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What is Multiple Sclerosis?

Multiple sclerosis is a disease of the central nervous system (brain and spinal cord) in which the insulating protective covering (myelin sheath) surrounding the nerves is destroyed or damaged, resulting in interference with the brain’s signals to various parts of the body. Hard or firm scar tissue replaces areas where the myelin has been lost, hence the name multiple sclerosis (multiple scars) in many patients. MS symptoms can be relatively benign in some cases to completely debilitating in other patients, as communication between the brain and other parts of the body is disrupted.

What are the symptoms of MS?

Multiple sclerosis causes a wide variety of symptoms. The most common symptoms are:

- Numbness or tingling
– Unusual fatigue, weakness and exhaustion
– Vision problems
– Poor coordination or difficulty walking
– Slurred speech
– Bladder problems

No two persons with MS will necessarily display the same symptoms, making it difficult to predict the course of the disease for an individual patient. Symptoms may occur suddenly and remain constant, or may continue in a progressive or episodic pattern. The uncertainty and unpredictability of MS makes living very difficult for the victims, their families and friends.

What is the clinical course of MS?

There are several different clinical courses: relapsing-remitting, secondary-progressive, primary-progressive and, rarely, progressive-relapsing. Relapsing-remitting occurs in 85% of newly diagnosed MS patients. Patients will have an attack or relapse, which lasts usually a few weeks, and will have either new symptoms develop, or have symptoms recur or worsen. Patients may return to normal or have permanent remaining symptoms. Secondary-progressive usually develops in about half the patients initially diagnosed with relapsing-remitting MS. In this type the patient slowly and steadily gets worse. There may be an occasional relapse or attack, or perhaps no recurrence of attacks with this type. Primary-progressive MS affects about 15% of all MS patients and the patient worsens steadily without having a relapse or attack. Progressive-relapsing MS is similar to primary-progressive MS in its steady deterioration except that the patient experiences occasional attacks along with the already worsening symptoms.

Statistics About MS

·  Most people experience their first symptoms of multiple sclerosis between the ages of 20 and 40, but a diagnosis is often delayed.

· Symptoms rarely begin before age 15 or after age 60. However, scientists have documented cases of MS in children as young as two and elderly adults.

· Caucasian individuals are more than twice as likely as other races to develop MS.

· In general, women are affected almost twice as much as men; however, among patients who develop the symptoms of MS at a later age, the gender ratio is more balanced. Also, the diagnosis in children before puberty is a 1/1 ratio while after puberty it is 2/1 ratio with more women being diagnosed than men.

· There are currently about 250,000 to 350,000 people in the United States who have been diagnosed with multiple sclerosis.

· There are 2 million people worldwide living with MS

· This estimate suggests that approximately 200 new cases are diagnosed each week.

· MS is five times more prevalent in temperate climates—such as those found in the northern United States, Canada, and Europe—than in tropical regions.

· Furthermore, the age of 15 seems to be significant in terms of risk for developing the disease. Some studies indicate that a person moving from a high-risk (temperate) to a low-risk (tropical) area before the age of 15 tends to adopt the risk (in this case, low) of the new area and vice versa. Other studies suggest that people moving after age 15 maintain the risk of the area where they grew up.

Who contracts MS?

Young adults between the ages of 20 and 40 are most likely to develop MS. The disease is also at least twice as common in women as men, perhaps related to hormonal factors. The incidence of MS is ten times higher for those living above the 40th parallel, worldwide. Most scientists think the cause of MS is “multifactorial”. The person’s genetic heritage, gender, birthplace, age and environment contribute to susceptibility, resistance, and pattern of the course of MS. It is not an inherited disease, in the strict sense, but certain susceptibility does run in families. One theory suggests a common viral infection in your early teens results in the development of an immune response (autoimmune reaction) when one becomes an adult. In this autoimmune process, immune cells mistake myelin for a foreign invader and attack it.

How is MS diagnosed?

To be accurately diagnosed with MS, your doctor will order a complete set of MRI studies, nerve conduction studies and possibly a spinal tap. From those results the doctor will determine if your symptoms are attributable to MS. Currently there is a blood test being developed that will identify MS, hopefully giving many people a chance at early detection and treatment.

Is there a cure for Multiple Sclerosis?

Although no cure exists at present for MS, many symptoms can be relieved and the severity of attacks may be reduced through special treatments called the ABC drugs – Avonex, Betaseron and Copolymer 1. These chemicals regulate the immune response and reduce in about 30% of people the severity of relapses or attacks. Progressive MS symptoms are less responsive to current MS therapies, although there may be a limited role for the interferons in some patients with progressive MS. The MRI has redefined the natural history of MS and has proven an invaluable aid in diagnosing and monitoring the disease. Scientists are now able to visualize and follow the development of MS lesions in the brain and spinal cord using MRI. This ability is a tremendous aid in assessing a person’s response to therapy and can speed the process of evaluating new treatments. Because of these advances, investigators are optimistic that safer and more effective treatments are on the way to unlock the mysteries of MS.

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