
This
definition was taken from www.answers.com and it’s a good explanation. I can make it simpler. MS strips the protective sheath (Myelin) off
the wires (Axons) in my nervous system.
It affects the signal going down my nerves (wires) just like stripping
the sheath off your cable TV wire would mess that signal up too. So imagine if you had a mouse in your house
you could not kill that was intent on chewing the protective sheath off of the
wires in your house (Central Nervous System).
The Mouse just happens to be my immune system.
So
my body thinks the sheath on my nerves is an enemy. It attacks it thinking it’s a foreign
invader. I take drugs to help slow the
process down. There are no cures for MS.
There
are close to 200 symptoms for MS. Keep
in mind what is described in any description of MS is what they know. They are the author. Generally there are some symptoms common,
balance, weakness, numbness, and heat sensitivity. There are still 196 other symptom possible
for that person.
By
the way, don’t you hate it when people say: “Oh, but you look so good!”
Multiple sclerosis (MS) is a chronic autoimmune
disorder affecting movement, sensation, and bodily functions.
It is caused by destruction of the myelin insulation covering nerve fibers (neurons) in the
central nervous system (brain and spinal cord).
Description
MS is a nerve disorder caused by
destruction of the insulating layer surrounding neurons in the brain and spinal
cord. This insulation, called myelin, helps electrical signals pass quickly and
smoothly
between the brain and the rest of the body. When the myelin is destroyed, nerve
messages are sent more slowly and less efficiently. Patches of scar tissue,
called plaques, form over the affected areas, further disrupting nerve
communication. The symptoms of MS occur when the brain and spinal cord nerves
no longer communicate properly with other parts of the body. MS causes a wide variety
of symptoms and can affect vision, balance, strength, sensation, coordination,
and bodily functions.
Multiple sclerosis affects more than a
quarter of a million people in the
Causes and symptoms
Causes
Multiple sclerosis is an autoimmune
disease, meaning its cause is an attack by the body's own immune system. For
unknown reasons, immune cells attack and destroy the myelin sheath
that insulates neurons in the brain and spinal cord. This myelin sheath,
created by other brain cells called glia, speeds
transmission and prevents electrical activity in one cell from short-circuiting
to another cell. Disruption of communication between the brain and other parts
of the body prevent normal passage of sensations and control messages, leading
to the symptoms of MS. The demyelinated areas appear as plaques, small round
areas of gray neuron without the white myelin covering. The progression of
symptoms in MS is correlated with development of new plaques in the portion of
the brain or spinal cord controlling the affected areas. Because there appears
to be no pattern in the appearance of new plaques, the progression of MS can be
unpredictable.
Despite considerable research, the trigger
for this autoimmune destruction is still unknown. At various times, evidence has
pointed to genes, environmental factors, viruses, or a
combination of these.
The risk of developing MS is higher if
another family member is affected, suggesting the influence of genetic factors.
In addition, the higher prevalence of MS among people of northern European
background suggests some genetic susceptibility.
The role of an environmental factor is
suggested by studies of the effect of migration on the risk of developing MS.
Age plays an important role in determining this change in risk—young people in
low-risk groups who move into countries with higher MS rates display the risk
rates of their new surroundings, while older migrants retain the risk of their
original home country. One interpretation of these studies is that an
environmental factor, either protective or harmful, is acquired in early life;
the risk of disease later in life reflects the effects of the early
environment.
These same data can be used to support the
involvement of a slow-acting virus, one that is acquired early on but begins
its destructive effects much later. Slow viruses are known to cause other
diseases, including AIDS.
In addition, viruses have been implicated in other autoimmune diseases. Many
claims have been made for the role of viruses, slow or otherwise, as the
trigger for MS, but as of 2001 no strong candidate has emerged.
