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Genetic Factors
Sex:
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.
Racial Group:
Family History:
In a normal population the chance of someone to exhibit the symptoms of MS is only 0.1%. Now if someone in your family has MS, the risk increases. If your parent, brothers, or sisters (your first-degree relatives) have MS your chance increases to 3%. If a second-degree relative has it, you only have a 1% chance of having MS. If both of your parents have the disease you have a risk of 20%. Other percentages are if you have a half sister/brother, identical twin, or fraternal twin your risks are as follows, 1.5%, 30%, and 3-4%. ***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.
Latitude: SES:
Environmental Factors
As you increase latitude, mainly above and below 40 latitude, MS is more common. These are temperate and cooler climates. It is five times more likely in these regions. Your socioeconomic status can also affect the occurrence of MS. It is least common in the lower class and in rural residence.
Migration:
The age at which you may move may also be an important factor. If you move before the age of 15, your risk is that of the people in the country you move to. If you move after the age of 15, your risk stays fixed at that of the country you grew up in (OConnor 15).
Infection:
They believe MS is a delayed reaction to a viral infection contracted during childhood by a genetically susceptible person (OConnor 13). The viral infections may include shingles, chicken pox, measles, or certain herpes. An idea they also have is the age at which you get the infection. The older you are the higher the risk for MS. ***Remember that in warm countries, children contract viruses
Diagnosing MS
The most important principle to consider when diagnosing MS is whether the person fulfils the diagnostic criteria on clinical grounds (Barnes 29). To date there is no diagnostic or blood test for MS. Family physician will send you to a neurologist who goes over your symptoms and history. You can be given one of four test to help the doctor see if there is damage to the spinal cord and brain. These test are only half of the diagnostic process. The tests you can take are MRI, MRS, evoked potentials, and lumbar puncture. These tests may be able to rule out a viral infection that can exhibit the same symptoms as an MS attack. Remember that these tests are just as important as a clinical evaluation.
Diagnostic categories of MS
The phrase multiple abnormalities in space and time sums up what a physician needs to find a diagnosis of MS (OConnor 32). There are three categories of MS; Definite, Probable, and Possible MS. 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). The age of onset is between 10 and 50 years of age. Probable MS: Here the signs are not previously documented and there is one current sign of MS. There is more than one site of lesions, they have a good recovery and have a history of relapseremitting symptoms. Possible MS: There is no documented signs of MS and more than one lesion. There is also a history of one relapse-remitting symptoms.
Courses of MS
Listed below are the different paths that MS can take.
Relapse-remitting MS (RRMS): Secondary-progressive MS (SPMS): This stage of MS Here you have an attack, go starts with RRMS symptoms into complete or partial and continues on to show signs remission, then have the symptoms return. of PPMS. Primary-progressive MS Progressive-relapsing MS (PPMS): Here you continually (PRMS): This is a rare form decline and have no remissions. but here it takes a progressive There may be a temporary relief route made worse by acute in symptoms. attacks. A few patients have malignant MS which is where they have a 20% of the people with MS have a benign form. Here they quick decline which leaves show little progression after the them severely disabled or even lead to death. first attack.
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, the prognosis in general is not as poor as commonly thought (Barnes 15). 5-20% of all patients will develop benign MS, and another 33% will have little to no disabilities allowing them to live independently while not in relapse. Only 33% of MS patients will have a severe disability.
Disease-Modifying Drugs
Interferon Beta 1a (Avonex and Rebif):
is a protein that is a replica of human interferon. It suppress the immune system and helps to maintain the blood-brain barrier. You inject Avonex into the muscle once a week and Rebif is injected under the skin three times a week. This drug is useful to people who have definite progressive MS. One side effect of the drug is a flu like symptom.
In summary all three of these drugs decrease relapses by 33%, have manageable side effect, are injected, stabilize the disease, and tend to be costly.
Alternative Treatments
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
Works Cited
Barnes, David. Multiple Sclerosis Questions and Answers, Merit Publishing International, Florida, 2000. Multiple Sclerosis: Hope Through Research, <http://intelihealth.com/IH/ihtIH/WSIHW000/8320/2 1151/195415.html?d=dmtcontent>, 06 April 2003. OConnor, Dr. Paul. Multiple Sclerosis The Facts You Need, Firefly Books Inc., New York, 1999.