Multiple Sclerosis (MS)
Multiple Sclerosis is an unpredictable, chronic disease of the
central nervous system. It affects between 350,000 and 500,000 people
in the United States and is one of the main causes of adult disability.
It is more prevalent in certain regions of the world. It is an autoimmune
disease, meaning it causes a person's own immune system to mount
a destructive response against his or her own body. In MS, this
immune response is against the myelin fibers, a fatty substance
that insulates the nerves and helps transmit nerve impulses between
the brain and other parts of the body. Plaque forms when the myelin
sheath is destroyed, a process called demyelination. Without the
myelin, signals are disrupted or halted. The symptoms and the course
of the disease vary widely, partly due to the location of scar tissue
and to the extent of demyelination.
There is no known cause of MS. The course of the disease varies
with each person, leaving much uncertainty and unpredictability
as to what is to come. The role of trauma in causing MS or in triggering
attacks is controversial. Traumatic events are most likely caused
by MS symptoms, rather than being a precipitating factor. Many different
viruses have been suggested as a cause of MS but there is no definitive
evidence linking any one virus to the disease. Multiple Sclerosis
is not directly inherited, nor is it contagious or fatal. Epidemiology
surveys show that the risk increases if a close family member has
MS, but is still relatively low. The average life expectancy after
onset is about 50 years.
TYPES OF MULTIPLE SCLEROSIS:
Relapsing-Remitting: acute attacks called exacerbations,
followed by full or partial remission of symptoms
Primary Progressive: gradual but steady progression of disability,
without any obvious relapses or remissions
Secondary Progressive: initially begins with relapsing-remitting
course but evolves into progression at a variable rate
Progressive Relapsing: characterized by a steady progression
in disability with acute attacks that may or may not be followed
by some recovery
Diagnosis usually occurs (90%) between the ages of 16 and 60 years.
Rarely is MS diagnosed in childhood or after age 60. Depending on
the area of the brain where the myelin is attacked, patients may
start with one or two symptoms. As the disease progresses, the number
of symptoms can increase. They can develop or worsen over several
hours, days, or even weeks. The most common early symptoms include
tingling sensations, numbness, loss of balance and blurred or double
vision. Less common symptoms are slurred speech, sudden onset of
paralysis, and lack of coordination. As the disease progresses symptoms
may include heat sensitivity, fatigue, a change in thinking or perception
and sexual disturbances. Patients do not generally have all of these
Primary Symptoms are a direct result of demyelination and
include weakness, tremors, numbness, loss of balance, vision impairment,
paralysis, and bladder or bowel dysfunction. These symptoms can
be helped by medications and rehabilitation.
Secondary Symptoms are the result of primary symptoms. These
might include urinary tract infections due to bladder dysfunction
or muscle weakness from disuse due to inactivity due to MS. These
symptoms can be treated but it is best to avoid them by treating
the primary symptoms.
Tertiary Symptoms are social, psychological and vocational
complications associated with the primary and secondary symptoms.
Depression is a good example of a tertiary symptom and is a common
problem in MS patients.
Fatigue is the most common complaint of MS patients. Almost 78%
of patients complain of extreme fatigue in the late afternoon that
improves by early evening. Modifying one's activities, occupational
therapy and medication can be helpful in the case of extreme fatigue.
There is no single tool for a positive diagnosis of MS. As many
as ten percent of diagnosed patients actually have another condition
that mimics MS. Listed below are some tools that are commonly used
during the diagnostic process.
- MRI (please link) magnetic resonance imaging) can show
evidence of scar tissue in the deep parts of the brain or spinal
cord that characterize MS.
- Spinal Tap (Lumbar Puncture) is sometimes used to examine
cerebrospinal fluid but is not always considered necessary.
- Evoked Potentials (please link) (electrical tests of
the nerve pathologies), can confirm whether MS has affected the
visual, auditory or sensory pathways.
- Blood Tests may be used to rule out other conditions
but MS cannot be detected in the blood.
