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Multiple Sclerosis Fast Facts

MS damages fragile nerve cells in the brain and spinal cord. Normally, tiny jolts of electricity flash through the brain, directing every movement and thought.

Nerves are like electrical wires wrapped with a protective layer of insulation called myelin. The myelin sheath covers fibers called axons — spiky branches that radiate from the main body of the nerve cell. The fatty layer of myelin shields the signals speeding from the brain down the spinal cord to the muscles and memory.

As MS progresses, the myelin frays and nerve impulses slow to a crawl, disrupting transmission of signals in the brain, optic nerve, and spinal cord. Over time, neurological problems erupt as the myelin deteriorates in widespread regions of the brain.

Treatment advances and novel therapies are bringing hope to the more than 2.3 million people worldwide who suffer from MS.

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a neurological disease that affects the transmission of nerve impulses in the brain and from the central nervous system to the rest of the body.

Nerves are like electrical wires wrapped with a protective layer of insulation called myelin. The fatty layer of myelin shields the signals moving from the brain down the spinal cord to the muscles to other parts of the body. Multiple sclerosis strips the myelin from nerve cells, scarring multiple areas of the brain. The disease erodes the protective covering around the nerves and blocks the delivery of nerve impulses between the body and brain.

Types of Multiple sclerosis

There are four distinct types of multiple sclerosis:

  • Relapsing-Remitting Multiple Sclerosis. In this type of the disease, symptoms come and go. Between attacks, people often feel better and the disease stops its steady progression. The disease typically flares up again over time. These relapses are followed by quiet periods of remission that can last months or years. About 80% of people with Multiple sclerosis have this type of Multiple sclerosis.
  • Secondary Progressive Multiple Sclerosis.  In this type, symptoms of MS come and go but then worsen over time. Many people start with relapsing-remitting Multiple sclerosis and progress to secondary progressive disease. About 60-70% of people with relapsing-remitting Multiple sclerosis eventually develop secondary-progressive Multiple sclerosis.
  • Primary Progressive Multiple Sclerosis. In this type, symptoms gradually become more severe as the disease progresses. The disease comes on gradually and onset and progresses steadily without remission. Approximately 15-18% percent of people with Multiple sclerosis are diagnosed with this form of the disease.
  • Progressive Relapsing Multiple Sclerosis. In this type, symptoms gradually worsen and are accompanied by attacks that come and go. Progressive relapsing Multiple sclerosis is a rare form of multiple sclerosis that initially appears with constant symptoms. People with progressive relapsing Multiple sclerosis also experience clinical attacks marked by more severe symptoms.

Symptoms of Multiple Sclerosis

Multiple sclerosis causes many different symptoms, which vary in severity from person to person. While some people remain symptom-free most of their lives, others suffer severe symptoms that never go away.

Symptoms of Multiple sclerosis include:

  • Numbness and tingling
  • Depression
  • Fatigue
  • Impaired coordination
  • Muscle weakness or spasms
  • Pain (headache, back pain, spasms, neuralgia)
  • Itching sensations
  • Sensitivity to heat
  • Cognitive or memory issues (rarely, dementia)
  • Vision problems, eye pain, eye movement abnormalities, and blindness
  • Feeling dizzy or off-balance
  • Walking and gait disturbances
  • Trouble speaking
  • Bowel and bladder problems
  • Sexual dysfunction
  • Permanent nerve damage
  • Paralysis

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

What Causes Multiple Sclerosis?

The cause of Multiple sclerosis remains unknown. Researchers suspect that genetic susceptibility, abnormalities in the immune system, and environmental factors combine to cause Multiple sclerosis. Some think a childhood virus may trigger the disease later in life.

Many experts think MS is sparked by an overactive immune system. Autoimmune disorders strike when the body’s infection-fighting system goes awry and damages healthy tissues. Inflammation defends the body against acute injury or infection, but the system must turn on at just the right moment to repel an assault and then quickly switch off when the threat is over.

Within the nervous system, the immune response may kindle inflammation that destroys the myelin sheath. As the faulty immune system battles a non-existent threat, the body’s disease-fighting defenses unleash a cascade of destructive chemicals.

Additional factors associated with an increased risk of developing MS include:

  • Exposure to the Epstein-Barr virus
  • Low levels of vitamin D
  • Smoking

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Is Multiple Sclerosis Hereditary?

While Multiple sclerosis tends to run in families, a definite genetic cause has not yet been identified. The risk of developing the disorder is higher for siblings or children of someone with Multiple sclerosis than for the general population.

The human leukocyte antigen (HLA) DRB1*1501 has been consistently associated with multiple sclerosis in nearly every population studied. Changes in the HLA-DRB1 gene are the strongest genetic risk factors for Multiple sclerosis,  although exactly how those changes increase the risk of developing Multiple sclerosis is not yet fully understood.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Multiple Sclerosis Detected?

