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A look at Multiple Sclerosis A look at Multiple Sclerosis
In MS, the myelin tissue that acts as insulation for the nerves in the brain and spinal cord deteriorates. The damage caused to... A look at Multiple Sclerosis

by Kimberly Allen R.N.

Multiple sclerosis, or MS, is a chronic degenerative disease that affects the brain and spinal cord.  It affects more than 350,000 people in the US alone.  MS was first diagnosed in 1849 with the earliest description of MS seen in 14th century Holland.

An MRI showing the lesions caused by MS on the brain.

In MS, the myelin tissue that acts as insulation for the nerves in the brain and spinal cord deteriorates.  The damage caused to the myelin tissue causes the transmission of nerve impulses to be slowed or even blocked.  There are four subtypes of MS listed by the National Multiple Sclerosis Society:

1. Relapsing remitting MS which is characterized by unpredictable cycles of symptomatic periods followed by periods without symptoms known as remissions.  A person with relapsing remitting MS can have periods ranging from months to years with no sign of active disease.

2. Secondary Progressive MS occurs in approximately 65% of patients diagnosed with relapsing remitting MS.  The cycle changes toward longer episodes of symptomatic disease and shorter periods of remission.  The average length of time between onset of relapsing remitting MS and progression to secondary progressive MS is 19yrs.

3. Primary progressive MS occurs in approximately 10-15% of patients that do not have any periods of remission after the onset of their first symptoms.  In this type there is a progression of disability from the first signs of symptoms with either no periods of remission or only occasional short episodes of remission.

4. Progressive relapsing MS is the least common of all the subtypes.  Patients with this subtype demonstrate steadily declining neurologic function as well as superimposed attacks.

There is no exact cause for MS documented, however, research indicates it results from a combination of factors including genetic, environmental and infectious factors.  Thhough MS is not believed to be a hereditary disease, the risk of developing MS is greater in relatives of  patients diagnosed with the disease, especially in immediate family, ie parents, siblings and children than the rest of the population.

It is also a fact that people living in the colder climates, like that in the northern US, Canada and Europe have a higher rate of MS than those living in the warmer climates.  There have been some studiesdone that indicate the age of 15 yearrs as being significant in regards to the environment.  The studies show that a child that moves from a cold environment to a warm environment before the age of 15 years will adapt to their new environment and vise versa.  However, if they move after the age of 15 years they retain the same risk as the environment from which they moved.

In general, most patients experience the onset of symptoms between the ages of 20 to 40 years.  MS is also twice as likely to be diagnosed in whites than any other race and women are also twice as likely to be diagnosed with MS than men.

The symptoms of MS vary from patient to patient. Patients can experience any number of neurological symptoms including changes in sensation, muscle weakness and difficulty moving as well as slurred speech and difficulty swallowing.  The symptoms can also vary in severity from mild to debilitating.  Most patients with MS experience periods when the symptoms are acute and worsening – progressively deteriorating neurologic function alternating with periods of remission.

MS is one of those diseases that is difficult to diagnose and sometimes can take years to be correctly diagnosed because the symptoms are similar to those in many other diseases.  There is no single test that can positively diagnose MS, so if you feel you are experiencing symptoms of MS contact your doctor and schedule an appointment for a complete physical exam.  There are also several new technologies available to your doctor to assist in diagnosis.

There is no known cure for MS currently available, however there are several treatments available that can relieve symptoms and possibly slow the deterioration process.  The type of treatment plan your doctor will use depends of the severity if the disease, however in all cases there are 3 common goals – improving the recovery speed from acute attacks, decreasing the number of attacks and /or lessions and slowing the progression of the  disease.  Maintaining good communication with your doctor about your disease and medications is crucial to an effective treatment plan.