Mary Wendell
Women’s Studies
10/18/10
Multiple Sclerosis
Multiple sclerosis (also known as MS) is not a familiar term, unless you
are one of the affected. One out of every seven hundred people lives with the
disease. I am not one with the disease but my mother is. I have had to live with
this disease my whole life. It is a struggle day to day. I will cover understanding
Multiple sclerosis, the process of diagnosis, major symptoms, and ways to treat
it, although there is no cure.
Multiple sclerosis is an autoimmune disease that affects the central
nervous system (the brain and spinal cord). It has been listed as a “rare” disease.
It can be thought of as an inflammatory process that involves various areas of the
Central Nervous System at points of time. As suggested by in the name, multiple
sclerosis affects many different areas of the Central Nervous System.
(" W e b M D . c o m " ) It affects one in every seven hundred people or 0.14 percent
of the population of the United States. That is equivalent to 388,571 people. MS
is also more dominant in females. Sex hormones are partly responsible for this
gender preference, since these hormones affect both the autoimmune and
nervous systems in various ways. These hormones, which fluctuate constantly in
females, can also affect cognitive function and coordinated movements. There
are four different types of MS- Relapsing-remitting MS, Primary-progressive MS,
Secondary-progressive MS, Progressive-relapsing MS. Relapsing-remitting MS
is characterized by unpredictable attacks with a worsening of symptoms before a
total, partial, or no recovery of some function. These attacks appear and worsen
over several days or weeks while recovery takes weeks or even months. This is
typical in the early stages of multiple sclerosis development. Primary-progressive
MS is characterized by gradual but steady progression of the disease. There are
typically no obvious relapses or remissions. This form only occurs in fifteen
percent of all cases, but is most prevalent in those who develop multiple sclerosis
after the age of 40. Secondary-progressive MS is initially a relapsing-remitting
course, but later develops into the progressive disease. The progressive part of
the disease may occur in early onset or may occur decades later. Progressive-
relapsing MS is a steady progression in disability with acute attacks that may be
followed with or without recovery. This is the least common form of the disease.
People who have progressive-relapsing MS often appear to have primary-
progressive MS. (" T h e P r o g r e s s i o n o f M u l t i p l e S c l e r o s i s . " ) Woman
are twice as likely as men to develop multiple sclerosis. ( " W e b M D . c o m " ) In
the Caucasian population, 62 out of every 100,000 people are affected with
multiple sclerosis. While in the nonwhite population, 31 out of every 100,000
people are affected. Multiple sclerosis rarely affects people of Asian descent.
Most people are diagnosed between the ages of twenty and forty. The average
age of those diagnosed is 34 years. It usually affects people in their third and
fourth decade of life. Although the unpredictable effects, physical and emotional,
will continue to affect the person throughout their life.
Multiple Sclerosis is tricky to diagnose as it tends to appear as another
disease. It is up to you to notify your physician if you experience symptoms of
multiple sclerosis. Although you may not discover too much discomfort, you may
not have multiple sclerosis, but because of the broadness of the symptoms of the
disease, it is best to check with your physician. There are no specific tests that go
along with multiple sclerosis. Doctors combine history, physical exams, laboratory
work, and sophisticated medical imaging to come to a diagnosis. They use a
complete blood count, blood chemistry, urine analysis, and spinal fluid
evaluation. An MRI, which creates an image of the brain, is used to search for
lesions, or scarring, on the brain. A neurologist is used to make the final
diagnosis. ( " M a y o c l i n i c . c o m " ) There has been a new development in
genetic clues to why certain people develop MS. The new genes, IL-2 and IL-7
are associated with interluiken (IL) that helps direct T-cells to fight cellular
devices. While this doesn’t cover the whole story of degeneration of the nerves,
they at least “give us a working hypothesis for what may be causing MS” says
David Hafler, MD, who is a professor of neurology at Harvard Medical School’s
center for neurological diseases. (About.com) This is a beacon of hope to many
because as they find and understand these diseases better, there are more likely
to be drugs to help tame the symptoms of multiple sclerosis. Because there is no
known cause for multiple sclerosis, there can be no specific test.
