MS = Multiple Sclerosis

For anyone, the sudden news of being told that you have something called Multiple Sclerosis is truly a major shock to all of us. With it, brings a frightening but tremendous overwhelming need for information, support, advice and reassurance. We turn to family, friends, (who seem to know nothing about MS, except that they say that they support "Jerry's Kids" for the Labor Day Telethon). Then we have to turn to strangers for help, support and reassurance, and a shoulder to cry on when we need it. Our families are very important to us, BUT they are no help if they do not know anything about MS!

There are many great web sites, support groups, mailing lists, clubs, chat rooms, message boards, etc. on the internet to search for all kinds of information. You should also contact your local MS Society. They can offer a wealth of information and support, but it is NOT the same as the support and love that you need from family and friends.

The problem is that the cause of MS is unknown and the most frightening fact is that there is no cure!

YET!!

What I aim to do here is to inform you of the basic information that is available.

The following is from a booklet that is written for people with MS by people with MS, who know what it means to live with the disease and thus who better understand your need for information, practical advice and help in managing MS. The booklet seeks to bring this support to those for whom, until now, Multiple Sclerosis has just been a vaguely menacing name.

What Is MS?

This is simple to answer: multiple means "many" and sclerosis means "scarring" - a literal description of the damage that is seen in the brain and spinal cord, but it is not a diagnosis because it does not indicate a cause for the disease. Why then do specialists insist that there must be more than one area affected? This is simply because the first description of the disease, by the French neurologist Charcot, over one hundred years ago, as "la sclerosis en plaques", is translated as "multiple" sclerosis, implying several symptoms. Yet single attacks - such as optic neuritis or Bell's Palsy - are often the first symptoms of MS but many patients never have another, different attack.

However, Magnetic Resonance Imaging (MRI = Magnetic resonance imaging. A diagnostic procedure that produces visual images of different body parts without the use of X-rays. Nuclei of atoms are influenced by a high frequency electromagnetic impulse inside a strong magnetic field. The nuclei then give off resonating signals that can produce pictures of parts of the body. An important diagnostic tool in MS, MRI makes it possible to visualize and count lesions in the white matter of the brain and spinal cord) of patients, with a single symptom and no evidence of other problems on clinical examination, has shown that about three-quarters of these patients already have multiple areas of the brain affected. The patient may never have another, different attack so, in these circumstances what can the neurologists say? MRI has also shown this in children as young as four, so MS is not, as frequently stated, confined to adult years.

Our nervous system controls everything we do through a highly complex network of nerve cells and interconnecting fibres that run through the body. The disease process in MS can result in structural damage to the nerve cell, to the myelin sheath which surrounds the fibres and to the central core or fibre which transmits the signals to and from the brain and the rest of the body. When such damage is present, the passage of these signals can be delayed or partially or completely blocked by the very scars which, in other parts of the body, are the mark of healing. There are preferred sites such as the eye nerves, areas around the ventricles (cavities) of the brain and the spinal cord at mid-neck level. The areas of damage always develop around small veins and are associated with the leakage of proteins and even red blood cells into the nerve tissue. This causes inflammation and swelling.

The cells which are most vulnerable to damage are not the actual nerve cells but those, called oligodendrocytes, which form the myelin sheaths. In recent years, most of the research into MS has been upon the immune system and it has been suggested that there may be links to viruses. But there is no evidence whatever of infection in MS - despite samples of brain tissue having been taken from living patients during an attack in an attempt to culture a virus. So MS is definitely NOT infectious. The immune changes are seen in many different diseases of the nervous system and hence are secondary features.

Multiple sclerosis is a disease of the central nervous system with effects that can range from relatively minor physical annoyances to major disabilities. The root problem is electrical. Normally, most nerves in the body are insulated by a fatty substance called myelin, which permits the efficient transmission of electrical impulses signalled by the nerve cell. Multiple sclerosis, or MS, occurs when this protective sheath becomes inflamed and ultimately destroyed in places in a process called demyelination. This short-circuits the electrical flow.

It is often very difficult to predict the course of MS. The great variability of this disorder must be considered in each individual case. Some studies have shown that the degree of disability present at five years after the onset of symptoms is a good predictor of disability at 10 or 15 years after onset, and many neurologists use this "five year" rule in predicting a person's course. Other studies suggest that sensory problems (e.g., loss of feeling on the skin's surface, "pins and needles," or increased sensitivity to pain) are associated with a good prognosis, that is, a relatively benign course. Early onset of cerebellar findings, (e.g., tremor, coordination problems and slurred speech) tend to be linked to a more progressive disease course.

The Nature Of MS

In Multiple Sclerosis, the protective coating on nerve fibers (myelin) becomes detached and eventually destroyed. Depending on where the nerve damage occurs, MS can affect vision, sensation, coordination, movement and bladder and bowel control (see red areas).

