Multiple Sclerosis

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Multiple sclerosis (MS) is a disease involving the nerves of the brain and spinal cord.

To function properly, these nerves depend upon myelin, a fatty insulation. MS develops when the body's own immune system starts to destroy the myelin. Thus, the disorder is an autoimmune disease, in which the body reacts to being "allergic" to itself.

Though MS is not fatal, the disease is chronic and sometimes debilitating. Without a cure, the disease's physical and emotional effects can be lifelong, depending upon the type of MS.

There are five types of MS:

1. Benign - Symptoms are mild to moderate and don't grow worse or lead to permanent disability. This type accounts for approximately 10 to 15 percent of all MS patients.

2. Relapsing-Remitting - Symptoms come and go. They can relapse for a period of time, from weeks to months, and then disappear for another period. This form of MS accounts for approximately one-half of all patients. Most cases of MS begin with this type and gradually change into one of the other forms.

3. Primary-Progressive - Symptoms appear and gradually worsen from the start, without periods of remission. Symptoms occasionally plateau, and minor improvement is possible. Approximately 10 to 15 percent of patients begin with this disease pattern.

4. Secondary-Progressive - Symptoms run a deteriorating course after years of a relapsing-remitting pattern. Relapses can still occur. Approximately one-half of patients with the relapsing-remitting form of MS develop this form.

5. Progressive-Relapsing - Symptoms gradually worsen from the start with new symptoms periodically appearing and existing symptoms intensifying. A rare form of MS, accounting for less than 5 percent of all patients.

While scientists haven't yet pinpointed an exact cause of MS, they have found several factors that increase a person's risk of developing the disease:

1. Geography - People who live above and below the 40th parallel (away from the equator) have a greater tendency to develop MS than people who live closer to the equator. In the United States, people who live north of the 37th parallel (extending from Newport News, Va., to Santa Cruz, Calif., and running along the northern border of North Carolina to the northern border of Arizona) have a greater chance of developing MS than people who live south of the 37th parallel.

2. Ethnicity - People of Northern European ancestry are at greater risk.

3. Sex - Twice as many women develop MS as men.

4. Genetics and Heredity - Inheriting a specific combination of genes may increase risk for developing MS. If a family relative has MS, a person's risk increases depending upon the relation. (Scientists believe that some of the genes involved in MS may be those of the immune system, since it is this system that seems to go awry.)

Initial symptoms may include weakness, tremor, loss of vision, pain, loss of balance, fatigue, decreased control of arms and legs, poor coordination, bladder and bowel dysfunction, difficulty in walking and numbness or tingling sensations. A sudden, otherwise-unexplained loss of vision may be the first symptom of MS.

New symptoms appear as the disease progresses. These include imbalance, sexual dysfunction, hearing loss, vertigo, paralysis, facial pain, memory loss, depression and difficulty in concentrating and problem solving. MS patients may also experience spasticity, a decreased ability to control movement.

• Medications treat symptoms of fatigue, spasticity, bladder dysfunction, tremors, pain, sexual dysfunction and depression. Other medications that suppress or adjust the immune system may also alleviate MS symptoms.
• Some MS patients who experience severe pain can elect to have surgery to remove or block parts of a nerve.
• Exercise, drinking sufficient amounts of water, avoiding caffeinated drinks and eating a high-fiber diet alleviate symptoms of bowel dysfunction.
• Supervised exercise to regain or maintain muscle tone is important.
• Maintaining emotional and mental health through psychological support from family, friends and professional counselors is very important for MS patients.
• Several medications and therapies are under research for their effectiveness in treating MS.

Because scientists don't know what causes MS, preventing the disease isn't possible yet. However, studies have shown that people can decrease their risk if they move away from a high-risk location. This phenomenon, however, only applies to individuals who move before 15 years of age.