What is Multiple Sclerosis?
Multiple sclerosis (MS) is a chronic, often disabling disease that attacks the central nervous system (brain and spinal cord). The exact cause of MS is unknown, and at this time there is no cure. Many advances in research and treatments are giving hope to people who are affected by the disease.
The National Multiple Sclerosis Society estimates that more than 400,000 people in North America are living with MS. In Michigan, more than 15,000 people are diagnosed with the disease. Most people with MS are diagnosed between the ages of 20 and 40, but the unpredictable physical and emotional effects last a lifetime.
The progression and specific symptoms of MS in an individual cannot be predicted. They vary depending on the extent and severity of the disease and the location of lesions within the brain and spinal cord. Some of the most common symptoms are:
- Numbness, tingling or a burning sensation in the arms and legs
- Muscle weakness in the arms or legs
- Blurred, double vision or a loss of vision
- Problems with balance and coordination
- Slurred speech, or difficulty finding words
- Cognitive difficulties such as impairment of memory, reasoning and thought processes
- Emotional changes including depression
While the progression, severity and specific symptoms of MS vary by patient, MS is divided into four distinct classifications.
- Relapsing/remitting (RRMS) - This is the most common form of multiple sclerosis and is often seen in early onset. It involves attacks of neurological dysfunction lasting days to weeks, with periods of full or partial recovery -- or periods with no recovery, but no progression in symptoms -- between attacks. Eighty percent of people diagnosed with MS are diagnosed with RRMS.
- Secondary progressive - Gradual neurological deterioration, with or without relapses, remissions or plateaus, in a patient who previously had RRMS.
- Progressive relapsing - A gradual progression of disability; unlike relapsing-remitting MS, the disease continuously progresses without stabilizing.
- Primary progressive - A gradual neurological deterioration, but with some relapses.
If your doctor suspects you have multiple sclerosis, he or she may refer you to MidMichigan's MS Clinic, which is affiliated with the National Multiple Sclerosis Society.
Because there is no known cause for MS, it is often difficult to diagnosis. Several tests are necessary for confirmation, including:
- Clinical assessment
- Laboratory tests
- MRI of the brain and spinal cord
- Electroencephalogram (EEG)
- Brainstem auditory evoked response (BAER)
- Somatosensory evoked potentials (SSEP)
- Electromyography (EMG)
- Nerve Conduction Study (NCS)
Because there is no known cause and as yet no cure, a multidisciplinary approach is the most beneficial in preventing progression of MS. This approach consists of medications, exercise, stress management, relaxation, adequate nutrition and an overall healthy lifestyle. Again, MidMichigan's MS Clinic is available to help with many of these services.
Many medications can help manage the symptoms of MS. Your neurologist will choose the right medication for you based on the results of diagnostic testing and clinical examination. Treatments may include:
- AVONEX® (interferon beta 1-a)
- BETASERON® (interferon beta 1-b)
- COPAXONE® (glatiramer acetate)
- REBIF® (interferon beta-1a)
- EXTAVIA® (interferon beta 1b)
- TYSABRI® (natalizumab)
- GILENYA® (fingolimod)
- NOVANTRONE® (mitoxantrone hydrochloride)
- Other medications, including high dose steroids for acute exacerbations of flare-ups
It is important to become familiar with your symptoms in order to recognize flare-ups and seek appropriate and timely intervention.
AVONEX® is a registered trademark of Biogen
BETASERON® is a registered trademark of Berlex Laboratories, Inc.
COPAXONE® is a registered trademark of Teva Pharmaceutical Industries, Ltd.
REBIF® is a registered trademark of Serono S. A.
EXTAVIA® is a registered trademark of Novartis Pharmaceuticals Corporation
TYSABRI® is a registered trademark of Elan Pharmaceuticals, Inc. & Biogen Idec
GILENYA® is a registered trademark of Novartis AG
NOVANTRONE® is a registered trademark of Immunex Corp.
If you have MS, your doctor may recommend rehabilitation therapy in addition to other treatment options. Rehabilitation therapy can help you and your caregiver better adapt to the changing realities of the disease and help you maintain as much independence as possible.