000-300.000 people have been diagnosed with MS and there are 200 new cases diagnosed every week. It is a life-long disease with no cure. 250. Currently in the US. White matter is below the top layer of our brain and spinal cord. In MS.What is Multiple Sclerosis?
It is an Auto Immune Disease which is when the body starts to destroy itself. the body attacks and destroys the fatty tissue called myelin that insulates an axon/nerve.
. If damage is severe it can also destroy the nerve/axon itself. Plaques block a signal from being passed from the body to the spinal cord and brain. and is called demyelination. MS affects the central nervous system and inflames the white matter in the brain which creates plaques.
It was Jean-Martin Charcot who is credited with giving us the first signs and symptoms of Multiple Sclerosis. the first actual case was first diagnosed in 1849. 1421. was given its name. that the earliest descriptions were seen.History of Multiple Sclerosis
Multiple Sclerosis. also known as MS. It was in Holland on August 4.
. Even though the previous description. “There are accounts of probable MS dating back to the 14th century but the history of the disease really begins in the 19th century with the first illustrations and clear clinical description of the disease beginning to appear in 1838” (Barnes 16). multiple because of the numerous sites of demyelination and „sclerosis‟ which means scarring.
However they have found associations and links between many factors including genetic and environmental. Genetic Environmental
Sex Racial Group Family history Latitude SES Migration Infections
. we still don’t know what causes MS” (O'Connor 8).What Causes MS?
“Despite extensive research.
Women are more likely to have MS than men by a 2:1 ratio. They also think that this is true because women are in general more likely to have an Auto immune Disease. brothers. Now if someone in your family has MS. If your parent. you only have a 1% chance of having MS. 30%.
“Whites are more than twice as likely as other
races to develop MS” ( Hope 2). If both of your parents have the disease you have a risk of 20%. and 3-4%. Other percentages are if you have a half sister/brother.1%. the risk increases. If a second-degree relative has it. or sisters (your first-degree relatives) have MS your chance increases to 3%. or fraternal twin your risks are as follows. 1.
. identical twin.5%.
In a normal population the chance of someone to exhibit the symptoms of MS is only 0. ***Remember that women have a slightly higher risk and that if one identical twins has MS it is not 100% positive that the other twin will have MS due to the environmental factors.
It is five times more likely in these regions. measles. Your socioeconomic status can also affect the occurrence of MS. or certain herpes. It is least common in the lower class and in rural residence. If you move after the age of 15. The viral infections may include shingles. chicken pox. The older you are the higher the risk for MS. your risk stays fixed at that of the country you grew up in” (O‟Connor 15). MS is more common. An idea they also have is the age at which you get the infection. mainly above and below 40° latitude. ***Remember that in warm countries.
The age at which you may move may also be an important factor. children contract viruses
As you increase latitude. your risk is that of the people in the country you move to.
“They believe MS is a delayed reaction to a viral infection contracted during childhood by a genetically susceptible person” (O‟Connor 13). “If you move before the age of 15. These are temperate and cooler climates.
and parasites” (Hope 3). They help keep the immune system in order and directly destroy the infected or damaged cell.
. for different invaders. In our body we have different antigens. the antigen multiples to destroy the invader. fungi. When the right invader and antigen met. It goes out looking for the invaders and kills them. The bbb is a membrane that surround the brain and allows substances to cross from the blood to the central nervous system.What actually happens in the Immune System?
“The immune system – a complex network of specialized cells and organs – defends the body against attacks by “foreign invaders such as bacteria. Another aspect ofthe immune system that they are looking at is the blood-brain barrier (bbb). viruses. Since MS is a autoimmune disease that persons body does not know the difference between self and non-self cells. Some feel that the bbb is breached and some of the immune system defense cross over and cause damage to the CNS. How do these T-cells know that the cell they are attacking is an invader? Well on each of our cells there are markers that let our immune system know it is our own cell or a foreign body. which cause an immune response. T-cells are also important in the role of MS.
• Family physician will send you to a neurologist who goes over your symptoms and history. • These tests may be able to rule out a viral infection that can exhibit the same symptoms as an MS attack. MRS.
. • To date there is no diagnostic or blood test for MS. and lumbar puncture. • You can be given one of four test to help the doctor see if there is damage to the spinal cord and brain. evoked potentials. These test are only half of the diagnostic process. The tests you can take are MRI. • Remember that these tests are just as important as a clinical evaluation.Diagnosing MS
• “The most important principle to consider when diagnosing MS is whether the person fulfils the diagnostic criteria on clinical grounds” (Barnes 29).
