By Dr. Mark Tullman | Posted: January 01, 2012
More than 400,000 Americans are living with multiple sclerosis (MS). Most people are 20 to 40 when diagnosed, but both children and older adults can develop the disease. The good news is that recent advances in therapeutics and promising treatments on the horizon point to a brighter future, enabling many to live well despite their MS.
What is multiple sclerosis (MS)?
MS is a chronic disease that affects the brain, optic nerves (the nerves that connect the eyes to the brain), and spinal cord. The cause of MS is unknown, but it is likely due to a complex interaction between genetic factors, environmental triggers, and the immune system. In individuals with MS, the body’s own immune system attacks the myelin, which surrounds nerve fibers, thus disrupting the rapid transmission of signals from the brain to various parts of the body.
What are the symptoms of MS?
MS is a highly variable and unpredictable illness. The progression, severity, and specific symptoms differ among individuals, and may result in a variety of symptoms, including blurred vision, double vision, dizziness, numbness, tingling, impaired balance, incoordination, and weakness.
Most people with MS initially experience episodes, which are characterized by attacks of neurologic dysfunction (known as relapses or exacerbations). These are interspersed with periods of remission. Symptoms of a relapse usually develop over a few days and often improve with time. However, approximately 35 percent of relapses result in permanent neurologic problems.
Some people with relapsing-remitting MS enter a progressive phase of the disease with gradual deterioration of neurologic function and accumulation of disability. This is known as secondary progressive MS. About 10% of individuals have primary progressive MS, which is characterized by a gradual decline in functioning in the absence of exacerbations or remissions.
How is MS diagnosed?
There is no one test to determine if someone has MS. The diagnosis should only be made after a detailed interview, thorough neurologic examination, extensive blood work, and, unless contraindicated, magnetic resonance imaging (MRI). Additional tests, such as a lumbar puncture (also known as a spinal tap), are sometimes required. A number of other illnesses can mimic MS and should be excluded before MS is diagnosed.
How is MS treated?
The treatment of MS involves corticosteroids (e.g. a form of prednisone that is infused into a vein in the arm) to hasten recovery from exacerbations. We also have new disease-modifying drugs that reduce the frequency of relapses and lessen the likelihood of MS worsening. Plus, we also prescribe medications and other interventions, like physical therapy, exercise, and diet, to alleviate some of the daily symptoms associated with the disease.
No single treatment regimen is right for everyone. MS therapy should always be individualized. Realistic treatment goals include minimizing relapses and the development of disability, maximizing a person’s ability to function, and maintaining or improving quality of life. Recent advances in therapeutics and promising treatments on the horizon point to a brighter future for individuals with MS.
Mark J. Tullman, MD, is board-certified neurologist specializing in the diagnosis and treatment of multiple sclerosis. He has a website www.MSLivingWell.org.
He is a member of BJC Medical Group and on-staff at Missouri Baptist Medical Center. For an appointment call 314-996-LIFE.