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Multiple Sclerosis

MS What Is Multiple Sclerosis?

MS is thought to be an autoimmune disease that affects the central nervous system (CNS). The CNS consists of the brain, spinal cord, and the optic nerves. Surrounding and protecting the nerve fibers of the CNS is a fatty tissue called myelin, which helps nerve fibers conduct electrical impulses.

In MS, myelin is lost in multiple areas, leaving scar tissue called sclerosis. These damaged areas are also known as plaques or lesions. Sometimes the nerve fiber itself is damaged or broken.

Myelin not only protects nerve fibers, but makes their job possible. When myelin or the nerve fiber is destroyed or damaged, the ability of the nerves to conduct electrical impulses to and from the brain is disrupted, and this produces the various symptoms of MS.

People with MS can expect one of four clinical courses of disease, each of which might be mild, moderate, or severe.

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What Causes MS?

While the exact cause of MS is unknown, most researchers believe that the damage to myelin results from an abnormal response by the body’s immune system. Normally, the immune system defends the body against foreign invaders such as viruses or bacteria. In autoimmune diseases, the body attacks its own tissue. It is believed that MS is an autoimmune disease. In the case of MS, myelin is attacked.

Scientists do not yet know what triggers the immune system to do this. Most agree that several factors are involved, including:

* Genetics
* Gender
* Environmental Triggers

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Who Gets MS?

Anyone may develop MS, but there are some patterns.

* Most people with MS are diagnosed between the ages of 20 and 50.
* Two-three times as many women as men have MS.
* Studies indicate that genetic factors make certain individuals more susceptible than others, but there is no evidence that MS is directly inherited.
* MS occurs more commonly among people with northern European ancestry, but people of African, Asian, and Hispanic backgrounds are not immune.

Approximately 400,000 Americans acknowledge having MS, and every week about 200 people are diagnosed. Worldwide, MS may affect 2.5 million individuals.

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Symptoms

Symptoms of MS are unpredictable and vary from person to person and from time to time in the same person. For example, one person may experience abnormal fatigue, while another might have severe vision problems. A person with MS could have loss of balance and muscle coordination making walking difficult; another person with MS could have slurred speech, tremors, stiffness, and bladder problems. While some symptoms will come and go over the course of the disease, others may be more lasting.

Read more about the categories of symptoms or refer to the chart below for information on a specific symptom.
Most Common Symptoms
Symptom Description/Overview Management/Resources
Bladder Dysfunction Bladder Dysfunction

Personal Care: Bladder and Bowel Problems
Bowel Dysfunction Bowel Dysfunction
Changes in Cognitive Function, including problems with memory, attention, and problem-solving

Cognitive Function
MS and Cognition
Dizziness and Vertigo Dizziness and Vertigo
Depression and other Emotional Changes

Emotional Aspects

Depression

Emotional Aspects of MS

Depression and Multiple Sclerosis
Fatigue (also called MS lassitude)

Fatigue
MS and Fatigue
Difficulty in Walking and/or Balance or Coordination Problems

Gait

Gait or Walking Problems: The Basic Facts

MS and Mobility
Abnormal sensations such as Numbness or “pins and needles” Numbness
Pain

Pain
MS and Pain
Sexual Dysfunction Sexuality MS and Intimacy
Spasticity Spasticity Controlling Spasticity in MS
Vision Problems

Visual Symptoms

Optic Neuritis
MS and Vision

Less Common Symptoms
Symptom Description/Overview Management/Resources
Headache Headache
Hearing Loss Hearing Loss
Itching Itching
Seizures Seizures
Speech and Swallowing Disorders

Speech and Swallowing Disorders

Dysphagia (Swallowing Problems)
Speech and Swallowing: The Basic Facts
Tremor

Tremor
Tremor: The Basic Facts

Additional resources

* “But You Look So Good”
Coping with invisible MS symptoms

* Exacerbation
An exacerbation (also known as an attack, a relapse, or a flare) is a sudden worsening of an MS symptom or symptoms, or the appearance of new symptoms

* Heat/Temperature Sensitivity
Many people with MS experience a temporary worsening of their symptoms when exposed to hot or cold conditions

* Medications Commonly Used in MS
Chart of chemical name, brand name, and the common usage
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Diagnosis of MS

At this time, no single test is available to identify or rule out MS. Several tests and procedures are needed. These are likely to include:

Complete Medical History
Healthcare providers need an overall view of the individual’s health picture, including symptoms and when they began.

Nervous System Functioning
Testing of reflexes, balance, coordination, and vision— as well as checking for areas of numbness

Diagnostic Tests such as:

* MRI scan, which gives detailed view of the brain
* Evoked potential tests, which measure how quickly and accurately a person’s nervous system responds to certain stimulation
* Spinal tap, which checks spinal fluid for signs of the disease

Two Basic Signs are Required to Confirm MS
1. Signs of disease in different parts of the nervous system
2. Signs of at least two separate flare-ups (also called relapses or exacerbations) of the disease

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Just the Facts

MS is a chronic, unpredictable neurological disease that affects the central nervous system.

MS is not contagious and is not directly inherited.

Most people with MS have a normal or near-normal life expectancy.

The majority of people with MS do not become severely disabled.

There is no cure for MS yet, but drugs can help slow the course and/or symptoms in some patients.

The above is from the brochure Just the Facts: 2005-2006.

* Relapsing-Remitting
Characteristics: People with this type of MS experience clearly defined flare-ups (also called relapses, attacks, or exacerbations). These are episodes of acute worsening of neurologic function. They are followed by partial or complete recovery periods (remissions) free of disease progression.
Frequency: Most common form of MS at time of initial diagnosis. Approximately 85%.

* Primary-Progressive
Characteristics: People with this type of MS experience a slow but nearly continuous worsening of their disease from the onset, with no distinct relapses or remissions. However, there are variations in rates of progression over time, occasional plateaus, and temporary minor improvements.
Frequency: Relatively rare. Approximately 10%.

* Secondary-Progressive
Characteristics: People with this type of MS experience an initial period of relapsing-remitting disease, followed by a steadily worsening disease course with or without occasional flare-ups, minor recoveries (remissions), or plateaus.
Frequency: 50% of people with relapsing-remitting MS developed this form of the disease within 10 years of their initial diagnosis, before introduction of the “disease-modifying” drugs. Long-term data are not yet available to demonstrate if this is significantly delayed by treatment.

* Progressive-Relapsing
Characteristics: People with this type of MS experience a steadily worsening disease from the onset but also have clear acute relapses (attacks or exacerbations), with or without recovery. In contrast to relapsing-remitting MS, the periods between relapses are characterized by continuing disease progression.
Frequency: Relatively rare. Approximately 5%.

Last updated August 1, 2005

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