Diagnostic categories of MS
• • • “The phrase „multiple abnormalities in space and time‟ sums up what a physician needs to find a diagnosis of MS” (O‟Connor 32). There is also a history of one relapse-remitting symptoms. Probable MS: Here the signs are not previously documented and there is one current sign of MS. Definite. There is more than one site of lesions. The age of onset is between 10 and 50 years of age. they have a good recovery and have a history of relapseremitting symptoms. Probable. Definite MS: “Consistent course (relapse-remitting course with at least 2 bouts separated by at least 1 month or slow or stepwise progressive course for at least 6 months) of documented neurological signs of lesions in more than one site of brain or spinal cord white matter” ( Hope 7).
. There are three categories of MS. Possible MS: There is no documented signs of MS and more than one lesion. and Possible MS.
. Here they quick decline which leaves show little progression after the them severely disabled or even lead to death. first attack. of PPMS.
• Relapse-remitting MS (RRMS): • Secondary-progressive MS (SPMS): This stage of MS Here you have an attack.Courses of MS
Listed below are the different paths that MS can take. go starts with RRMS symptoms into complete or partial and continues on to show signs remission. • A few patients have malignant MS which is where they have a • 20% of the people with MS have a benign form. then have the symptoms return. attacks. but here it takes a progressive There may be a temporary relief route made worse by acute in symptoms. • Primary-progressive MS • Progressive-relapsing MS (PPMS): Here you continually (PRMS): This is a rare form decline and have no remissions.
Symptoms of MS
• • • • • • • • Fatigue Depression Memory change Pain Spasticity Vertigo Tremor Double Vision/Vision Loss • • • • • • • Weakness Dizziness/Unsteadiness Numbness/Tingling Ataxia Euphoria Speech disturbance Bladder/Bowel/Sexual dysfunction
Is disability inevitable?
As mentioned above there are numerous different paths that MS can take you on. “Although MS as a disease is much feared. Only 33% of MS patients will have a severe disability.
. 5-20% of all patients will develop benign MS. the prognosis in general is not as poor as commonly thought” (Barnes 15). and another 33% will have little to no disabilities allowing them to live independently while not in relapse.
It was once thought that women should not have children at all if she was diagnosed with MS. The thought behind this process is that the mother‟s immune system changes so her body does not reject the unborn child who has a different genetic makeup. Some drugs are not to be taken if you are going to become pregnant.Can I still have children?
This question is important to many sufferers. are pregnant. there is a similar increase in the relapse rate. This question is mainly for women though.
. within three months after the child is born. Also. Although there is a brief decrease in symptoms. be aware of the medication and the effects it will have. Actually during the mothers‟ last trimester there is a 70% reduction in the relapse rate. or are nursing.
Isoniazid.Viagra. Dantrolene Optic Neuritis. Aspirin Sexual Dysfunction. Amantadine Pain.Codeine. Oral steroids Fatigue. Propranolol Disease-Modifying Drugs.Baclofen. Pravatine Tremor. Tizanidine.Methlyprednisolone.Antidepressant.Interferon beta 1a and
1b. and Glatiramer acetate
. Primidone.Medications used for MS
• • • • • • • Spasticity. Diazepam.
but is injected just under the skin every two days.Disease-Modifying Drugs
• Interferon Beta 1a (Avonex and Rebif):
is a protein that is a replica of human interferon.
• Interferon Beta 1b (Betaseron): is slightly
different from our own interferon. You inject Avonex into the muscle once a week and Rebif is injected under the skin three times a week. Side effects include irritation. This medication does the same thing as beta 1a. This is also given to people who have definite progressive MS. This drug is useful to people who have definite progressive MS.
. It suppress the immune system and helps to maintain the blood-brain barrier. One side effect of the drug is a flu like symptom. and redness at the site of injection and the flu like symptoms. bruising.
It decrease the reoccurrence of relapse.Disease-Modifying Drugs (con‟t)
• Glatiramer Acetate ( Copaxone):
“is a small fragment of a protein that resembles a protein in myelin” ( O‟Connor 106). A few amount of people do experience brief shortness of breathe.
• In summary all three of these drugs decrease relapses by 33%. It is injected just under the skin every day. There is no flu like symptoms but occasional redness may occur at the injection site. and tend to be costly. are injected.
. have manageable side effect. stabilize the disease.
• • • • • • • Acupuncture Aromatherapy Cannabis (Marijuana) Chiropractic Cold Immersion Dietary Supplements Herbal Medication • Homeotherapy • Injection of Venom such as snake and bee • Massage • Meditation • Reflexology • Tai Chi • Yoga
David. Multiple Sclerosis Questions and Answers.
. Merit Publishing International. Paul. 2000. New York. • O‟Connor..Works Cited
• Barnes. <http://intelihealth. Firefly Books Inc. Dr. Florida. 06 April 2003. Multiple Sclerosis The Facts You Need. 1999. • Multiple Sclerosis: Hope Through Research.com/IH/ihtIH/WSIHW000/8320/2 1151/195415.html?d=dmtcontent>.