Multiple sclerosis (patient information)
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What is Multiple sclerosis?
Multiple sclerosis, often abbreviated MS, is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS. Multiple sclerosis refers to the scars (sclerosis - or legions) of white matter of the brain of the spinal cord. No one knows what causes MS. It may be an autoimmune disease, which happens when your body attacks itself. Multiple sclerosis affects women more than men. It often begins between the ages of 20 and 40. Some people lose the ability to write, speak or walk. New symptoms can either come in discrete attacks or accumulate slowly over time. There is no cure for MS, but medicines may slow it down and help control symptoms. Physical and occupational therapy may also help.
What are the symptoms of Multiple sclerosis?
Almost any neurological symptom can occur from MS, but some of the most common symptoms include:
- Trouble with coordination and balance, trouble walking, loss of motor coordination and trouble swallowing.
- Sensations such as numbness, prickling, or "pins and needles"
- Bladder problems: increased frequency, incontinence, hesitation, leaking, retention, etc. May lead to urinary tract infections
- Cognitive: loss of memory, attention, processing speed, visual-spatial abilities and executive function.
- Emotional: depression is most common but may also include anger, anxiety, frustration. Suicide is the causes 15% of deaths.
- Fatigue
- Visual: Nystagmus (involuntary eye movement), optic neuritis (inflamation of optic nerve), double vision.
- Pain: Most often form headaches, but also dysesthetic limb pain, back pain, spasms. Acute pain is often from optic neuritis.
- Sexual dysfunction
Causes
Most likely MS occurs as a result of some combination of genetic, environmental and infectious factors.[1] Epidemiological studies of MS have provided hints on possible causes for the disease. Theories try to combine the known data into plausible explanations, but none has proved definitive.
MS is not a hereditary disease, but some genetic variations can increase the risk of developing MS. Specifically differences in the human leukocyte antigen system, a group of genes on chromosome 6, are linked to MS. MS is more common in some ethnic groups than in others.
Environmental factors, such as smoking and decreased light exposure have been shown to increase the risk of MS, while other factors, such as diet and hormone intake, have had inconclusive results.
Lastly, many different microbes have been proposed as potential triggers of MS, but none have been substantiated.
Diagnosis
MS can be difficult to diagnose since the symptoms are very similar to other medical problems. Clinical data alone may be sufficient for a diagnosis of MS if an individual has suffered separate episodes of neurologic symptoms characteristic of MS. Since some people seek medical attention after only one attack, other testing may hasten and ease the diagnosis. The most commonly used diagnostic tools are neuroimaging, analysis of cerebrospinal fluid and evoked potentials. Magnetic resonance imaging of the brain and spine shows areas of demyelination (lesions or plaques).
Treatment options
Although there is no known cure for multiple sclerosis (MS), several therapies for multiple sclerosis have proven helpful. Multiple sclerosis is a chronic inflammatory demyelinating disease that affects the central nervous system (CNS).
The most common initial course of the disease is the relapsing-remitting subtype, which is characterized by unpredictable attacks (relapses) followed by periods of relative remission with no new signs of disease activity. After some years, many of the people who have this subtype begin to experience neurologic decline without acute relapses as the secondary progressive subtype. Other, less common, courses of the disease are the primary progressive (decline from the beginning without attacks) and the progressive-relapsing (steady neurologic decline and superimposed attacks). Different therapies are used for patients experiencing acute attacks, for patients who have the relapsing-remitting subtype, for patients who have the progressive subtypes, for patients without a diagnosis of MS who have a demyelinating event, and for managing the various consequences of MS.
The primary aims of therapy are returning function after an attack, preventing new attacks, and preventing disability. As with any medical treatment, medications used in the management of MS have several adverse effects, and many possible therapies are still under investigation. At the same time different alternative treatments are pursued by many patients, despite the paucity of supporting, comparable, replicated scientific study.
Where to find medical care for Multiple sclerosis
Directions to Hospitals Treating Multiple sclerosis