Multiple Sclerosis

By:    Published: May 14, 2014

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Multiple sclerosis is an autoimmune disorder in which the body’s immune system attacks the protective sheath (myelin) that insulates your nerves and helps mediate the transmission of nerve impulses. As a result, the electrical impulses that travel along the nerves decelerates, which slows down the communication between your brain and rest of the body. Furthermore, nerve damage also occurs. Symptoms of multiple sclerosis may vary with the extent of nerve damage and the type of nerves affected.

Who Is Affected?

As multiple sclerosis progresses, a person may begin to lose the ability to see, walk, write or speak. According to the National Multiple Sclerosis Society, multiple sclerosis is the leading cause (with the exception of physical trauma) of neurological disability beginning in early to mid-adulthood (most people are diagnosed between the ages of 20 and 50), with 200 people being diagnosed with multiple sclerosis every week.

Overall, multiple sclerosis affects an estimated 400,000 Americans and is significantly more common amongst women. Currently there is no cure for multiple sclerosis. However, treatments can help treat attacks, modify the course of the disease and treat symptoms.

Symptoms

Symptoms of multiple sclerosis vary between individuals and can change as the disease progresses. Episodes can last for days, weeks, or months. These episodes alternate with periods of reduced or no symptoms (remissions). Multiple sclerosis symptoms include:

  • Dizziness
  • Double vision or blurring of vision
  • Electric-shock sensations that occur with certain head movements
  • Fatigue
  • Lack of coordination or unsteady gait
  • Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement (optic neuritis)
  • Muscle stiffness
  • Numbness or weakness in one or more limbs, which typically occurs on one side of your body at a time or the bottom half of your body
  • Difficulty controlling urination
  • Decreased attention span, poor judgment, and memory loss
  • Slurred or difficult-to-understand speech

Causes

The exact cause of multiple sclerosis is currently unknown. It is generally accepted that multiple sclerosis is an autoimmune disorder. Scientists believe that a host of factors may contribute to the onset of multiple sclerosis including, exposure to environmental toxins, genetics, and childhood exposure to certain viruses or bacteria.

Risk Factors

The following factors may increase your risk of developing multiple sclerosis:

  • Your age. Being between the ages of 20 and 50.
  • Being female. Women are two to three times more likely to develop multiple sclerosis.
  • Having a family history. If one of your parents or siblings has had multiple sclerosis, you have a 1 to 3 percent chance of developing the disease.
  • Having had certain infections. A variety of viruses have been linked to multiple sclerosis.
  • Being Caucasian. Caucasians, particularly those of Northern European descent are at highest risk of developing multiple sclerosis. People of Asian, African or Native American descent have the lowest risk.
  • Living in countries with temperate climes. Multiple sclerosis is far more common in Europe, southern Canada, northern United States, New Zealand and southeastern Australia. The risk seems to increase with latitude.
  • Moving to a new location. A child who moves from a high-risk area to a low-risk area, or vice versa, tends to have the risk level associated with his or her new home area. However, if the move occurs after the onset of puberty, then the young adult usually retains the risk level associated with their first home.
  • Having certain other autoimmune diseases. There is a slight increased risk for multiple sclerosis if you have thyroid disease, type 1 diabetes or inflammatory bowel disease.

Diagnosis

In order to make a diagnosis of multiple sclerosis, your doctor must definitively conclude all of the following:

  • Find damage in at least two separate areas of the central nervous system, which includes the brain, spinal cord and optic nerves.
  • Find that the damage occurred at least one month apart.
  • Rule out all other possible diagnoses.
  • Your doctor may utilize the following diagnostic tests in order to confirm a diagnosis of multiple sclerosis.
  • A blood test can help rule out some infectious or inflammatory diseases that have symptoms similar to multiple sclerosis.
  • A medical professional will remove a small sample of cerebrospinal fluid from within your spinal canal for laboratory analysis. This procedure can also help rule out viral infections and conditions that present with symptoms similar to multiple sclerosis.
  • MRI is an imaging technology for detecting the presence of multiple sclerosis lesions in different parts of the central nervous system.
  • Evoked potential tests are recordings of the nervous system's electrical response to the stimulation of specific sensory pathways. Visual evoked potentials are considered the most useful for confirming the MS diagnosis.

Treatment

There is currently no cure for multiple sclerosis. Treatment regimens typically focus on managing symptoms and attacks of multiple sclerosis.

Multiple sclerosis treatment regimens include:

  • Corticosteroids. Corticosteroids help decrease the inflammation associated with a multiple sclerosis attack and are the most common treatment. Side effects may include increased blood pressure and weight gain. Long-term use can lead to cataracts, high blood sugar and increased risk of infections.
  • Plasma exchange. This procedure separates your blood cells from your plasma, removes the plasma from the blood, replaces the plasma, and then is transfused back into the patient (with blood). Since damaging factors have been found in the plasma of those with MS, this is utilized to help ameliorate severe symptoms of multiple sclerosis relapses in people who aren't responding to intravenous steroids.
  • Physical therapy.
  • Muscle relaxants.
  • Medications to reduce fatigue.
  • Medications to combat depression, pain, and bladder and/or bowel control problems.

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