How a virus could trigger the autoimmune reaction is also unclear. There are two main
models of virally induced autoimmunity. The first suggests the immune system is
actually attacking a virus (one too well-hidden for detection in the laboratory),
and the myelin damage is an unintentional consequence of fighting the infection. The
second model suggests the immune system mistakes myelin for a viral protein,
one it encountered during a prior infection. Primed for the attack, it destroys
myelin because it resembles the previously-recognized viral invader.
Either of these models allows a role for
genetic factors, since certain genes can increase the likelihood of
autoimmunity. Environmental factors as well might change the sensitivity of the
immune system or interact with myelin to provide the trigger for the secondary
immune response. Possible environmental triggers that have been invoked in MS
include viral infection, trauma, electrical injury, and chemical exposure,
although controlled studies do not support a causative role.
Symptoms
The symptoms of multiple sclerosis may
occur in one of three patterns:
Between 10–20% of people have a benign type of MS,
meaning their symptoms progress very little over the course of their lives.
Because plaques may form in any part of the
central nervous system, the symptoms of MS vary widely from person-to-person
and from stage-to-stage of the disease. Initial symptoms often include:
Weakness in one or both legs is common, and
may be the first symptom noticed by a person with MS. Muscle spasticity, or
excessive tightness, is also common and may be more disabling than weakness.
Double vision or eye tremor (nystagmus) may
result from involvement of the nerve pathways controlling movement of the eye
muscles. Visual disturbances result from involvement of the optic nerves (optic
neutritis) and may include development of blind spots in one or both eyes,
changes in color vision, or blindness. Optic neuritis
usually involves only one eye at a time and is often associated with movement
of the affected eye.
More than half of all people affected by MS
have pain during the course of their disease, and many experience chronic pain,
including pain from spasticity. Acute pain occurs in about 10% of cases. This
pain may be a sharp, stabbing pain especially in the face, neck, or down the back.
Facial numbness and weakness are also common.
Cognitive changes, including memory
disturbances, depression, and personality changes, are found in people affected
by MS, though it is not entirely clear whether these changes are due primarily
to the disease or to the psychological reaction to it. Depression may be severe
enough to require treatment in up to 25% of those with MS. A smaller number of
people experience diseaserelated euphoria, or abnormally elevated mood, usually after a long
disease duration and in combination with other psychological changes.
Symptoms of MS may be worsened by heat or
increased body temperature, including fever, intense
physical activity, or exposure to sun, hot baths, or showers.
Diagnosis
There is no single test that confirms the
diagnosis of multiple sclerosis, and there are a number of other diseases with
similar symptoms. While one person's diagnosis may be immediately suggested by
her symptoms and history, another's may not be confirmed without multiple tests
and prolonged observation. The distribution of symptoms is important: MS
affects multiple areas of the body over time. The pattern of symptoms is also
critical, especially evidence of the relapsing-remitting pattern, so a detailed
medical history is one of the most important parts of the diagnostic process. A
thorough search to exclude other causes of a patient's symptoms is especially
important if the following features are present:1) family history of neurologic
disease, 2) symptoms and findings attributable to a single anatomic location,
3) persistent back pain, 4) age of onset over 60 or under 15 years of age, or
5) progressively worsening disease.
In addition to the medical history and a
standard neurological exam, several lab tests are used to help confirm
or rule out a diagnosis of MS:
The clinician making the diagnosis, usually
a neurologist, may classify the disease as "definite MS," meaning
the symptoms and test results all point toward MS as the cause. "Probable
MS" and "possible MS" reflect less
certainty and
may require more time to pass to observe the progression of the disease and
the distribution of symptoms.
Treatment
The three major drugs previously approved
for the treatment of MS affect the course of the disease. None of these drugs
is a cure, but they can slow disease progression in many patients.
Known as the ABC drugs, Avonex and
Betaseron are forms of the immune system protein beta interferon,
while Copaxone is glatiramer acetate (formerly called copolymer-1). All three have been
shown to reduce the rate of relapses in the relapsing-remitting form of MS.
