Do all people with MS become disabled

Some neurologists, many in academic circles, have a perception that MS is predictably associated with disability. Before the advent of new testing procedures, particularly MRI of the brain and spinal cord, many patients were not diagnosed during life. Without proven treatments, there was little incentive to do so in those without disability. The training of many more neurologists in recent years has led to greater availability of neurologic consultation therefore, a larger proportion of...

How does latitude affect MS

Observations that MS is more common in the Northern latitudes of Europe and North America were originally interpreted as showing a latitude effect, the so-called North-South gradient. Recent evidence suggests that this may be an artifact that caused immi gration patterns. Emigrating Northern (European) peoples originally settled in northern latitudes in America that more closely resembled their homelands. It has been found that veterans with Scandinavian surnames living in the northern United...

Is biofeedback useful in MS

In recent years, biofeedback has become commonly used in the management of pain in pain clinics. The use of biofeedback now appears to be generally well accepted. However, in past studies with Dr. Ronald Melzack at McGill University, surprisingly, we found that Workman's Compensation patients with back pain responded better to biofeedback than MS patients with back pain did. Biofeedback, however, may be helpful in some MS patients. More sophisticated approaches to biofeedback have recently...

Is there going to be a vaccine for MS

There is ongoing research into T-cell vaccines for MS. The original experiments in Europe attracted great interest. They involved injecting crude preparations of blood lymphocytes into patients in an attempt to eliminate or reduce the number of activated lymphocytes in MS patients. Ongoing studies involve a more the use of suggestion the field of study which encompasses, among other things, hypnotic trance its induction, management, and application and related subjects such as the phenomena of...

What are genes What genes cause MS

Genes are the smallest bits of DNA that can pass on a hereditary characteristic to a child. They are located almost exclusively in chromosomes that are contained in the nucleus in the center of every cell in the body. Genes related to energy production are present in the mitochondria. Mutations are changes in the structure of the DNA that often alter the normal function of that gene. For those readers interested in the details of genes and their function, reviews of the subject can be found in...

What causes the inflammation in the plaque

Inflammation in the nervous system is usually caused by white blood cells (WBCs), called lymphocytes (mostly CD4+ cells) monocytes (macrophages) from the blood stream usually cause inflammation in the nervous system. Cells and fluids in the blood are normally restricted from entering the nervous system by the blood-brain barrier. This is formed by endothelial cells lining the venules with tight junctions uniquely occurring in the brain and spinal cord. A second layer of foot processes from...

What is a clinically isolated syndrome or CIS

Neurologists have long recognized optic neuritis (or retrobulbar neuritis) to be a forerunner of MS in the majority of cases. Recognizing this and the fact that other problems such as transverse myelitis and acute symptoms of brainstem origin also usually end up diagnosed as MS, the McDonald committee has modified the Poser criteria to establish the McDonald crite These criteria embrace the rational use of laboratory investigation in making the diagnosis of MS and but have abandoned the terms...

What is chronic progressive MS

Both secondary progressive and relapsing progressive MS were referred to as chronic progressive in the past. The term chronic progressive is no longer used. Primary progressive patients were also sometimes referred to as chronic progressive. Importantly, if an MS a very aggressive form of MS in which the disease advances quickly and relentlessly, leading to rapid disability and death. Also called malignant MS, Marburg's variant of acute MS, or fulminant MS. the smallest amount of DNA in...

What is spinal MS

Spinal MS was a term used for primary progressive MS but has not generally been used for the last 30 years or so. It was a good descriptor for this illness because the predominant symptoms were those of slowly progressive weakness and sensory problems, predominantly affecting the legs. In the past, it was especially difficult to distinguish from cervical spondylosis. Modern imaging has made this distinction much easier. For the sake of clarity, the term primary progressive MS is preferable.

What is the futureI

Advances in the therapy of MS and autoimmune dis- I ease in general will certainly continue just as they have in other disorders. Although T-cell vaccination has some promise, results to date have been somewhat disappointing, but those trials are continuing. A dream treatment of eliminating immune reactions aimed at myelin, a theoretical possibility, when given early in the course of disease could result in permanent cessation of clinical activity. This third-generation type of T-cell vaccine...

Who gets progressive disease without attacks

At first, my response was to assume that the person who asked this question was simply asking about the definition of this type of illness. However, he was actually asking about differences in populations and their risk of this type of illness. Here again, ethnic differ ences become apparent. In France, Charcot first described the spinal form (primary progressive MS) as an incomplete form of MS, occurring in about 10 of patients. Subsequently, this form of illness was recognized as occurring in...

