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Monday, January 21, 2013

Multiple sclerosis is now a treatable disease. Get the facts about MS, and find out why MS experts are upbeat about this common neurological disorder.

January 2013

Medically reviewed by Lindsey Marcellin, MD, MPH

10 Facts You Should Know About Multiple Sclerosis

Multiple sclerosis, or MS, is a disease of the nervous system that can affect the brain and spinal cord. MS symptoms are caused by the progressive loss of myelin, the outer protective lining of nerve fibers. Myelin is like the coating around an electrical wire: Without enough myelin, nerve signals have trouble passing through the nerves. The full cause of MS is not completely understood, but it's partly due to the body's immune system mistakenly attacking myelin cells. That's why multiple sclerosis is called an autoimmune disease.

Anyone Can Get MS

In the United States, MS affects approximately 1 in 700 to 1 in 1,000 people. Over two million people worldwide are affected by MS. “The incidence varies widely," says John Wilson, MD, a neurologist at Gottlieb Memorial Hospital in Maywood, Ill., part of the Loyola University Health System. "It is a disease that is more common the farther north from the equator one gets. It tends to be more common in women than men and to occur in people between 20 and 40, but people any age can get it.” According to the National Multiple Sclerosis Society, about 200 people are diagnosed with MS every week.

MS Causes and Triggers Vary

Doctors think MS is caused by a combination of factors. "Part of the cause is genetic, but there must also be some environmental factors that trigger the disease," says Matthew McCoyd, MD, a neurologist, assistant professor, and associate neurology residency program director with the Loyola University Health System in Illinois. “Possible MS triggers may include things like decreased sunlight, vitamin D deficiency, or viral infections.” The genes you’re born with may increase your risk for multiple sclerosis, but there is no evidence that MS is directly passed down through families.

Some MS Symptoms Are Common, Some Are Not

"Commonly, multiple sclerosis can cause problems with vision, including sudden loss of vision in one eye or, rarely, both eyes; double vision; blurred vision; severe dizziness; imbalance; numbness; weakness; muscle spasms; tremors; speech problems; depression; and facial pain,” says Dr. Wilson. “While facial pain is a symptom of MS, headache is almost never caused by MS." Other MS symptoms include fatigue and mental fogginess or confusion. The most important thing to know about these symptoms is that they come and go unpredictably.

MS Can Flare and Relapse

MS flares may be old symptoms, such as fatigue, numbness, or tingling, which start up when someone with MS is overtired or perhaps fighting off an infection. "A relapse occurs when the disease acts up and causes new damage to the nervous system," says Dr. McCoyd. "Relapse symptoms that last for more than a full day and include symptoms that are disabling are usually treated." After treatment, these symptoms may go away completely, a period known as remission. New medications to treat MS are aimed at keeping people in remission for longer periods of time. Flare symptoms that have occurred before and are not disabling usually don’t require any treatment.

There Are Four Types of MS

"There is relapsing-remitting, the most common type; relapsing-progressive; secondary-progressive; and primary-progressive MS," explains Wilson. People who have the relapsing-remitting type of MS have periods of remission between attacks, when the disease does not progress. About 85 percent of people have this type of multiple sclerosis. The progressive types of MS are more difficult to manage and treat because they have few or no periods of remission between attacks. These types of MS are rare.

MS Is Treatable

There was a time when doctors could only treat severe MS symptoms with steroids, and then hope for the best. Now, however, there are promising medical advances. "If I have to say one thing about MS, it is that it is treatable,” says Wilson. “Gone are the days when we had to stand by and watch the disease progress without being able to treat it. There are a number of medications available, and more in the pipeline. Today's medications are effective in reducing the symptoms and the progression of the disease."

MS Medications Are Evolving

Steroid drugs are still used to treat MS relapse symptoms, but the big advance in MS treatment over the past 20 years has been a category of medication called disease-modifying drugs. These drugs are started as soon as possible after diagnosis to prevent MS progression. Medications called interferons, given by injection, prevent immune cells from getting into the brain and the spinal cord. Other medications are given by periodic intravenous infusion, and some can be taken by mouth. Newer drugs are becoming available that have fewer side effects, can be taken by mouth, and may need to be given only a few times a year. In 2012, for example, great advancements were made in the use of nanotechnology for treating multiple sclerosis.

The Prognosis for People With MS Is Improving

Early treatment with disease-modifying drugs has changed the prognosis of multiple sclerosis. "Except for rare cases of progressive disease, data from the past 20 years now show that people with MS can expect to live full and normal lives with no drop in life expectancy," says McCoyd. The majority of people with MS do not become severely disabled. Although some people will need the help of a cane or wheelchair because of fatigue or weakness, about two-thirds of people with MS never lose their ability to walk.

You Can Live a Full Life With MS

"Generally, eating healthy foods and exercise help," says Wilson. "The most common triggers for symptoms are infections, heat, and high stress. Avoiding these can reduce flare-ups in many people." Although most people with MS do not become severely disabled, they do have bothersome and unpredictable MS symptoms, and they may tire easily. They need to know their limitations and work closely with their MS treatment team. Women with MS can get pregnant and often go into remission during pregnancy.

There Is Hope for a Cure

Although there is still no cure for MS, treatment and management have come a long way. "There are several new drugs that will be approved this year alone," says McCoyd. New drugs have also been approved to reduce symptoms of the rarer relapsing forms of MS. According to the Multiple Sclerosis Society, advances in the treatment and understanding of MS are being made every year, and the possibility that future research will finally find the cure for multiple sclerosis is very encouraging. Meanwhile, research into the use of stem cells to cure MS is ongoing.
Source: Everyday health

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Unknown said...

It is wrong to state that MS is treatable since PPMS has no known treatment or anything even in the pipeline. Better to say that RRMS is treatable.


Unknown said...
This comment has been removed by the author.
Unknown said...

In early day, relapses will subside anyway, medications or not. Once the "secondary" stage is reached, it is less clear - to say the least. The condition equals PPMS, where claims of immune treatment fail. Then, even the diagnosis is questioned because progression no longer fits the picture. My case.
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