Different measurements from tests of each have demonstrated other benefits as
well: Avonex may slow the progress of physical impairment,
Betaseron may reduce the severity of symptoms, and Copaxone may decrease
disability. All three drugs are administered by injection.
Two major clinical studies were recently
completed that focused on the question of whether disease-modifying therapy
known to slow the disease, can postpone the development of clinically definitive MS in high
risk patients. Data presented at the annual meeting of the
Although the ABC drugs stop relapses and
may keep patients in relatively good health for the short-term, their long-term
success has not been proven and they don't work well for patients who have
reached a steadily progressive stage of MS. In the meantime, new approaches to
using current therapies are being researched especially using combinations of
different types of agents when one agent alone is not effective. Clinical
trials are now evaluating the safety and efficacy of
combining cyclophosphamide
(Cytoxan) and methylprednisolone (Medrol) in patients who do not respond to
the ABC drus, and of adding mitoxantrone (Novantrone), prednisone (Prelone),
azathioprine (Imuran),
or methotrexate (Rheumatrex) to beta-interferon for further benefit.
In addition, Miloxzantrone HCI
(novantrone), a drug approved for cancer treatment, has been approved for treating patients
with advanced or chronic multiple scelereosis. In clinical trials, mitoxantrone
reduced the number of relapse episodes and slowed down the disease. Reserved
for progressive forms of MS, it is given intravenously
by a doctor to help maintain mobility and reduce the number of flare-ups.
However, there are serious side effects with the drug including heart problems,
nausea, and
hair thinning.
As reported in the Spring, 2001, Volume 19,
No 2 issue of InsideMS, the FDA recently approved the Copaxone Autoject and the
Mixject vial adapters to help people using Copaxone self administer the drug.
The autoject keeps the syringe steady and hides the needle. The same syringe may be
used for both mixing and injecting with the Mixject vial adapters. A similar
device is available for patients using Betassseron. Some patients are using the
needlefree Biojector 2000 which uses a CO@ cartridge to deliver doses of
medication through the skin. The FDA has not approved its use and patients
should discuss this with their physician for its use with either Copaxone or
Betaseron. Avonex must be injected in the muscle.
Immunosuppressant
drugs have been used for many years to treat acute exacerbations
(relapses). Drugs used include corticosteroids
such as prednisone
and methylprednisone; the hormone adrenocorticotropic hormone (ACTH); and azathioprine.
Recent studies indicate that several days of intravenous methylprednisone may
be more effective than other immunosuppressant treatments for acute symptoms.
This treatment may require hospitalization.
MS causes a large variety of symptoms, and
the treatments for these are equally diverse. Most symptoms can be treated and
complications avoided with good care and attention from medical professionals.
Good health and nutrition
remain important preventive measures. Vaccination
against influenza
can prevent respiratory complications, and contrary to earlier concerns, is not
associated with worsening of symptoms. Preventing complications such as pneumonia, bed
sores, injuries from falls, or urinary infection requires attention to the primary problems
which may cause them. Shortened life spans with MS are almost always due to
complications rather than primary symptoms themselves.
Physical therapy helps the person with MS
to strengthen and retrain
affected muscles; to maintain range of motion to prevent muscle stiffening; to
learn to use assistive devices such as canes and walkers; and to learn safer
and more energy-efficient ways of moving, sitting, and transferring. Exercise and
stretching programs are usually designed by the physical
therapist and taught to the patient and caregivers for use at home.
Exercise is an important part of maintaining function for the person with MS.
Swimming is often recommended, not only for its low-impact workout, but also
because it allows strenuous
activity without overheating.
Occupational therapy helps the person with
MS adapt to her environment and adapt the environment to her. The occupational therapist
suggests alternate strategies and assistive devices for activities of daily
living, such as dressing, feeding, and washing, and evaluates the home and work
environment for safety and efficiency improvements that may be made.