Symptoms of MS vary from person to person. The first symptoms typically
are visual changes. Many people with multiple sclerosis develop optic neuritis,
often described as painful vision loss. Before the actual vision loss, you may
have visual changes such as blurred or hazy vision, flashing lights or alterations
in color. Most people recover in several months, but others are left with
permanent visual affects. Symptoms include, but are not limited to: decreased
ability to control small movements, decreased attention span, coordination,
judgment, and memory, depression, difficulty speaking or understanding speech,
dizziness, double vision, eye discomfort, fatigue, loss of balance, movement
problems, muscle atrophy, muscle spasms (especially in legs), numbness,
paralysis in one or more arms or legs, slurred speech, tingling, vertigo, or
walking/gait abnormalities. Symptoms may vary with each attack and they may
last days to months, then reduce or disappear, then recur periodically. Multiple
sclerosis commonly affects the cerebellum, which is responsible for balance and
fine motor coordination, which is why many of the symptoms include problems
with walking, speaking, and movement problems. It also affects major nerves of
the head, causing vertigo, facial pain, and sometimes hearing loss.
( " M e d i c i n e n e t . c o m " ) Every part of the body can be affected, making the
disease the great imitator of other nervous system diseases.
Multiple sclerosis has no cure, but there are therapies and medicines to
help slow the disease. Medicine used may include:
• Immune modulators to help control the immune system. This includes
interferons, monoclonal antibodies, and glatiramer acetate.
◦ Glatiramer acetate has been shown to decrease the relapse rate of MS
by 30 percent. Glatiramer acetate is a mixture of amino acids used
to treat multiple sclerosis. It is better tolerated then interferons and
the side effects are better tolerated.
◦ Interferons are made by the body, used to combat viral infections. It has
been shown to decrease the relapsing or worsening of multiple
sclerosis, although the overall disease progression is not changed.
The side effects often are poorly tolerated.
◦ Natalizumb is a monoclonal antibody that binds to white blood cells and
interferes with their movement from the bloodstream to the brain
and spinal cord. These cells are believed to have a role in causing
the nervous system damage in multiple sclerosis.
• Steroids to decrease the severity of an attack when it occurs.
• Corticosteroids suppress the viral symptoms and reduce inflammation. They
are natural chemicals released by the body.
• Medicines to reduce muscle spasms.
• Cholinergic medications to reduce urinary problems.
• Antidepressants for mood or behavior symptoms
• Amantadine for fatigue (" Tr e a t m e n t s a n d d r u g s . " )
A healthy life style is also encouraged which includes a healthy diet. Attempts
should be made to avoid fatigue, stress, and temperature extremes to avoid
triggering an attack. Also participating in activities such as physical therapy,
speech therapy, occupational therapy can help improve the person’s outlook,
decrease depression, maximize function and ability, and improve coping skills.
People sometimes decide to try alternative medicine, such as yoga for stress.
There are many support groups out there to help those struggling with the
disease.
Although therapy and medicines are helpful, MS still is not curable. There
are many things about this disease that we do not know. Like many diseases, it
may barely affect your life. This is the case for 20-35 percent of the population
living with multiple sclerosis. It barely affects their daily activities and does not
shorten their life span. About 65 percent of the MS population has a relapsing
and remitting form of MS. They have a worsening of the symptoms that may last
weeks to months before returning to the original state of health. Relapsing and
remitting MS is found in nearly fifteen percent of the population. This means that
after each attack they do not go back completely to the original state of MS. Five
to ten percent of the population has the rapidly progressive form. Their problems
may develop over weeks and months, or simply in days. Death usually results
from other diseases because of a weakening of the immune system and typically
takes up to 35 years from the diagnosis. ( " E M e d T V " ) Many people’s life
spans are not shortened too dramatically.
Multiple Sclerosis is more prevalent than believed. It is greatly affecting
the population and you may believe you do not have it, but it is not always
genetic. You must be well informed about what MS is, the symptoms, how to treat
it. You could be one of the 700 and not know it. Now you know. Take advantage
of this knowledge. Multiple Sclerosis will not be stopped until we find a cure.
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