Symptoms of Multiple sclerosis often appear as early as 10 to 15 years before diagnosis. Some people spend a decade or more seeking an explanation for their frequent falls, fatigue, muscle weakness, tingling sensations, balance issues, and cognitive problems before Multiple sclerosis is identified as the cause.

A number of secondary problems often worsen as the disease progresses. These symptoms include:

  • Fatigue
  • Depression
  • Infections
  • Limited mobility
  • Anemia
  • Sleep disturbances
  • Foggy memory
  • Sensations of weakness and dizziness

According to guidelines from the American Academy of Neurology, most people should start taking medications as soon as symptoms appear. Early treatment can prevent the development of new lesions in the brain. The sooner treatment begins, the less disability will develop.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Multiple Sclerosis Diagnosed?

No single laboratory test can diagnose or rule out MS. When someone experiences muscle spasms, numbness, lack of coordination, unsteady gait, and other subtle neurological problems, doctors run a battery of tests, including:

  • Blood tests to help rule out other diseases with symptoms similar to those of Multiple sclerosis.
  • lumbar puncture (spinal tap) that takes a small sample of cerebrospinal fluid from the spinal canal for laboratory analysis.
  • Magnetic Resonance Imaging (MRI) that examines damage to the brain and spinal cord. The noninvasive imaging test shows where nerve damage has occurred. An MRI scan can reveal the presence of lesions or scars in the central nervous system where the myelin has been destroyed.

PLEASE CONSULT A PHYSICIAN FOR MORE INFORMATION.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Multiple Sclerosis Treated?

There is no cure for Multiple sclerosis. There are several FDA-approved “disease-modifying” drugs that relieve symptoms. Most Multiple sclerosis treatments are delivered as injections or as monthly intravenous (IV) infusions, although new pills are coming onto the market. People frequently switch to a new drug when a particular disease-modifying drug stops working.

Although immune-system suppressing treatments are effective against Multiple sclerosis, they disrupt the entire immune system, including its ability to defend against infection. In people with a weakened immune system, a common virus, referred to as the John Cunningham Virus, can become reactivated in the body. People with antibodies to the virus are at risk for a potentially fatal brain inflammation called progressive multifocal leukoencephalopathy (PML).

Medications

Doctors recommend beginning treatment with an FDA-approved disease-modifying therapy as soon as possible following a diagnosis of relapsing or primary progressive Multiple sclerosis. Some medications for Multiple sclerosis relieve symptoms or treat specific problems, while other drugs affect the long-term course of the disease. Medications that suppress the immune system relieve symptoms and slow disease progression.

Infusion treatments can help individuals with progressive Multiple sclerosis who continue to demonstrate clinical relapses and/or inflammatory activity.

Treatment medications include:

  • Injectable medications. Interferon-beta (Avonex, Betaseron, Extavia, Rebif) was the first FDA-approved medication for Multiple sclerosis.
  • Oral medications. The medications available in pill form include teriflunomide (inhibits the function of specific immune cells), fingolimod (reduces the frequency of clinical relapses and delays physical disability), and dimethyl fumarate (thought to inhibit immune cells and molecules).
  • Infused medications. Therapies delivered through plastic tubing to a small needle into a vein in your arm. Infusions include alemtuzumab, mitoxantrone, ocrelizumab, and natalizumab.

Therapies

People with Multiple sclerosis benefit from a wide range of rehabilitative therapies:

  • Physical Therapy (PT) helps with walking, strength, balance, posture, fatigue and pain. PT often includes stretching and strengthening exercises for mobility. Therapists also help people with Multiple sclerosis learn to use assistive devices, such as wheelchairs and scooters.
  • Occupational Therapy (OT) improves independence and safety at home and at work. OT helps people with Multiple sclerosis stay relatively active.
  • Speech Therapy. Multiple sclerosis can cause problems with the control of the muscles needed for talking and swallowing. A speech and language therapist helps people communicate as clearly as possible. The therapist can provide exercises to improve swallowing.

Managing Relapses

Relapses — also called attacks or exacerbations — are caused by inflammation in the central nervous system. Relapses may involve loss of vision, severe weakness or poor balance, which interfere with mobility, and overall ability to function.

Although relapse may gradually resolve without treatment, most neurologists recommend treatment with corticosteroids (methylprednisolone, prednisone, and ACTH are the most common). The treatment regimen is usually a three-to-five-day course of high-dose, intravenous corticosteroids to reduce inflammation and end the relapse more quickly.