Training in bowel and bladder care may be
needed to prevent or compensate for incontinence. If the urge to urinate becomes
great before the bladder is full, some drugs may be helpful, including
propantheline bromide
(Probanthine), oxybutynin
chloride (Ditropan), or imipramine (Tofranil). Baclofen (Lioresal) may relax the sphincter
muscle, allowing full emptying. Intermittent
catheterization is effective in controlling bladder dysfunction.
In this technique, a catheter is used to periodically empty the bladder.
Spasticity can be treated with oral
medications, including baclofen and diazepam (Valium), or by injection with botulinum
toxin (Botox).
Spasticity relief may also bring relief from chronic pain. Other more acute
types of pain may respond to carbamazepine
(Tegretol) or diphenylhydantoin (Dilantin). Low back pain
is common from increased use of the back muscles to compensate for weakened
legs. Physical therapy and over-thecounter pain relievers may help.
Fatigue may be partially avoidable with
changes in the daily routine to allow more frequent rests. Amanta-dine
(Symmetrel) and pemoline
(Cylert) may improve alertness and lessen fatigue. Visual disturbances often respond to
corticosteroids. Other symptoms that may be treated with drugs include seizures,
vertigo, and tremor.
Myloral, an oral preparation of bovine myelin, has
recently been tested in clinical trials for its effectiveness in reducing the
frequency and severity of relapses. Preliminary data indicate no difference
between it and placebo.
Alternative treatment
Bee venom has been suggested as a treatment
for MS, but no studies or objective reports support this claim.
In British studies, marijuana has
been shown to have variable effects on the symptoms of MS. Improvements have
been documented for tremor, pain, and spasticity, and worsening for posture and
balance. Side effects have included weakness, dizziness, relaxation, and
incoordination, as well as euphoria. As a result, marijuana is not recommended
as an alternative treatment.
Some studies support the value of high
doses of vitamins,
minerals, and
other dietary supplements for controlling disease progression or improving
symptoms. Alphalinoleic and linoleic acids, as well as selenium and
vitamin E, have shown effectiveness in the treatment of MS. The selenium and
vitamin E act as antioxidants. In addition, the Swank diet (low in saturated fats),
maintained over a long period of time, may retard the disease
process.
Removal of mercury fillings has been touted
as a possible cure, but is of no proven benefit.
Studies have also shown that t'ai chi can
be an effective therapy for MS because it works to improve balance and increase
strength.
There are conflicting views about Echinacea and
its benefit to MS. Some medicine books recommend Echinacea for people with MS.
However, Echinacea appears to stimulate different parts of the immune system, particularly
immune cells known as macrophages. In MS these cells are very active already
and further stimulation
could worsen
the disease.
Prognosis
It is difficult to predict how multiple
sclerosis will progress in any one person. Most people with MS will be able to
continue to walk and function at their work for many years after their
diagnosis. The factors associated with the mildest course of MS are being
female, having the relapsing-remitting form, having the first symptoms at a
younger age, having longer periods of remission between relapses, and initial
symptoms of decreased sensation or vision rather than of weakness or
incoordination.
Less than 5% of people with MS have a
severe progressive form, leading to death from complications within five years. At the other
extreme, 10-20% have a benign form, with a very slow
or no progression of their symptoms. The most recent studies show that about
seven out of 10 people with MS are still alive 25 years after their diagnosis,
compared to about nine out of 10 people of similar age without disease. On
average, MS shortens the lives of affected women by about six years, and men by
11 years. Suicide is a significant cause of death in MS, especially in younger
patients.
The degree of disability a person
experiences five years after onset is, on average, about three-quarters of the
expected disability at 10–15 years. A benign course for the first five years
usually indicates the disease will not cause marked disability.
Prevention
There is no known way to prevent multiple
sclerosis. Until the cause of the disease is discovered, this is unlikely
to change. Good nutrition; adequate rest; avoidance of stress, heat, and
extreme physical exertion;
and good bladder hygiene may
improve quality of life and reduce symptoms.