Category Archives: multiple-sclerosis

Multiple sclerosis (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. They can include

No one knows what causes MS. It may be an autoimmune disease, which happens when your immune system attacks healthy cells in your body by mistake. Multiple sclerosis affects women more than men. It often begins between the ages of 20 and 40. Usually, the disease is mild, but some people lose the ability to write, speak, or walk.

There is no single test for MS. Doctors use a medical history, physical exam, neurological exam, MRI, and other tests to diagnose it. There is no cure for MS, but medicines may slow it down and help control symptoms. Physical and occupational therapy may also help.

NIH: National Institute of Neurological Disorders and Stroke

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Multiple Sclerosis: MedlinePlus - National Library of Medicine

Multiple sclerosis (MS), also known as disseminated sclerosis or encephalomyelitis disseminata, is an inflammatory disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs and symptoms,[1][2] including physical, mental,[2] and sometimes psychiatric problems.[3] MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms).[4] Between attacks, symptoms may disappear completely; however, permanent neurological problems often occur, especially as the disease advances.[4]

While the cause is not clear, the underlying mechanism is thought to be either destruction by the immune system or failure of the myelin-producing cells.[5] Proposed causes for this include genetics and environmental factors such as infections.[2][6] MS is usually diagnosed based on the presenting signs and symptoms and the results of supporting medical tests.

There is no known cure for multiple sclerosis. Treatments attempt to improve function after an attack and prevent new attacks.[2] Medications used to treat MS while modestly effective can have adverse effects and be poorly tolerated. Many people pursue alternative treatments, despite a lack of evidence. The long-term outcome is difficult to predict, with good outcomes more often seen in women, those who develop the disease early in life, those with a relapsing course, and those who initially experienced few attacks.[7]Life expectancy is on average 5 to 10 years lower than that of an unaffected population.[1]

Multiple sclerosis is the most common autoimmune disorder affecting the central nervous system.[8] As of 2008, between 2 and 2.5 million people are affected globally with rates varying widely in different regions of the world and among different populations.[9] In 2013, 20,000 people died from MS, up from 12,000 in 1990.[10] The disease usually begins between the ages of 20 and 50 and is twice as common in women as in men.[11] The name multiple sclerosis refers to scars (scleraebetter known as plaques or lesions) in particular in the white matter of the brain and spinal cord.[12] MS was first described in 1868 by Jean-Martin Charcot.[12] A number of new treatments and diagnostic methods are under development.

A person with MS can have almost any neurological symptom or sign; with autonomic, visual, motor, and sensory problems being the most common.[1] The specific symptoms are determined by the locations of the lesions within the nervous system, and may include loss of sensitivity or changes in sensation such as tingling, pins and needles or numbness, muscle weakness, very pronounced reflexes, muscle spasms, or difficulty in moving; difficulties with coordination and balance (ataxia); problems with speech or swallowing, visual problems (nystagmus, optic neuritis or double vision), feeling tired, acute or chronic pain, and bladder and bowel difficulties, among others.[1] Difficulties thinking and emotional problems such as depression or unstable mood are also common.[1]Uhthoff's phenomenon, a worsening of symptoms due to exposure to higher than usual temperatures, and Lhermitte's sign, an electrical sensation that runs down the back when bending the neck, are particularly characteristic of MS.[1] The main measure of disability and severity is the expanded disability status scale (EDSS), with other measures such as the multiple sclerosis functional composite being increasingly used in research.[13][14][15]

The condition begins in 85% of cases as a clinically isolated syndrome over a number of days with 45% having motor or sensory problems, 20% having optic neuritis, and 10% having symptoms related to brainstem dysfunction, while the remaining 25% have more than one of the previous difficulties.[16] The course of symptoms occurs in two main patterns initially: either as episodes of sudden worsening that last a few days to months (called relapses, exacerbations, bouts, attacks, or flare-ups) followed by improvement (85% of cases) or as a gradual worsening over time without periods of recovery (10-15% of cases).[11] A combination of these two patterns may also occur[4] or people may start in a relapsing and remitting course that then becomes progressive later on.[11] Relapses are usually not predictable, occurring without warning.[1] Exacerbations rarely occur more frequently than twice per year.[1] Some relapses, however, are preceded by common triggers and they occur more frequently during spring and summer.[17] Similarly, viral infections such as the common cold, influenza, or gastroenteritis increase their risk.[1]Stress may also trigger an attack.[18] Women with MS who become pregnant experience fewer relapses; however, during the first months after delivery the risk increases.[1] Overall, pregnancy does not seem to influence long-term disability.[1] Many events have not been found to affect relapse rates including vaccination, breast feeding,[1] physical trauma,[19] and Uhthoff's phenomenon.[17]

The cause of MS is unknown; however, it is believed to occur as a result of some combination of genetic and environmental factors such as infectious agents.[1] Theories try to combine the data into likely explanations, but none has proved definitive. While there are a number of environmental risk factors and although some are partly modifiable, further research is needed to determine whether their elimination can prevent MS.[20]