Why am I so fatigued

Fatigue (a lack of energy) is a common and important manifestation of MS and is even more common than numbness and tingling. Although not specific to MS, it occurs in the vast majority of patients. Many report that it is their major problem. Increased fatigue accompanies most attacks of MS and is an important factor aggravating other manifestations of MS. In actuality, when many patients complain of fatigue, they often are referring to fatigability. A typical example of this occurs when a...

Why do some patients with MS become unable to urinate when they have to urinate all day and night

Emptying the bladder is the result of three parts of the bladder functioning in sequence. To empty the urine from the bladder effectively, the bladder wall (the detrusor muscle) has to contract. When the pressure in the bladder has reached the right level, and only then, the bladder neck will normally relax and then the internal sphincter will relax. If the external sphincter is relaxed, voiding will occur. Sometimes, early in the course of MS, the bladder may not...

Is it true that Botox injections can be used to treat spasticity

Botox can be used to relieve spasticity. However, only neurologists or specialists in physical rehabilitation who are familiar with the special problems that MS patients may encounter should use Botox. Generally, the use of this drug is reserved for patients who have severe spasticity with early contractures in a single muscle group, such as the gastrocnemius, and have failed management with stretching and the drugs previously discussed. Botox is not a panacea for the management of...

Can I go blind with MS

Although visual loss accompanying attacks of MS, diagnosed as optic neuritis or retrobulbar neuritis, may occasionally be severe, blindness is unusual. There may be a small blind spot left after an attack, and occasionally, this may be large enough to interfere with vision. Glaucoma, which is another type of eye disease, unrelated to MS, is more common as a cause of blindness in MS patients. My vision problems range from a bit of blurriness to a complete lack of sight. I inherited extreme...

What are the symptoms of MS Which symptoms are most common

Symptoms of MS vary from common problems such as unexplained difficulty in walking (occurring in about half of patients at the very beginning) to those that are relatively less common, such as blurred vision, to truly uncommon symptoms such as repeated sudden and brief spasms in one or more limbs (paroxysmal dystonia). Optic neuritis (retrobulbar neuritis) an inflammation of the optic nerve with pain and variable loss of vision. Most patients will eventually be diagnosed as having MS. Despite...

What causes walking difficulty in MS

Difficulty with walking in MS can result from plaques in different places in the brain stem and spinal cord. The location of the plaques determines, in large part, whether that difficulty is due to the particular problems of weakness, loss of sensation, or incoordination of the legs. In certain places in the brain and spinal cord, plaques can produce weakness those in the back part of the spinal cord cause certain kinds of sensation loss (position sense) others in the cerebellum and its...

What can I do about getting rid of this stiffness in my legs What is the best treatment for spasticity

A feeling of stiffness often is symptomatic of spastic-ity, although it may occur for other reasons. If you have cramps in your calves, especially at night, the problem is probably spasticity, for which there are a number of different therapies. If, however, a feeling of stiffness is due to impaired sensation in the legs, these treatments will not help. Runners and other athletes use stretching of muscles to relieve muscle cramps. Not surprisingly, the first proven approach to the treatment of...

Are there treatments to prevent attacks and lessen risk of disability

Successful clinical and MRI study results for four drugs resulted in FDA approval of their marketing for the treatment of relapsing MS. The first was inter-feron-beta-1b (Betaseron) in 1993, interferon-beta-1a (Avonex in 1996 and Rebif in 2002), and glatiramer acetate (Copaxone) in 1997. There is a marked reduction in new MRI lesions within the first month with the higher dose interferon product Betaseron and by inference with Rebif. However, none of these drugs reveals any reduction of relapse...

Now that I have been diagnosed with MS how do I learn to cope with this disease

Over the last four decades that I have dealt with persons diagnosed with MS, I have learned that each person reacts somewhat differently to a new diagnosis of MS. In many patients, the diagnosis is welcomed as an explanation for an event affecting their health that had previously remained unexplained. Others anticipated the diagnosis on the basis of life experience (the experience of a friend, relative, or celebrity dealing with MS). In some, surfing the web or reading provided some insight...

How is a diagnosis of MS made

A diagnosis of MS is not generally accepted unless a neurologist confirms the diagnosis. In actuality, many general physicians are aware of the illness and recognize the characteristic problems that patients have with MS. Some have a heightened awareness of the disease, whereas others are more proficient in carrying out a neurologic exam. However, other than neurologists with subspecialty training in MS, few have the training and experience to carry out a quantitative neurologic examination....

How long do the symptoms of MS last

To be considered a symptom of MS, the symptom should last at least 24 hours. However, certain rare symptoms such as recurrent brief spasms in one or more limbs can be recognized as part of MS (paroxysmal dystonia). Although they are of short duration, typically seconds to minutes, they are identified because they recur in a stereotyped fashion. Other symptoms, such as the loss of muscle tone, difficulty with articulation during speaking, pain, and so on, may be due to MS. Symptoms in MS...

