Multiple Sclerosis

GENERAL INFORMATION:

What is multiple sclerosis?

• Multiple (MUL-ti-pl) sclerosis (skle-ROH-sis) is also called "MS". It is a long-term disease that affects the central nervous system (CNS). The CNS includes the brain, spinal cord and the optic nerve (nerve of the eye). Nerve fibers in the brain and spinal cord are covered with myelin. This is a fatty material that surrounds and protects the nerve fibers. Normally, myelin covers the nerve fibers and helps conduct nerve messages to and from the brain.
  
  
• With MS, this myelin is damaged or destroyed. Damage to or loss of myelin slows down nerve messages going to and from the brain. MS is more common among women and young adults. Signs and symptoms of the disease usually begin between 20 and 50 years of age.

What causes MS? No one knows the exact cause of MS. It is believed that MS is an autoimmune disease. The immune system is the part of your body that fights infection. When you have an autoimmune disease like MS, your body attacks itself. The following factors may trigger the immune system to attack your myelin:

• Environmental: MS is seen more often in colder climates than in warmer climates. It is more likely to affect people who live in northern Europe, northern United States, and southern Australia.
  
  
• Genetic: This is something you are born with. You have a greater chance of getting MS if you have a parent or a sibling with MS.
  
  
• Infections: Germs such as bacteria and viruses can damage the myelin.

What are the signs and symptoms of MS? The signs and symptoms of MS depend on where the damages are in the CNS. They may also vary from person to person and from time to time in the same person.

• The most common early signs and symptoms of MS include:
  
  
  • Abnormal sensations such as numbness or "pins and needles" usually felt in the arms and legs.
    
    
  • Changes in mental function such as problems with memory, attention, and problem-solving.
    
    
  • Depression, dull affect (showing no emotion), and having mood swings such as going from very happy to very sad.
    
    
  • Fatigue (feeling tired) that is worse in the afternoon. This is also called “MS lassitude”.
    
    
  • Muscle weakness and cramps. This may make it hard or painful to walk.
  
  
• Other problems:
  
  
  • Controlling your urinary bladder or bowels.
    
    
  • Having sexual problems such as difficulty in maintaining an erection.
    
    
  • Vision may be blurred, you may see double, or you may feel dizzy.
  
  
• Less common signs and symptoms include:
  
  
  • Trouble hearing.
    
    
  • Speech and swallowing problems.
    
    
  • Your body may not seem like it is working together when you move (incoordination). You may have problems with walking or balancing.

What are the types of MS? MS may be any of the following:

• Relapsing-remitting MS: Also called “RRMS”, this is the most common type of MS. It has quiet and active periods. The quiet periods when you have few or no symptoms of the disease are called "remission". Remission may last for months or years. The active periods when you have symptoms of the disease are called "relapse" or "flare-ups".
  
  
• Primary progressive MS: This is also called “PPMS”. There is a slow or steady worsening of symptoms from the first signs of illness.
  
  
• Secondary progressive MS: This is also called “SPMS”. At the start of the disease, it may show quiet and active periods. It is then followed by a steadily worsening disease.
  
  
• Progressive-relapsing MS: This is also called “PRMS”. It is steadily worsening disease from the start or onset of MS.

How is MS diagnosed? You may have any of the following tests.

• Evoked potential tests: This test is also called "EVT". This test measures how quickly and correctly your brain responds to certain stimulation such as sight, sound, or touch.
  
  
• Lumbar puncture: This test is also called "LP" or spinal tap. This test may be done in your caregiver’s office or at the clinic or hospital. Fluid is taken from your spine during the spinal tap and is sent to a lab for tests.
  
  
• Magnetic resonance imaging: This test is also called an "MRI". During the MRI, computerized pictures are taken of your brain using radiowaves. Caregivers use these pictures to look for patches of scar tissue on the myelin in your brain.

How is MS treated? There is no cure for MS at this time. Your caregiver will treat your MS based on its type and your symptoms.

• Chemotherapy: This medicine, often called "chemo" is used to treat cancer, but also may be used to treat MS. Chemo acts by temporarily shutting down the immune system to change the course of MS.
  
  
• Immunotherapy: Immunotherapy prevents the immune system from attacking your body. This helps increase the time between the episodes of symptoms or relapses.
  
  
• Steroids: These medicines may shorten the time an episode of symptoms lasts. These medicines also ease inflammation (swelling) at the affected site.
  
  
• Other treatments: You may have one or both of the following:
  
  
  • Medicines: Certain medicines may be used to control and decrease MS symptoms. Medicines can be used to treat symptoms such as muscle cramps, urinary bladder or bowel problems.
    
    
  • Rehabilitation program: This program may include mental and physical exercises. These exercises may help improve your ability to perform, or maintain your ability to continue doing tasks that are important to daily living. These tasks may include preparing meals and doing self-care.

Where can I find support and more information? MS is a life-changing disease for you and your family. Accepting that you have MS is hard. You and those close to you may feel angry, depressed, or frightened. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may also want to join an MS support group. This is a group of people who have MS. Ask your caregiver for the names and numbers of support groups near you. You may also want to contact the following for more information.

• Well Spouse Foundation
  63 West Main St, Ste H
  Freehold, NJ 07728
  Phone: 1-800-838-0879
  Web Address: www.wellspouse.org
  

• Multiple Sclerosis Association of America
  706 Haddonfield Road
  Cherry Hill, NJ 08002
  Phone: 1-856-488-4500
  Phone: 1-800-532-7667
  Web Address: http://www.msaa.com
  

• National Multiple Sclerosis Society
  733 Third Avenue
  New York, NY 10017
  Phone: 1-800-344-4867
  Web Address: http://www.nmss.org
  

• Multiple Sclerosis Foundation
  6350 North Andrews Avenue
  Fort Lauderdale, FL 33309-2130
  Phone: 1-888-673-6287
  Web Address: http://www.support@msfocus.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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