Contributing Author: Gentle Heron
March is Multiple Sclerosis Awareness Month, and March 5-11 this year is MS Awareness Week. Here are some answers to common questions about Multiple Sclerosis.
What is Multiple Sclerosis?
Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system (CNS). The central nervous system is the brain and spinal cord, but does not include the nerves that run throughout the body. Nerve cells in the CNS have fibers called axons that are coated with a fatty insulation known as myelin. The myelin insulation allows nerve messages to travel properly along the axons.
What is an Autoimmune Disease?
Autoimmune diseases occur when the body’s immunity defense system mistakes the body’s own tissues for “enemies” and destroys them. In Multiple Sclerosis, the immune system randomly attacks the myelin coating of nerve cells in the CNS. Damage to myelin leads to scars in the tissue of the brain and spinal cord. These scars or lesions disrupt transmission of nerve messages. Distorted nerve messages lead to a variety of symptoms in the body and mind.
It is these scars in nervous tissue that the disease is named for. There are numerous (multiple) scars (scleroses) seen on MRI scans when the disease has been active.
Is Multiple Sclerosis contagious or fatal?
It is important to note that MS is not fatal. It is also not contagious. Symptoms of MS can be managed medically. However, MS is a chronic progressive neurological disease for which there is no known cause or cure. It is a highly individualized disabling condition, due to the randomness of the scarring on nerves in the CNS.
What does it mean that MS is chronic and progressive?
Chronic progressive diseases persist throughout the person’s lifetime, and tend to cause more problems over time. MS follows different courses of progression in different people. Most people who are first diagnosed with MS have the relapsing-remitting form of the disease. For them, the progression is uneven. After an initial set of symptoms appear, leading to the diagnosis, the symptoms may go away entirely or may continue to be present at some level. The disappearance of the symptoms is the remission phase of MS. People with MS who are in remission may not appear to be disabled.
When the same or different symptoms reappear at a later date, that is the relapse phase of the disease. The reappearance of symptoms is also called a flare or exacerbation. It is impossible to predict when exacerbations will occur.
Over time, almost all persons with MS experience an increase in the number and/or severity of symptoms. This means the disease is progressing. In some people the progression begins or becomes steady, without the acute relapses and remission phases.
You can view an llustration at http://mymsaa.org/ms-information/overview/types/ showing the different types of Multiple Sclerosis.
How common is Multiple Sclerosis? Who gets it?
It is estimated that about 2.5 million people have MS around the globe. The prevalence of MS is approximately 90 in every 100,000 people in a population. In the US, about 400,000 people have been diagnosed with MS. Most are between the ages of 10 and 80.
Multiple Sclerosis can affect people of any age, gender or ethnicity. However, some people are at a higher risk of getting MS. Women are three times as likely to get MS as are men. Caucasians are more likely to get MS than Hispanics or blacks, and MS is rare in Asians. Persons who have a close relative with MS have an increased risk of also having MS.
The incidence of MS increases the farther north you go from the equator. In the United States, northern states (above the 37th parallel) have twice as many cases of MS as southern states. Nobody really knows why this occurs, but it may be related to lower amounts of sunlight at higher latitudes.
What causes MS?
The cause of Multiple Sclerosis remains unknown, although scientists who study the disease believe it may result from a combination of several factors. In addition to an abnormal immunological reaction, viruses or other infectious agents, inadequate vitamin D, environmental factors or genetic defects may lead to the development of MS in a susceptible person.
Is there a cure for MS? Are there treatments?
Unfortunately, since it is not known exactly what causes MS at the present time, there is no cure. However, there are two kinds of treatments.
Disease-modifying drugs, mainly available as injections, slow the progression of MS by altering the functioning of the immune system. They typically control the inflammation characteristic of the early stages of relapsing-remitting MS, and are not thought to be as effective when the disease becomes more neurodegenerative. Side effects of disease-modifying medications can be significant. While they can not cure MS, disease-modifying drugs do lower the frequency and severity of relapses and slow the development of new brain lesions in many patients.
Symptomatic treatment is available for individual problems such as spasticity, tremors, urinary incontinence, and gait abnormalities. During a relapse, steroids or other treatments are used to deal with the symptoms. Each symptomatic treatment brings additional side effects that must be taken into account in creating a treatment plan.
What is it like to have MS?
Multiple Sclerosis destroys nerve cells randomly in the brain and spinal cord. This results in highly individualized and unpredictable symptoms in the body, senses and mental capacity.
What kind of symptoms can MS cause? One of the most common physical symptoms is fatigue. A person with MS may have spasticity, tremors, muscle weakness, or impaired coordination and balance. Other physical symptoms are bladder, bowel, and sexual dysfunctions.
Sensory input is often altered with MS. A person with MS may feel numbness in various body parts, or have burning, itching, or painful sensations. Cognitive symptoms can include memory loss, inability to make decisions, depression, confusion, or difficulty finding a desired word in speech or writing.
Symptoms also can appear and disappear randomly. A person with MS may not know from day to day what capabilities he or she will have, and what difficulties he or she will need to face. The unpredictability of the disease is one of its most troubling symptoms.
How is Multiple Sclerosis diagnosed?
Diagnosis of Multiple Sclerosis is not straightforward. In fact, in addition to showing that there are scars (lesions) in the central nervous system that occurred at different times, a variety of other diseases and disorders that can mimic the symptoms of MS must be ruled out before the diagnosis is confirmed. Neurologists use the detailed patient history and the results of tests such as MRIs, spinal taps and evoked potential exams in providing evidence for the diagnosis.
With no single test or combination of tests that always results in a clear diagnosis, patients are often left in limbo. It is important for persons with symptoms that might indicate MS to consult neurologists who are very familiar with MS, and to persist in seeking a correct diagnosis.
Is MS the same as MD?
No. MS stands for Multiple Sclerosis; MD is an abbreviation for Muscular Dystrophy. Although the symptoms of MS can be similar to those of MD, the diseases are completely different.
Muscular Dystrophy is a set of genetic diseases that affect muscles, not nerves. It is a rare disease, affecting mostly males. Although the causes of the various types of MD are known, there is still not a cure, although there are symptomatic treatments.
Where can I find out more about Multiple Sclerosis?
A display on Virtual Ability’s Healthinfo Island in Second Life provides additional detailed information about Multiple Sclerosis. You can visit the display here:
Many support organizations exist at national and local levels. Consult the ones closest to you. Here are a few links to national organizations that may prove helpful:
National MS Society: http://www.nationalmssociety.org/
Multiple Sclerosis Association of America: http://mymsaa.org/
Multiple Sclerosis Foundation: https://msfocus.org/
MS Trust: https://www.mstrust.org.uk/
MS Society: https://www.mssociety.org.uk/
MS Australia: https://www.msaustralia.org.au/
Multiple Sclerosis Society of Canada: https://mssociety.ca/
MS International Federation: https://www.msif.org/
For a listing of other national organizations supporting persons with MS: http://multiple-sclerosis-research.blogspot.com/2012/12/ms-socieities.html