Multiple Sclerosis (MS) is a disease that
affects the successful transmission of messages to the brain causing a variety
of problems for its victims. Scarring or sclerosis caused by inflammation of
the protective tissue surrounding the central nervous system in multiple places
interfere with a person’s ability to tell the body what to do. However, it is
important to remember that MS affects each individual differently, and that
there are several new treatments that cause MS to go into remission allowing
people with MS to continue working and socializing normally.
What are the causes of MS?(top
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Causes: There appear to be multiple possible causes for MS. These include
autoimmune dysfunction, heredity, viruses and environmental exposure to various
chemicals such as zinc oxide and Agent Orange. Although family members of
people with MS have a slight predisposition to the disease, it is not directly
inherited.
What are the symptoms of MS?(top
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The symptoms of MS can be diverse and
confusing, often coming and going without any pattern, making it difficult to
diagnose, even today. Symptoms of MS vary greatly from one person to another,
depending on which nerves are affected and to what degree. Initial symptoms can
include:
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Fatigue
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Bowel and bladder
problems
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Sexual dysfunction
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Dizziness
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Lack of coordination
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Visual problems
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Muscle weakness, spasticity and/or stiffness
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Numbness, prickling, or "pins and needles"
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Moderate to severe pain
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Unclear speech
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What is the course of the disease?(top
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Course of the Disease: Despite the fact that the disease is progressive,
patients can continue working for years or even decades after their initial
diagnosis, or they can have long periods of remission followed by periods of
disability.
Throughout the course of the disease, patients may need to be in a wheelchair
for periods, and may also have varying degrees of bladder control. They can
also experience mental confusion at times.
The course of the disease has been classified into four categories as follows:
1. Relapsing-Remitting
Characteristics: People with this type of disease feel well for periods
followed by periods of when the disease returns. This is the most common form
of MS at the time of the initial diagnosis. Approximately 85% of MS patients
have this type of MS.
2. Secondary-Progressive
Characteristics: People with this type of MS experience an initial period of
relapsing-remitting disease (see above) followed by a steadily worsening
disease course. The patient may or may not have periods where the disease
plateaus or goes into remission. Prior to the discovery of disease-modifying
drugs in the last few years, 50% of people with relapsing-remitting MS tended
to develop this form of the disease within 10 years of their initial diagnosis.
It is too early to tell what effect new drugs will have on the long-term
effects of the disease, but the outlook is hopeful.
3. Primary-Progressive
Characteristics: People with this type of MS experience a slow but nearly
continuous worsening of their disease with no remissions. However, there are
variations in rates of progression over time, occasional plateaus, and
temporary minor improvements. This type of the disease appears in approximately
10% of cases.
4. Progressive-Relapsing
Characteristics: People with this type of MS experience a steadily worsening of
the disease from the onset and have clear acute flare-ups, with or without
recovery. In contrast to relapsing-remitting MS, the periods between relapses
are characterized by continuing disease progression. This type of MS appears in
approximately 5% of cases.
Who gets MS?(top
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Geography: In the U.S., MS occurs more frequently in states that are above the
37th parallel than in states below it. From east to west, the 37th parallel
extends from Newport News, VA, to Santa Cruz, and runs along the northern
border of North Carolina to the northern border of Arizona and across
California. The MS prevalence rate for the region below the 37th parallel is 57
to 78 cases per 100,000 people. The prevalence rate for those above the 37th
parallel is 110 to 140 cases per 100,000 people. It is interesting to note that
when an individual born in an area with a higher risk of developing MS moves to
an area of lower risk, the person acquires the risk of the new home if the move
occurs prior to adolescence.
Epidemiologists have identified Disease Clusters of MS in several locations,
including the Faroe Islands, a Danish possession between Norway and Iceland;
Galion, Ohio; DePue, Illinois and Rochester, New York. The presence of zinc
oxide in these locations is suspected of being a factor, but no one really
knows why MS occurs more frequently in these places.
Race: MS is more common among Caucasians, particularly those of Northern
European ancestry, than other races, and is almost unheard of in some
populations, such as the Inuit.
Gender: MS is two to three times as common in women than in men.
Age: Most cases are diagnosed in people between 20 and 40 years of age. It has
historically been viewed as an adult-onset disease, and the majority of the
research has targeted adults. However, initial symptoms have been seen as early
as 13 months old, with diagnosis as young as two years of age.
How is MS diagnosed?(top
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Diagnosis: Historically MS has been very difficult to diagnose. Today more
accurate diagnosis is available using Magnetic Resonance Imaging (MRI).
How is MS treated?(top
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Treatment: The management of MS has been substantially advanced by the
availability of two new classes of drugs: immunomodulators and
immunosuppressants. Immunomodulators include Betaseron, Avonex, Rebif and
Copaxone. Immunomodulators include Novantrone, which is used for the most
severe cases. These drugs can cost from $10,000 to $30,000 per year.
For decades it was believed that once the protective coating around the central
nervous system was lost, it could not be regrown. It is now known that this is
not true and that it does grow back. Unfortunately, studies have demonstrated
that in people with MS the protective coating is destroyed much faster than it
is regrown. In recent studies, statins, which are a class of inexpensive
cholesterol fighting drugs, have been shown to be effective in treating MS.
Why should people with MS worry about urinary tract infections?
Urinary Tract Infections (UTIs):(top
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UTIs are a serious health problem affecting millions of people with our without
MS each year. At some point in their illness, people with MS may experience
bladder problems and UTIs. Symptoms of a UTI can include fever, shaking chills,
sweats, lower abdominal pain, back pain, pain around the urethra and cloudy,
bad-smelling urine. Call your doctor as soon as you experience these symptoms.
UTIs can be treated with oral antibiotics. Click here
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