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Multiple Sclerosis Facts Multiple
sclerosis is a chronic unpredictable neurological disease. MS can cause blurred
vision, loss of balance, poor coordination, slurred speech, tremors, numbness,
extreme fatigue, problems with memory and concentration, paralysis, and
blindness. These problems may be permanent, or they may come and go. Most
people with MS are diagnosed between the ages of 20 and 50. The unpredictable
physical and emotional effects continue the rest of their lives. The progress,
severity, and specific symptoms of MS in any one person cannot be predicted, but
new treatments and
advances in research
offer hope to everyone affected by the disease.
Anyone
may develop MS but there are some patterns. Twice 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. It 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. Because it is not
contagious, which would require U.S. physicians to report new cases, and because
symptoms can be completely invisible, the numbers are estimated. What
are the typical symptoms of MS? 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. Even severe
symptoms may disappear completely and the person will regain lost functions. In
severe MS, people have partial or complete paralysis on a permanent basis. MS
symptoms result when inflammation and breakdown affect myelin, the protective
insulation surrounding nerve fibers of the central nervous system (the brain and
spinal cord). Myelin is destroyed and replaced by scars of hardened
“sclerotic” tissue. These are called plaques, and they appear in multiple
places within the central nervous system. Myelin is often compared to insulating
material around an electrical wire; loss of myelin interferes with the
transmission of nerve signals. Some underlying nerve fibers are permanently
severed in association with the loss of myelin. No,
MS is not considered a fatal disease. While in very rare cases MS is malignantly
progressive, most people who have MS have a normal or near-normal life
expectancy. Does
MS always cause paralysis? No.
Moreover, the majority of people with MS do not become severely disabled.
Two-thirds of people who have MS remain able to walk, though most will need an
aid, such as a cane or crutches, and some will use a scooter or wheelchair to
help fight fatigue, weakness, and balance problems. Is
MS contagious or inherited? No.
MS is not contagious and is not directly inherited. Studies do indicate that
genetic factors may make certain individuals more susceptible to the disease. Not
yet. There are now FDA-approved medications that have been shown to modify or
slow down the underlying course of MS. In addition, many therapeutic and
technological advances are helping people manage symptoms and lead productive
lives. Advances in treating and understanding MS are made every year and
progress in research to find a cure is very encouraging. What
medications and treatments are available for MS? The
National
Multiple Sclerosis Society recommends treatment with one of the FDA-approved
“disease-modifying” drugs as soon as possible after the diagnosis of a
relapsing form (the most common kind) of MS. These drugs help to lessen the
frequency and severity of MS attacks, reduce the accumulation of lesions (areas
of damage) in the brain, and slow the progression of disability. The
FDA has also approved another disease-modifying treatment for reducing
disability and/or the frequency of relapses in patients with
secondary-progressive, progressive-relapsing or rapidly worsening relapsing-remitting
MS. This is the first therapy approved in the U.S. for secondary-progressive MS.
The lifetime dose is limited due to cardiac toxicity. In
addition to these “disease-modifying” drugs, there are many therapies for
symptoms such as spasticity, pain, bladder problems, fatigue, sexual
dysfunction, weakness, and cognitive problems. People should consult a
knowledgeable physician to develop a comprehensive approach to managing their
MS. Why
is MS so difficult to diagnose? In
early MS, symptoms that might indicate any number of possible disorders come and
go. Some people have symptoms that are very difficult for physicians to
interpret, and these people must “wait and see.” While no single laboratory
test is yet available to prove or rule out MS, magnetic resonance imaging (MRI)
is a great help in reaching a definitive diagnosis. What
are the different types of MS? In
an effort to develop a common language for evaluating and researching MS, the
Society conducted an international survey among scientists who specialize in MS
research and patient care. Analysis of responses resulted in the following
definitions of disease categories, which were introduced in 1996. ·
Relapsing-Remitting
Characteristics: People
with this type of disease experience clearly defined flare-ups (also called
relapses 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 75%. ·
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 15%. ·
Secondary-Progressive
Characteristics: People
with this type of MS experience an initial period of relapsing-remitting disease
(see above) 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 ·
Progressive-Relapsing
Characteristics: People
with this type of MS experience a steadily worsening disease from the onset but
also have clear acute flare-ups (relapses), with or without recovery. In
contrast to relapsing-remitting MS, the periods between relapses are
characterized by continuing disease progression.
Frequency: Relatively rare.
Approximately 10%. ©
National Multiple Sclerosis Society, 2002 Updated
January 8, 2003 |