS. Currently the greatest interest is in the association of MS with Epstein-Barr virus, the virus that causes infectious mononucleosis. How Epstein-Barr virus might rsult in a higher rate of MS remains to be clarified.
- Being white. white people, particulary those whose families originated in northen Europe, are at hightest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.
- Living countries with temperate climes. MS is far more common in Europe, southern Canada northen United States, New Zeland and southeastern Australia. The risk seems to increase with latitude.
A child who moves from a high-risk area to a low-risk area, or vice versa, tends to have the risk level associated with his or her new home area. But if the move occurs after puberty, the young adult usually retains the risk level associated with his or her first home.
- Having certain other autoimmunes diseases. You’re very slightly more likely to develop MS if you have thyroid disease, type 1 diabetes or inflammatory bowel disease.
In some cases, people with MS may also develop:
- Muscle stiffness or spasms
- Paralysis, most typically in the legs
- Problems with bladder, bowel or sexual function
- Mental changes, such as forgetfulness or difficultes concertrating
TESTS AND DIAGNOSIS
There are no specific tests for MS. Ultimately, the diagnosis relles on ruling out other conditions that might produce similar symptoms. Your doctor may base a MS diagnosis on the following:
Analysis of your blood can help rule out some infections or inflammatory diseases taht have symptoms similar to MS.
Spinal tap (lumbar puncture)
In this procedure, a doctor or nurse removes a small sample of cerebrospinal fluid from within your spinal canal for laboratory analysis. This sample can show abnormalities associated with MS, such as abnormal levels of white blood cells or proteins. This procedure can also help rule out viral infections and other conditions that can cause neurological symptoms similar to those of MS.
This test uses a powerful magnetic field and radio waves to produce detailed images of internal organs. MRI can reveal lesions, indicative of the myelin loss on your brain and spinal cord. However, these types of lesions can also be caused by other conditions, such as Lyme disease, so the presence of these lesions isn’t definitive proof that you have MS.
During an MRI test, you lie on a movable table taht sides into a large, tube-shaped machine, which makes loud tapping or banging noises during the scans. Most MRIs take at least an hour. White the test is painless, some people feel claustrophobic inside the machine. Your doctor can arrange for a sedative if necessary.
You may also receive an intravenous dye taht may help highlight “active” lesions. This helps doctors know whether your disease is in an active phase, even if no symptoms are present. Newer MRI is in an active phase, even greater detail about the degree of nerve fiber injury or permanent myelin loss and recovery.
Newer MRI techniques may help with diagnosing MS. They include:
- Magnetic resonance spectroscopy (MRS). This provides information about the brain’s biochemistry.
- Magnetization transfer imaging (MTI). MTI can detect abnormalities before lesions are visible on standard MRI scans.
- Diffusion tensor imaging (DTI). This technology provides 3-D images of demyelinated area of the brain, which are useful in determining disease progression.
- Functional MRI (fMRI). This is used during cognitive performance tests.
Evoked potential test
This test measures the electrical signals sent by your brain in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli, in which short electrical impulses are applied to your legs or arms.
TREATMENTS AND DRUGS
There is no cure for MS. Treatment typically focuses on startegies to treat attacks, to modify the course of teh disease and to treat symptoms. Some people have such mild symptoms that no treatment is necessary.
Strategies to treat attacks
- Corticosteroids: the most common treatment for MS, corticosteroids reduce the inflammation taht spikes during a relapse. Exaples include oral prednisone and intravenous methylprednisolone. Side effects may include increasd blood pressure, mood swings and weight gain. Long-term use can lead to cataracts, high blood sugar and increase risk of infections.
- Plasma exchange (plasmapheresis): this procedure looks a little like dialysis as it mechanically separates your blood cells from your plasma, the liquid part of your blood. Plasma exchange is sometimes used to help combat severe symptoms of MS relapses in people who aren’t responding to intravenous steroids.
Strategies to modify the course of the disease:
- Beta interferons: these types of drugs – such as Avonex, Betaseron, Extavia and Rebif – appear to slow the rate at which MS symptoms worsen aver time. Interferons can tests to monitor your liver enzymes.
- Glatiramer (Copaxone): doctors believe that glatiramer works by blocking your immune system’s attack on myelin. You must inject this drug subcutaneously once daily. Side effects may include flushing and breath after injection.
- Fingolimod (Gilenya): An oral medication given daily, this works by trapping immune cells in lymph nodes. It reduces attacks of MS and short-term disability. To take this drug, you’ll need to have your heart rate monitored for six hours after the first dose because teh first dose can slow your heartbeat (bradycardia). You’ll also need to be immune to the chickenpox virus (varicella-zoster virus). Other side effects include high blood pressure and visual blurring.
- Natalizumab (Tysabri): this drug is designed to work by interfering with the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. Tysabri is generally reserved for people who see no results from or can’t tolerate other types of treatments. This is because Tysabri increases the risk of progressive multifocal leukoencephalopathy – a brain infection that is usually fatal.
- Mitoxantone (Novantrone): this immunosuppressant drug can be harmful to the heart, and it’s associated with development of blood cancers like leukemia, so it’s usually used to treat severe, advanced MS.
Strategies to treat symptoms
- Physical therapy: a physical or occupational therapist can teach you stretching and strengthening exercise, and show you how to use devices that can make it easier to perform daily tasks.
- Muscle relaxants: if you have MS, you may experience painful or uncontrollable muscle stiffness or spasms, particularly in your legs. Muscle relaxants such as baclofen (Lioresal) and tizanidine (Zanaflex) may improve muscle spasticity. Baclofen may increase weakness in the legs. Tizanidine may cause drowsiness or a dry mouth.
- Medications to reduce fatigue: drugs such as amantadine (Symmetrel) may help reduce fatigue.
- Other medications: Medications may be also be prescribed fro depression, pain and bladder or bowel control problems taht may be associated with MS.
A number of other drugs and procedures such as stem cell transplatation to trreat MS are under investigation.
LIFESTYLE AND HOME REMEDIES
These steps may relieve some symptoms of MS:
- Get plenty of rest: Fatigue is common symptom of MS, and although it’s generally unrelated your activity level, rsting may make you feel less tried.
- Exercise: Regular aerobic exercise may offer some benfits if you have mild to moderate MS. Benefits include improved strength, muscle tone, balance and coordination, and help with depression. Swimming is a good option for people who are bothered by heat.
- Cool down: MS symptoms often worsen when your body temperature increases. Cool baths reduce your core temperature, especially if you submerge your upper torso.
- Eat a balacend diet: Eating a healthy, balanced diet can help keep your immune system strong.
- Relieve stress: Because stress may trigger or worsen signs and symptoms, try to learn to relax. Activities such as yoga, tai chi, massage, meditation or deep breathing – or just listening to music – might help.
COPING AND SUPPORT
As is true with other chronic diseases, living with MS can place you on a roller coaster of emotions. Here are some suggestions to help you even out ups and downs:
- Maintain normal daily activities as best you can.
- Stay connected to friends and family.
- Continue to pursue hobbies that you enjoy and are able to do.
If MS impairs your ability to do things you enjoy, talk with your doctor about possibile ways to get around the obstacles.
Remembere that your physical health can affect your mental health. A counselor or therpist may help you put things in perspective, as well as teach you coping skills and relaxation techniques taht may b ehelpful.
Sometimes, joining a support group, where you are can share experiences and feelings with other people who have similar concerns, is a good approach. Ask your doctor what support groups are available in your community.