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Multiple Sclerosis
Basic Information

Multiple Sclerosis

Multiple Sclerosis (MS) is the most common disabling neurological disease of young adults. It most often appears when people are between 20 to 40 years old. However, it can also affect children and older people.

The course of MS is unpredictable. A small number of those with MS will have a mild course with little to no disability, while another smaller group will have a steadily worsening disease that leads to increased disability over time. Most people with MS, however, will have short periods of symptoms followed by long stretches of relative relief, with partial or full recovery. There is no way to predict, at the beginning, how an individual person’s disease will progress.

Researchers have spent decades trying to understand why some people get MS and others don't, and why some individuals with MS have symptoms that progress rapidly while others do not. How does the disease begin? Why is the course of MS so different from person to person? Is there ...

 

 
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What is multiple sclerosis?

  • An unpredictable disease of the central nervous system, multiple sclerosis (MS) can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted.
  • Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye.
  • Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance. In the worst cases, MS can produce partial or complete paralysis.
  • Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or "pins and needles" sensations. Some may also experience pain. Speech impediments, tremors, and dizziness are other frequent complaints.
  • Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked.
  • Depression is another common feature of MS.

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What are the causes of Multiple Sclerosis and how it is diagnosed?

  • The ultimate cause of MS is damage to myelin, nerve fibers, and neurons in the brain and spinal cord, which together make up the central nervous system (CNS).
  • Evidence appears to show that MS is a disease caused by genetic vulnerabilities combined with environmental factors.
  • Although there is little doubt that the immune system contributes to the brain and spinal cord tissue destruction of MS, the exact target of the immune system attacks and which immune system cells cause the destruction isn't fully understood.
  • There is no single test used to diagnose MS. Doctors use a number of tests to rule out or confirm the diagnosis. There are many other disorders that can mimic MS. Some of these other disorders can be cured, while others require different treatments than those used for MS. Therefore it is very important to perform a thorough investigation before making a diagnosis.
  • In addition to a complete medical history, physical examination, and a detailed neurological examination, a doctor will order an MRI scan of the head and spine to look for the characteristic lesions of MS.
  • Doctors may also order evoked potential tests, which use electrodes on the skin and painless electric signals to measure how quickly and accurately the nervous system responds to stimulation. In addition, they may request a lumbar puncture (sometimes called a "spinal tap") to obtain a sample of cerebrospinal fluid.
  • The course of MS is different for each individual, which makes it difficult to predict. For most people, it starts with a first attack, usually (but not always) followed by a full to almost-full recovery. Weeks, months, or even years may pass before another attack occurs, followed again by a period of relief from symptoms. This characteristic pattern is called relapsing-remitting MS.
  • Primary-progressive MS is characterized by a gradual physical decline with no noticeable remissions, although there may be temporary or minor relief from symptoms.
  • Secondary-progressive MS begins with a relapsing-remitting course, followed by a later primary-progressive course.

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How is Multiple Sclerosis treated?

  • There is still no cure for MS, but there are treatments for initial attacks, medications and therapies to improve symptoms, and recently developed drugs to slow the worsening of the disease.
  • These new drugs have been shown to reduce the number and severity of relapses and to delay the long term progression of MS.
  • The usual treatment for an initial MS attack is to inject high doses of a steroid drug, such as methylprednisolone, intravenously (into a vein) over the course of 3 to 5 days.
  • During the past 20 years, researchers have made major breakthroughs in MS treatment due to new knowledge about the immune system and the ability to use MRI to monitor MS in patients. As a result, a number of medical therapies have been found to reduce relapses in persons with relapsing-remitting MS.
  • These drugs are called disease modulating drugs.
  • MS causes a variety of symptoms that can interfere with daily activities but which can usually be treated or managed to reduce their impact. Many of these issues are best treated by neurologists who have advanced training in the treatment of MS and who can prescribe specific medications to treat the problems.
  • Although researchers haven't been able to identify the cause of MS with any certainty, there has been excellent progress in other areas of MS research—especially in development of new treatments to prevent exacerbations of the disease. New discoveries are constantly changing treatment options for patients.

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