Other diagnostic procedures include objective evidence of central
nervous system disease from a neurological exam, two or more episodes
of symptoms, lasting at least 24 hours and occurring one month apart,
or a progressive course of signs and symptoms lasting over six months.
Eliminating other possible causes for the symptoms also helps in
the diagnosis of Multiple Sclerosis. The expertise of the physician
in taking the medical history of a patient is of vital importance
in an accurate diagnosis.
Early treatment is necessary to delay disability, by decreasing
injuries to the nervous system caused by the disease. There are
two categories of treatment. One is symptom management and the other
is treatment that actually changes the course of the disease by
modifying the number and severity of attacks and the progression
of the disability. Significant progress has been made in both over
the last decade. Since 1993, there have been five new drugs that
can impact the underlying disease in common forms of MS, though
none can completely stop or reverse it. Avonex, Betaseron
and the most recent, Rebif, (interferon drugs) and Copaxone
are used to prevent the frequency of exacerbations and the size
and number of brain lesions. These medications are taken on a regular,
preventive basis. Other medications available or under investigation
for use in addition to these "disease modulating medications"
include Novantrone, Imuran, Methotrexate, and Cytoxan.
A patient and physician generally work together to determine which
is the best medical treatment for each individual to use.
Additional medications can be prescribed to help alleviate specific
symptoms. Other types of treatment include:
- Numbness and tingling: exercise, healthy diet, acupuncture
- Tremors: physical therapy, exercise, adaptive equipment,
- Balance: physical therapy, exercise, adaptive equipment,
- Vision Loss: eye patch, medication
CAM is short for complimentary and alternative methods. Complimentary
is in addition to conventional treatments and alternative is instead
of conventional methods of treatment. Approximately 90% of MS patients
who use CAM also use conventional methods. As in all forms of treatment
for MS, communication with one's physician is essential when using
CAM. Some components of CAM include:
- Health and well-being: diet, exercise, herbs, vitamins,
and hyperbaric oxygen
- Stress: massage, reflexology, meditation, tai chi, yoga
- Symptom management: acupuncture, homeopathy
Most people live happy, productive, successful lives with MS, learning
to take charge in dealing with their body, their doctor, their therapy
and their family and friends.
"But You Look So Good" Support Group
Hartville Village Hall
202 West Maple
Contact: Jay (330) 699-9507
Meets: The 2nd Thursday of the month 7:00 PM
A group for persons with hidden disabilities
MSOhio On-Line Group
MS World private chat room
Contact: Sharon at firstname.lastname@example.org
Meets: Every Tuesday 11:00 AM
You can also find information on finding an "e-mail Pal"
National MS Society, Ohio Buckeye Chapter
6155 Rockside Rd, Suite 202
Independence, Ohio 44131-2217
Fax: 330-434-9223 or 216-696-2817
Massillon Support Group
They meet at area restaurants in Massillon, Ohio
Contact: Cindy (330) 833-2240 or Jack (330) 833-0614
Meets: The 2nd Monday of the month 10:00am
National Multiple Sclerosis Society
733 Third Avenue
New York, New York 10017
1-800-Fight MS (1-800-344-4867)
"The mission of the National Multiple Sclerosis Society is
to end the devastating effects of MS. The Society and its network
of chapters nationwide promote research, educate, advocate on critical
issues, and organize a wide range of programs including support
for the newly diagnosed and those living with MS."
MS Warriors - Standing Tall Together
4105 Holiday St. NW
Canton, Ohio 44718
Contact: Jainyl 330-454-5482
Meets: The 4th Tuesday of the month at 7:00 pm
If you are interested in starting a self-help group in your area
or need any additional information about a current group or National
MS Society programs and services, we can be reached by calling 1-800-667-7131
or by e-mailing our Self-Help Group Coordinator, Wendy Vaught at
2009 MS Walk Sites
The Ohio Buckeye Chapter of the National Multiple Sclerosis Society
is proud to be a source of information about multiple sclerosis.
Our comments are based on professional advice, published experience
and expert opinion, but do not represent therapeutic recommendations
or prescriptions. For specific information or advice, consult a
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