Multiple sclerosis in Pregnancy

Multiple sclerosis affects women of childbearing age more often than any other group. Doctors suggest treating Multiple sclerosis with safer medications during pregnancy since several medications for Multiple sclerosis have been shown to cause birth defects. It can take six to 12 weeks for immune-suppressing medications to be cleared from the body. Women with Multiple sclerosis who plan to become pregnant should talk to their doctors in advance. A woman who suffers an attack while pregnant can safely take short-term steroids.

After childbirth, Multiple sclerosis relapses tend to occur during the first three to six months. The risk of relapse in the postpartum period is estimated to be 20-40%. These relapses do not appear to contribute to increased long-term disability.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Does Multiple Sclerosis Progress?

Scientists continue to study the complex brain changes that cause Multiple sclerosis. On average, people with Multiple sclerosis have only a slightly shorter lifespan than the general population. Many people may have long periods of symptom-free living, with occasional flares or exacerbations.

Lesions in the spinal cord and the brain develop as the disease progresses. Gradual worsening, sometimes with acute attacks of inflammation, may occur quickly or slowly. The typical pattern is one of the recurrent attacks followed by partial recovery, although chronic progressive Multiple sclerosis also occurs.

There is no way to predict how someone’s disease will progress. Despite difficult challenges, most people with Multiple sclerosis live long and productive lives.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is Multiple Sclerosis Prevented?

Because the cause of the disease has not yet been determined, there is no known way to prevent Multiple sclerosis. In the absence of a sure way to prevent the disease, it’s best to avoid the risk factors that have been positively linked to Multiple sclerosis.

  • Take supplements to maintain adequate vitamin D levels in the body. Researchers are studying whether vitamin D can prevent Multiple sclerosis. A large Finnish study showed that children of women who were vitamin D deficient early in their pregnancy had a 90% increased risk of developing Multiple sclerosis as an adult.
  • Quit smoking. Studies have shown that smoking can substantially increase the risk of developing Multiple sclerosis.
  • Lose weight. Obesity increases the chances of developing Multiple sclerosis.
  • Exercise slows the progression of Multiple sclerosis. Promising early results suggest resistance training may also slow Multiple sclerosis progression.
  • Omega-3 oils appear to reduce disease activity and progression. No one knows if they can stave off the disease.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Multiple Sclerosis Caregiver Tips

The most important thing you can do for a loved one with Multiple sclerosis is to be supportive. Try these helpful strategies:

  • Get an accurate diagnosis. The early signs of Multiple sclerosis can be subtle, making the disease very difficult to detect. Be watchful for the warning signs of Multiple sclerosis and bring them to your doctor’s attention whenever you have a concern.
  • Put a treatment plan in place. Be ready to switch medications. Multiple sclerosis progresses differently in different individuals, and a treatment that works for one patient might not work for another. Don’t expect your loved one’s treatment plan to go as planned without modifications.
  • Be patient when communicating with someone with Multiple sclerosis. Halting or slurred speech can make it difficult to understand what’s being said. Manage your frustration and focus on making your loved one feel comfortable and safe.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Multiple Sclerosis Brain Science

Multiple sclerosis causes gradual destruction of myelin throughout the brain and spinal cord. As the myelin sheath degenerates, Multiple sclerosis affects the nerve cells (neurons) in the brain and spinal cord that control the body and mind.

MRI studies reveal significant lesions in the brain and spinal cord in people with Multiple sclerosis. Over time, new lesions develop. An early MRI of the brain may appear normal, but abnormalities appear over time. Lesions are evidence of nerve cell damage in the brain or spinal cord.

Depending on where they occur, the effects of lesions vary:

  • Lesions on the spinal cord cause sensory or motor challenges.
  • Lesions in the front of the brain cause weakness or numbness.
  • Lesions on the back part of the brain cause issues with balance and coordination.

Brain scientists have several promising vaccines in the pipeline. One study showed that people with early signs of Multiple sclerosis who were given a vaccine to prevent tuberculosis (BCG) were less likely to develop full-blown Multiple sclerosis than those given a sugar pill. Exactly how BCG vaccination helps prevent Multiple sclerosis relapses is unknown. Although research is still early, some scientists believe that regular doses of a vaccine may someday become a routine preventive treatment.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Multiple Sclerosis Research

Scientists are working on several research projects to expand on what is known about Multiple Sclerosis (MS). The research will improve knowledge about the factors that increase the risk for Multiple Sclerosis (MS), as well as the causes, and best treatments, and will aid people living with Multiple Sclerosis (MS) and their caregivers.

We are currently gathering the information required to support projects such as Speed of Processing Training to Improve Cognition in Multiple SclerosisIntermittent vs Continuous Walking in People With Multiple Sclerosis, and Aspirin for Exercise in Multiple Sclerosis (ASPIRE).

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

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