Advances in Multiple Sclerosis
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Overview of Multiple Sclerosis

Multiple Sclerosis is a chronic neurological illness that affects the central nervous system (CNS). The CNS consists of the brain and the spinal cord and is composed of many nerve cells. The nerve cells transmit impulses or messages to different parts of the body. Each nerve cell has a special type of coating known as myelin. This coating is similar to the insulating material you see on an electric wire. The myelin provides protection and insulation and aides in quickening the transfer of messages.

For reasons presently unknown in Multiple Sclerosis, areas on the myelin become randomly destroyed and replaced by hardened plaques, similar to scabs that form on your skin after you are injured. When the myelin is destroyed, the transmission is interrupted and function becomes impaired. As the name multiple sclerosis implies, multiple areas of plaque formation may be found in the brain and spinal cord.

Approximately 350,000-400,000 people in the United States are afflicted with MS. It has been estimated that two-thirds of the population with MS are women. The average age of onset is the mid-thirties, although the age range of diagnosis may be between 20-50 years of age. The explanation for the high prevalence of MS in women and the age of onset are both areas that researchers are currently investigating.

At the present time, there is no known cure for MS. Its progression, severity, and prognosis cannot be predicted.

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Possible Causes of MS

It is important to note, that despite MS first being clinically identified in the mid-1800's, its cause remains unclear.

The following are some suspected causes of MS:

Autoimmune disorder

Considerable research has focused on the possibility that MS is a disease related to an impairment of the body’s immune system. In autoimmune diseases, the immune system reacts against the patients own body, rather than performing its normal protective role against illness.

Genetic factors

The clinical observation that MS sometimes occurs in families has served as basis that there may be a genetic predisposition. In those cases thought to be genetically transmitted there is a yet to be identified complex set of genetic factors that may help to determine who may be genetically susceptible to developing MS.

Environmental trigger

Scientific evidence exists that suggests that the environment plays a role in the cause of MS. Epidemiologic studies have shown that people born in areas with a high prevalence of MS are at a greater risk of developing the disease. Exposure to environmental agents such as bacteria and viruses may also be a causative factor. There is also a higher incidence of MS in colder climates.

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What are the Symptoms of MS?

Patients with MS experience a variety of symptoms such as:

  • Fatigue
  • Weakness
  • Tremors
  • Balance difficulty
  • Stiffness or spasms
  • Bowel and bladder dysfunction
  • sexual dysfunction
  • Walking difficulty
  • Visual disturbances
  • Dizziness
  • Pain
  • Numbness and tingling
  • Mood changes
  • Speech and swallowing difficulty

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What are the types of MS?

  • Primary Progressive -- The disease shows gradual progression of disability from its onset, without plateaus or remissions or with occasional plateaus and temporary minor improvements.
  • Secondary Progressive -- The disease begins with an initial relapsing-remitting course, followed by progression at a variable rate that may also include occasional relapses and minor remissions.
  • Relapsing-Remitting -- This form of MS is characterized by clearly defined acute attacks with full recovery or with some remaining neurological signs/symptoms and residual deficit upon recovery. The periods between disease relapses are characterized by a lack of disease progression.
  • Progressive Relapsing -- This pattern of MS shows progression from onset, but without clear acute relapses or remissions. It is more commonly seen in people who develop the disease after the age of 40.

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How is MS Treated?

There are many treatments that can alter the course of your disease. There is a group of medications referred to as, "Immuno-Modulating Agents or "IMA's" also commonly referred to as the "ABC's". These drugs include Avonex®, Betaseron®, and Copaxone®.

In the event that a patient has not responded or is no longer responding to the IMA’s, other therapies such as IVIG or Mitoxantrone may be used alone or in combination with IMA’s. The introduction of these secondary therapies are often associated with long periods of clinical remission.

It is important to remember that through combinations of these medications patients have been able to achieve long periods of remission that may last for years.

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