MS Information: An Overview

Multiple sclerosis (MS) is an unpredictable disease of the central nervous system. It can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk.

 

MS is a disease with a natural tendency to temporarily go away for a period of time, and for which there is no universally effective treatment.

 

MS Information on the Cause

Many investigators believe that MS is an autoimmune disease -- one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, the nerve-insulating myelin comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus.

 

MS Information on Symptoms

Most people experience their first symptoms of MS between the ages of 20 and 40. The initial symptoms of MS often include:

 

 

Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance. These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis.

 

Most people with MS also exhibit paresthesias, which are temporary abnormal sensory feelings, such as:

 

 

Some may also experience pain. Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss.

 

Approximately half of all people with MS experience cognitive impairments, such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked. Depression is another common feature of MS.

 

MS Information on How the Disease Is Diagnosed

A physician may diagnose MS in some patients soon after the illness begins. In others, however, doctors may not be able to readily identify the cause of the symptoms. This can lead to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously come and go.

 

MS Information on Treatment Options

There is currently no cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. However, three forms of beta interferon (Avonex^®, Betaseron^®, and Rebif^®) have now been approved by the U.S. Food and Drug Administration (FDA) for the treatment of relapsing-remitting MS. Beta interferon has been shown to reduce the number of MS attacks and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe.

 

The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone^®), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. An immunosuppressant treatment, Novantrone^® (mitoxantrone), is approved by the FDA for the treatment of advanced or chronic MS.

 

While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients.

 

Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile. Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physical fatigue.

 

If psychological symptoms of fatigue, such as depression or apathy, are evident, antidepressant medications may help. Another drug that may reduce fatigue in some, but not all, patients is amantadine (Symmetrel^®). Although improvement of visual symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol^®) followed by treatment with oral steroids is sometimes used.