This is What You Need to Know About MS
What are some common MS symptoms?
- Heat sensitivity: even with a ½ degree elevation in body temperature can make symptoms worse.
- Overwhelming fatigue which is out of proportion to your activity level.
- Blurred or double vision, optic neuritis or involuntary rapid eye movement.
- Loss of balance, unstable walking, tremors, vertigo and lack of coordination.
- Sensory problems- tingling, numbness or a burning sensation in an area of the body.
- Weakness in the legs and/or arms.
- Increased urinary frequency, urgency, incomplete emptying and loss of control.
- Problems with short-term memory, word-finding, focus, organization and planning.
- Emotional flooding: depression and/or mood swings; irritability and quick temper.
- Facial, or general muscle pain.
- Diminished sexual sensation or arousal.
- Muscle spasticity or stiffness.
- Constipation, loss of bowel control or diarrhea.
- Speech slurring or swallowing trouble.
At the earlier stages of the disease, MS symptoms vary from person to person, and are unpredictable as to how frequently they will occur. Many people have experienced isolated symptoms for years before a diagnosis is made. Once the inflammatory, symptom-remitting stage of the disease has become progressive, standardization of symptomatology among individuals occurs.
How is MS Treated?
Five medications are available to treat the inflammatory stage of MS. Four of them are referred to as the ABCR's - Avonex, Betaseron, Copaxone and Rebif. Studies have shown that they lessen the frequency and severity of MS attacks and slow progression. Currently, physicians are prescribing the ABCRs for secondary progressive MS as long as there is still inflammatory activity. The primary goal today is zero tolerance of inflammation. For those whose MRI shows evidence that (biologically) they are not responding to standard ABCR treatment, a combination of drugs can be used to attempt to stabilize the disease. The fifth drug, Novantrone (mitoxantrone), pulse Solu-Medrol, and increased doses of interferon are all options supported by current research evidence. The natural history of untreated MS is that, over the course of a lifetime, 80-90% will progress beyond the inflammatory stage of MS and remain in a progressive course.
Medications are also available to treat individual motor and mood symptoms as they occur. IV Solu-Medrol is the standard treatment to hasten recovery from exacerbations. Some people with MS take part in physical therapy or yoga to help maintain flexibility, coordination and strength. A balanced diet and being sensitive to fatigue can help a person keep a maximum energy level. Various compensatory techniques are available to help memory and concentration problems.
The consensus in the medical community today is that Multiple Sclerosis is an autoimmune disease in someone who is genetically vulnerable to immune system damage from cumulative virus exposure in childhood. Three quarters of people who have MS are women. The main targets of this particular autoimmune disease are axons in the nervous system. An Axon is the long output fiber of a nerve cell which transmits electrical impulses to one of another neuron's many input fibers (dendrites.) This occurs at a gap called a synapse by means of a chemical neurotransmitter.
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This system controls the flow of information throughout the nervous system and the body. Even an enhanced Magnetic Resonance Image will not show axonal (brain volume) shrinkage, which is detectable only by a brain Parenchymal Fraction Test. Axonal damage is responsible for the progression of disability and is currently beyond rescue by the time symptoms appear. MS is a continually active degenerative neuronal disease even before the appearance of visible symptoms, and also in those whose external symptoms have gone away. Because the mechanism of axon loss is still under investigation, we cannot yet modify this aspect of the disease.
We have, however, had success in modifying the degree of inflammatory activity in the protective insulation surrounding the nerve fibers of the brain and spinal cord (the myelin sheath), which is also a factor in the appearance of symptoms. Today's MRIs show that lesions are 5-10 times more common than are observable symptoms. Most people with MS live a normal lifespan, although before the new medications to slow the progression of the disease, 90% continued to progress over the course of their lifetime. No autoimmune disease has ever been shown to be contagious.
Autoimmune diseases are difficult to diagnose because symptoms may be short-lived for years, and laboratory tests inconclusive. However, enhanced MRI scans make diagnosis today much quicker than in the past. An early diagnosis is imperative, now that we have medications which can modify the course of the disease. People with MS require lifelong medical care and monitoring, preferably by a neurologist, even when they may look or feel well. Many people with MS can live productive lives when they receive appropriate medical care: treatment with an immuno-suppressant as soon as the diagnosis has been made, supplemental combination medication if there continues to be inflammatory activity, and prompt treatment for infections. Aggressive treatment of inflammation is vital. Of 100 people diagnosed with MS, 85% are initially diagnosed as having Relapsing MS, but before the ABCR drugs, only 10% remained neurologically functional 20-30 years after diagnosis. Fifteen percent will be diagnosed with several different types of Primary-Progressive MS and do not return to a symptom-free baseline, although the rate of progression varies. A rare 3% in this category have a life-threatening form of MS leading to total disability in only a few years. Before the new therapies, 50-80% of people had to retire from active employment within 10 years after symptom development.
Is there a cure for MS?
Because we do not understand the mechanism by which MS damages axons, and do not know what weight to assign to each of the causes, we cannot yet repair the damage that MS causes. MS is, however, one of the most intensively studied autoimmune diseases (400 currently), and treatments are now able to slow the progression of the disease for the first time in history. This allows us to "buy time". Recent advances in brain imaging technology are yielding encouraging new discoveries.
MS and Life Planning for planning ahead.
To see a video interview on early treatment of MS with MS specialists Frederick Munschauer, MD and Heidi Crayton, MD, click here: http://www.healthology.com/multiple-sclerosis/video3857.htm.
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