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Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system. With multiple sclerosis, the brain has difficulty getting messages to the rest of the body. Though we know relatively little about multiple sclerosis, research into its causes and possible treatments is rapidly developing.
Researchers believe that MS causes the body's immune system to attack myelin, which is an insulating coating around nerve cells.
When myelin erodes, communication between nerve cells in the central nervous system is disrupted. When this happens, some parts of the body do not receive instructions from the central nervous system, which controls everything the body does.
The disease can cause varying symptoms that appear with a wide range of severity, from mild discomfort to complete disability.
Relapsing-remitting: This form of multiple sclerosis comes and goes over time. Symptoms can be severe for a time but then disappear. About 85 percent of multiple sclerosis patients develop onset of the disease in this manner (Murray, T., et al., 2013).
Secondary-progressive: After the initial attack, the disease may begin to progress in a more deliberate way. In this type of MS, symptoms do not subside. Before new therapies were created, about 50 percent of people with multiple sclerosis entered a progressive stage. However, the effectiveness of the new therapies has not been fully evaluated (Murray T., et al, 2013).
Primary-progressive: People who develop this form of the disease generally do so later in life. They decline slowly, without many ups and downs.
Progressive relapsing: In this form of multiple sclerosis, symptoms initially progress slowly but eventually worsen over time.
Multiple sclerosis is very unpredictable. Some people have an initial attack and don't progress. Sometimes, in older people, progression will stop altogether. According to the Multiple Sclerosis Association of America, it is unclear why the disease affects people in such a variety of ways.
Nobody knows what causes multiple sclerosis. However, scientific evidence has led to four main theories about what triggers it.
It is commonly believed that the immune system plays a role in multiple sclerosis by attacking myelin. However, researchers don’t yet know if the body does this naturally or if other factors cause the attacks.
People living near the equator have a lower incidence of multiple sclerosis. Some believe that extra sunlight causes the body to make more vitamin D and reduces the risk of MS. In the United States, the incidence of multiple sclerosis in North Dakota is twice that of Florida, according to researchers at the University of California.
Researchers are also investigating whether diets high in saturated fat, or low in fish oils and vitamin D, are linked to the disease.
Incidence of multiple sclerosis among primary family members suggests genetics may play a role in MS. Although the risk of developing MS among the general population is about 0.15 percent, it can be as high as four percent among people who have a brother, sister, mother, or father with the disease (University of California, San Francisco, 2013).
Researchers are also exploring whether viral or bacterial infections or other pathogens trigger the immune response that is believed to lead to multiple sclerosis.
Multiple sclerosis most commonly affects people between the ages of 20 and 40, according to the Mayo Clinic. However, people can develop the disease at any age.
Women have a higher risk of developing the disease than men do.
While there is a hereditary link to MS, it is not the only factor. Research shows that among twins, a person has only a 30 percent chance of developing the disease if his or her twin has it, according to the Mayo Clinic.
Multiple sclerosis symptoms vary greatly from patient to patient. Common symptoms include:
There is no definitive diagnosis for multiple sclerosis. Doctors determine whether you have it by ruling out other illnesses. They do this by evaluating your symptoms, performing a clinical exam, and ordering tests.
Tests that may point to a possible multiple sclerosis diagnosis include:
Though multiple sclerosis has no cure, it can be treated in a variety of ways. New research has also led to new therapies.
Many medications exist to treat multiple sclerosis for the long term, including new classes of drugs that manipulate the body's immune response. Most are taken intravenously or by injection, but a few come in pill form.
During flare-ups, corticosteroids can offer relief.
Many over-the-counter and prescription medications can help manage the various symptoms associated with multiple sclerosis. These include medications for pain, anxiety, muscle spasms, infections, and bladder and bowel problems.
Surgeries may be performed to help control severe tremors and muscle spasms.
A variety of vitamins, herbs, and nutritional supplements may offer symptom relief. Always talk to your doctor before beginning one of these regimens.
Yoga, acupuncture, homeopathic remedies, and aquatic exercise are other alternative home therapies that may alleviate symptoms.
Plasmapheresis, also known as plasma exchange, can offer temporary relief during flare-ups.
Physical, speech, and occupational therapies can help someone suffering from multiple sclerosis better perform daily tasks.
Multiple sclerosis is a chronic condition. It progresses at varying rates. Although multiple sclerosis can lead to total disability, most people are able to manage symptoms with some degree of success. Most patients live 30 years or more after their diagnosis, according to the University of Maryland Medical Center.
Written by: June Halper, MSN, APN-C, FAAN, MSCN
Medically reviewed by George Krucik, MD, MBA
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