MS is more common in people who live farther from the equator, although exceptions exist.[1][21] These exceptions include ethnic groups that are at low risk far from the equator such as the Samis, Amerindians, Canadian Hutterites, New Zealand Mori,[22] and Canada's Inuit,[11] as well as groups that have a relatively high risk close to the equator such as Sardinians,[11] inland Sicilians,[23]Palestinians and Parsis.[22] The cause of this geographical pattern is not clear.[11] While the north-south gradient of incidence is decreasing,[21] as of 2010 it is still present.[11]

MS is more common in regions with northern European populations[1] and the geographic variation may simply reflect the global distribution of these high-risk populations.[11] Decreased sunlight exposure resulting in decreased vitamin D production has also been put forward as an explanation.[24][25][26] A relationship between season of birth and MS lends support to this idea, with fewer people born in the northern hemisphere in November as compared to May being affected later in life.[27] Environmental factors may play a role during childhood, with several studies finding that people who move to a different region of the world before the age of 15 acquire the new region's risk to MS. If migration takes place after age 15, however, the person retains the risk of his home country.[1][20] There is some evidence that the effect of moving may still apply to people older than 15.[1]

MS is not considered a hereditary disease; however, a number of genetic variations have been shown to increase the risk.[28] The probability is higher in relatives of an affected person, with a greater risk among those more closely related.[2] In identical twins both are affected about 30% of the time, while around 5% for non-identical twins and 2.5% of siblings are affected with a lower percentage of half-siblings.[1][2][29] If both parents are affected the risk in their children is 10 times that of the general population.[11] MS is also more c
ommon in some ethnic groups than others.[30]

Link:
Multiple sclerosis - Wikipedia, the free encyclopedia

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.

Learn the typical progression of MS and what to expect

Multiple sclerosis may appear in several forms. The types of MS include:

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.

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What is Multiple Sclerosis? Life Expectancy, Symptoms ...

Introduction

Multiple sclerosis is a progressive autoimmune disease and the most common neurological disease diagnosed in young adults. It is believed that multiple sclerosis occurs when the bodys own immune system attacks the central nervous system. Commonly called MS, the disease generally gets worse with time and can cause significant nerve damage.

The progression and severity of multiple sclerosis varies greatly among individuals. The severity of multiple sclerosis ranges from mild to severe and disabling, and it can result in muscle weakness, loss of balance, and difficulty walking.

In some cases, multiple sclerosis can lead to serious complications, such as choking and paralysis. Early diagnosis and medical care can help manage and control symptoms and minimize complications of multiple sclerosis.

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Multiple Sclerosis - Symptoms, Causes, Treatments

What is multiple sclerosis (MS)?

MS is a disease where patches of inflammation occur in parts of the brain and/or spinal cord. This can cause damage to parts of the brain and lead to various symptoms (described below).

Many thousands of nerve fibres transmit tiny electrical impulses (messages) between different parts of the brain and spinal cord. Each nerve fibre in the brain and spinal cord is surrounded by a protective sheath made from a substance called myelin. The myelin sheath acts like the insulation around an electrical wire, and is needed for the electrical impulses to travel correctly along the nerve fibre.

Nerves are made up from many nerve fibres. Nerves come out of the brain and spinal cord and take messages to and from muscles, the skin, body organs and tissues.

MS is thought to be an autoimmune disease. This means that cells of the immune system, which normally attack germs (bacteria, viruses, etc), attack part of the body. When the disease is active, parts of the immune system, mainly cells called T cells, attack the myelin sheath which surrounds the nerve fibres in the brain and spinal cord. This leads to small patches of inflammation.

Something may trigger the immune system to act in this way. One theory is that a virus, or another factor in the environment, triggers the immune system in some people with a certain genetic makeup.

The inflammation around the myelin sheath stops the affected nerve fibres from working properly, and symptoms develop. When the inflammation clears, the myelin sheath may heal and repair, and nerve fibres start to work again. However, the inflammation, or repeated bouts of inflammation, can leave a small scar (sclerosis) which can permanently damage nerve fibres. In a typical person with MS, many (multiple) small areas of scarring develop in the brain and spinal cord. These scars may also be called plaques.

Once the disease is triggered, it tends to follow one of the following four patterns.

Nearly 9 in 10 people with MS have the common relapsing-remitting form of the disease. A relapse is when an attack (episode) of symptoms occurs. During a relapse, symptoms develop (described below) and may last for days, but usually last for 2-6 weeks. They sometimes last for several months. Symptoms then ease or go away (remit). You are said to be in remission when symptoms have eased or gone away. Further relapses then occur from time to time.

The type and number of symptoms that occur during a relapse vary from person to person, depending on where myelin damage occurs. The frequency of relapses also varies. One or two relapses every two years is fairly typical. However, relapses can occur more or less often than this. When a relapse occurs, previous symptoms may return, or new ones may appear.

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Multiple Sclerosis. Medical information about MS | Patient