The National Multiple Sclerosis Society

MS is "a disease that randomly attacks your central nervous system, wearing away the control you have over your body. Symptoms may range from numbness to paralysis and blindness. The progress, severity and specific symptoms cannot be foreseen. You never know when attacks will occur, how long they will last, or how severe they will be. Most people are diagnosed with MS between the ages of 20 and 40...." In medical terms, MS involves demyelinization of the white matter sometimes extending into the gray matter. Demyelinization is loss of myelin, the coating of nerve fibers composed of lipids (fats) and protein that serves as insulation and permits efficient nerve fiber conduction. The "white matter" is the part of the brain which contains myelinated nerve fibers and appears white, whereas the gray matter is the cortex of the brain which contains nerve cell bodies and appears gray. When myelin is damaged in MS, nerve fiber conduction is faulty or absent. Impaired bodily functions or altered sensations associated with those demyelinated nerve fibers give rise to the symptoms of MS. Recent research (1998) has also identified nerve cell death as part of the nervous system injury in MS.

MS tends to take one of four clinical courses. Some people have the benign sensory form, where attacks are characterized by sensory symptoms and/or optic neuritis. These individuals generally do not have severe long-term disability. Many people with MS have a relapsing/remitting course characterized by periodic, unpredictable exacerbations where existing symptoms worsen or new symptoms appear. Remission from such flare-ups may be complete or partial. When remission is partial, the course may be referred to as relapsing/remitting turned progressive. Such individuals sometimes develop a progressive form. A minority of people with MS have a severe, progressive form of the disease from onset, where symptoms generally do not remit, but tend to be progressive from the onset. Research is currently going on to try and identify more precise prognostic indicators of disease activity.

Symptoms Of MS

Types Of MS

Treatment

Causes Of MS

Frequently Asked Questions

QUESTION: "How many people suffer from Multiple Sclerosis?"

ANSWER: In the United States, there are approximately 250,000 - 350,000 reported cases of MS. In Canada, the count is much higher. This estimate suggests that nearly 200 new cases are diagnosed each week.

QUESTION: "Are there different forms of Multiple Sclerosis?"

ANSWER: There are three forms of MS -- relapsing-remitting, secondary progressive, and chronic-progressive.

In relapsing-remitting MS, the person experiences acute attacks during which new symptoms appear or existing symptoms become more severe. These relapses are usually followed by remissions, which may bring you back to your pre-relapse state or leave you with a disability.

In secondary-progressive MS, the person will have a steady pattern of relapses and recoveries. Over time, however, the person's symptoms will become progressively worse with no periods of remission.

Another course is called chronic-progressive. With this form of MS, there are no periods of remission and the person's symptoms simply become progressively worse.

QUESTION: "What are the symptoms of Multiple Sclerosis?"

ANSWER: The symptoms of MS vary from person to person, depending on the area of the nervous system affected. They may include: balance and coordination problems, vertigo, weakness, spasticity of muscles, pain, blurred vision, bladder and bowel problems, sexual dysfunction, and cognitive abnormalities.

QUESTION: "How is Multiple Sclerosis diagnosed?"

ANSWER: The neurosurgeon's first step in MS diagnosis is taking a thorough medical history of the patient. By doing so, the doctor can obtain a detailed description of the patient's symptoms, past illnesses, and surgeries.

The next step in diagnosis is for the doctor to identify the neurological signs of MS, such as damage to the optic nerve, abnormal reflexes, or poor coordination.

The doctor also may perform a spinal tap. In this procedure, a needle is inserted into the spinal column and spinal fluid is removed for analysis. The presence of white blood cells in the fluid may be indicative of an inflammatory reaction resulting from MS. The presence of a pattern of antibodies called oligoclonal bands in the spinal fluid is also common in MS.

In addition, more specialized diagnostic procedures may be performed such as evoked potential tests that record the brain's response to visual, auditory and pain stimuli; computer-assisted tomography (CT) scans that can detect areas of demyelination; and magnetic resonance imaging (MRI) that provides a specialized image of the central nervous system that can't be captured through traditional x-rays or even a CT-scan.

QUESTION: "Can Multiple Sclerosis be treated?"

ANSWER: At present, there is no cure for MS; however, there are effective treatments that can help reduce the severity and frequency of exacerbations and help manage the symptoms.

Two common courses of treatment include drug therapy or alternative healing modalities, commonly known as holistic treatments.

If you have any more questions, please contact your local MS Society. They are more than willing to help. To find an MS Society near you, please see our "Links" page under "MS Societies".

Did You Know?

1. There are approximately 2,500,000 people in the world with multiple sclerosis.

2. There are approximately 50,000 in Canada. One of the highest per capita ratios in the world.

3. Canadians have one of the highest rates of MS in the world. Why? Is it the cold weather? The drastic change of seasons? No one knows!

4. MS can cause loss of balance, impaired speech, extreme fatigue, double vision and paralysis.

5. WOMEN are twice as likely to develop MS as men.

6. MS is the most common neurological disease affecting young adults in Canada.

7. About 350,000 people nationwide have MS.

8. MS affects people of all ages, but is most likely to begin between the ages of 20 and 40.

9. MS differs markedly from one patient to another.

10. MS was first identified and described (MS History) (Natural History) by a French neurologist.

We don't know what causes MS but researchers are closer to finding the answer. So they say.

If you did not find the information that you were looking for, try the search below.

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Famous People with MS

Please feel free to email me if you have any questions or comments.

All of the above information is taken from parts of several different MS web sites. I have gathered it together to try to give a little better understanding and maybe a little comfort to those who have been newly diagnosed. I also hope to try to help those who have been diagnosed for many yrs. We all have to try to help each other deal with this devastating disease everyday.

If there is any information here that you wish to be removed, please email me and I will remove it promptly.


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