3/21/2023
Looking for a Good Explanation of MS to Provide Others?
Multiple Sclerosis Awareness Month is a time for everyone to learn more about the neurological disease that currently affects almost one million Americans. About 200 people are diagnosed with MS each week and it is becoming more prevalent every year. It affects all races and nationalities, but is more prevalent in areas further from the equator. Both men and women are impacted, but four times as many women are stricken with MS than men. Despite years of intense research, the cause of MS is still unknown. Risk factors include smoking, stress, low vitamin D levels, inflammation, and obesity.
MS is an autoimmune disease that affects the central nervous system, the brain, and the spinal cord. With MS, a person’s own immune system mistakenly attacks their myelin, the outer protective covering of nerves, the brain and the spinal cord. Myelin enables nerve signals to travel effectively without getting short- circuited like the electrical current in a worn electrical wire. Where and how much myelin is destroyed by the immune system determines the type and severity of symptoms a person will have. As such, people with MS have a wide variety of symptoms The most common are fatigue, numbness and tingling, loss of balance and dizziness, spasms, tremor, pain, bladder problems, bowel problems, vision problems, loss of strength and mobility, depression, and anxiety.
When someone is suspected of having MS, doctors employ a number of tests to confirm the diagnosis. While there is no specific blood test to diagnose MS, doctors may order blood tests to exclude other diseases that may mimic MS. A spinal tap is often performed to identify antibodies indicative of MS in the cerebral spinal fluid. Evoked potential testing can also be performed to measure abnormalities in nerve transmission seen in MS. Since the widespread use of MRIs, the diagnosis of MS has become more straightforward. Now, in most cases, a diagnosis of MS can be made based on a pattern of symptoms consistent with the disease and MRI changes that confirm it.
There are four types of MS often starting with Clinically Isolated Syndrome (CIS). In CIS, a person has neurologic symptoms that last at least 24 hours and usually either totally or partially resolve. While individuals who develop CIS do not technically have MS, they are at risk of developing the full-blown disease. To delay the progression to MS, these patients are currently treated with disease modifying therapy.
The most common form of MS is Relapsing- Remitting MS (RRMS). in which there are attacks followed by remissions. 85% of people with MS are initially diagnosed with this form. Many patients with RRMS will subsequently develop Secondary Progressive MS (SPMS), where the clinical course is relentlessly downhill without any significant remissions. The last type of MS is Primary Progressive MS (PPMS), in which neurologic function progressively worsens from the time of diagnosis.
Unfortunately, there is no cure for MS. However, in recent years more than a dozen Disease Modifying Therapies have been developed that can significantly slow the progression of MS and limit disability. They are particularly successful with RRMS, less so with the progressive forms of the disease. They are available in oral formulations, as well as injectable and infused types. Hopefully, continued research will uncover the cause of MS and a cure will be developed.
Stephen Yerkovich, MD
Chief of Medical Services
Paralyzed Veterans of America
Article Credit: Paralyzed Veterans of America
