What is Multiple Sclerosis?
This is a disease that involves inflammation in the central nervous system (the brain and the spinal chord) often leading to demyelination (loss of the protective myelin sheath, which surrounds nerve fibers, much like the coating on electrical wires.) When myelin is damaged, the nerve fibers of the brain and spinal cord do not transmit nerve impulses quickly or efficiently. As a result, lesions (plaques) develop in the brain and spinal cord causing a variety of neurologic symptoms.
What is the course of MS?
MS is a disease that may include definitive attacks with ou without partial or complete recover or slowly progressing problems or a combination thereof.
What are the signs and symptoms?
There are many signs and symptoms, such as: decreased or double vision, fatigue, weakness, tingling, numbness or impaired sensation, lack of coordination, disturbances in equilibrium, sensitivity to heat, problems with memory, impaired eye movements, partial or complete paralysis, electric shock sensations when bending the neck, and often continence and sexual dysfunction.
These symptoms may go away or remain after an attack. They may get progressively worse over time. For individuals with progressive forms of MS, these symptoms may gradually worsen without rapid or abrupt changes. Symptoms associated with a relapse or attack usually develop over a period of hours to days, persist for a matter of days or weeks and then partially or completely disappear with or without treatment.
What type of testing is needed to determine if I have MS?
No one test proves or disproves the diagnosis of MS. The diagnosis is made after a clinical history, neurologic exam, MRI of the brain and (possibly the spinal cord), a lumbar puncture (L.P. or spinal tap) to detect characteristic markers in the cerebrospinal fluid, and computer assisted electrodiagnostic tests called evoked responses are completed. Often only time and ongoing neurological exams will tell if the course of your condition is consistent with MS.
What type of treatment is available?
There are several medications to treat MS. Some of them dampen the progression of the illness while others alleviate symptoms.
- Cramps and Spasticity
Lioresal (oral or via intrathecal pump), Zanaflex, Klonopin, Dantoline, and Botox injections.
Many disorders, including those shown below, respond well to treatment. Ask your Neurologist which treatment may be right for you.
- Bladder dysfunction/infection
- Sexual dysfunction
- Swallowing/speech difficulties
- Visual problems
- Fatigue/Pain – often responsive to medication or physical therapy modalities
- Large doses of Solumedrol or an injection called ACTH
Suppression Treatment Available
There are four disease dampening medications:
- Avonex (interferon beta-1a)
It slows progression and decreases the frequency of attacks. It is given once a week by intramuscular injection. The side effects are flu-like symptoms.
- Rebif (interferon beta-1a)
Decreases the frequency of clinical exacerbations and delays the accumulation of physical disability. Given subcutaneously three times a week.
- Betaseron (interferon beta-1b)
It slows progression and reduces the frequency and severity of MS attacks. It is an injection under the skin every other day. Side effects include flu-like symptoms, depression and injection site irritation.
- Copaxone (galatiramer acetate)
It is thought to interfere with the factors underlying the immune dysfunction in MS. The side effects are post-injection site reaction and a fleeting collection of symptoms immediately after this daily injection is given.
Treatment in Refractory Cases
- Tysabri – I.V. infusion two hours monthly
- IgG infusion intravenously
- Novantrone intravenously
- Chemotherapy – Imuran, Cytoxin or Methotrexate
*Most forms of unfusion or injection therapy can be performed on site.
What can I do to help myself?
It is important to get adequate rest and to eat a balanced diet. Exercise is essential to maintain strength. Avoid overexertion or stress, as both can weaken your reserve. Many patients note that their symptoms increase when they become too warm. It is a good idea to avoid extremes in temperature. Attempt to maintain your own independence. Get involved with a support group. Keep your mind active. Usually you will have some reactive depression in response to your diagnosis, but if it should persist or become worse, psychological support may be needed.
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