Read that toxins can cause MS Is this true Can I be detoxified

When people thought about toxins in the past, they usually referred to mercury, lead, arsenic, antimony, and other metals. Nowadays, insecticides are more often considered as potentially injurious. Hydrocarbons, poly-chlor-vinyls (PCVs) used in the manufacture of certain plastics, and other organic compounds are also topics of conversation and speculation regarding their impact on myelin and nervous system disease in general. In fact, many potential toxins exist in our environment, but federal...

Why should I take drugs that have side effects

Although patients recover from attacks of MS with or without drug treatment, recovery is hastened with ACTH treatment. In the 1970 national study, MS patients in relapse were all placed at rest in hospitals. In this relatively small study, despite being in hospitalized and benefiting from rest, actively treated patients receiving ACTH were significantly better after 1,2, and 3 weeks of ACTH treatment compared with those receiving placebo injections. Although the...

How are MS attacks treated Why are there different drugs to treat attacks of MS

MS is characterized by unpredictable attacks of neurologic symptoms that vary greatly in type and severity. After being diagnosed, all patients are familiar with at least one symptom. They are concerned about recovering from the difficulty as soon as possible. Generally, recovery follows all attacks whether treatment is given or not. The speed of recovery is the only predictable outcome that is affected by treatment. If a patient cannot perform his or her responsibilities at home or at work,...

Do viruses cause MS

The onset of an acute demyelinating disease (postinfectious encephalomyelitis) occurs after a number of different infections such as measles and mumps as well as smallpox vaccination. About one quarter of these cases diagnosed as postinfectious encephalomyelitis end up with a diagnosis of MS. This naturally raised the theory that viruses might be the cause of MS. Over the years, research has implicated many infectious agents, such as the measles virus (and other paramyxoviruses), distemper, the...

Is my stuttering due to my MS

However, intermittent difficulty with speech was recognized as a rare manifestation of MS 40 years ago (paroxysmal dysarthria). This difficulty with articulation is often associated with difficulty in finding the right word. It is rarely recognized as a manifestation of MS, and many doctors incorrectly regard it as an emotional problem. Misdiagnosis is unfortunate because this disorder is amenable to treatment. There are a number of other brief (typically seconds...

What causes an MS plaque

The typical MS plaque seen in patients who have died early in their illness or who have had brain biopsies is composed of a mixture of lymphocytes with many more macrophages, without antibody. The macrophages in the plaque contain myelin within their cell bodies in various stages of digestion. Some axons are damaged, but they are relatively preserved as compared with myelin. After the initial insult by these cells, scarring begins. This process varies greatly from one individual to another....

Is MS hereditary

Genetic factors are recognized as playing a role in MS. This is not to say that they cause MS. Although MS is typically a disease of people of European ancestry, it also occurs in African Americans, who share genes common in both African and European populations. The observation that MS is about one half as common in African Americans as white Americans would seem to correlate with a risk related to European ancestry. Among Europeans, MS is much more common in northwestern Europe, particularly...

What is a macrophage

Macrophages (meaning big eaters) are actually monocytes from the blood stream that have been turned on by interacting with lymphocytes, which themselves have been turned on by other macrophages that have encountered a foreign protein. These cells have an amazing appetite and ability to damage tissue. For example, in tuberculosis, macrophages cause the tissue damage to lungs and other tissues. In MS, as seen in Figures 4 and 5, macrophages appear to be the primary cause of myelin damage. Using...

Can stress cause MS

Stress has been shown to be an aggravating factor in MS but not a causal factor. More than 30 years ago, in conjunction with the McGill department of psychiatry in Montreal, we found that major life stress (such as death or serious illness in a child or other family member, marital discord, and loss of employment) was three to four times more common in MS patients than in medical patients who had been referred to psychiatrists for psychiatric consultation and care. Moreover, this stress was...

Are there treatments for loss of genital sensation

A loss of sensation in the genital area can pose problems for both men and women with MS. Fortunately, such a loss of sensation in most patients is usually temporary. In men, the use of Viagra and the other drugs in this group can, in part, overcome erectile dysfunction related to decreased sensation in some cases. Temporary or not, for many women, the use of vibrators can overcome the inability to achieve orgasm. Eros is a specially designed commercially available device to enhance clitoral...

Organizations

The National Multiple Sclerosis Society (NMSS) It is headquartered in New York, has local chapters in most communities. They publish educational pamphlets and sponsor research. Their website, http www.nmss.org, is one of the few truly helpful websites available to MS patients and their families as well as to neurologists and other physicians. Multiple Sclerosis International Federation Information about MS in English, Spanish, French, Italian, German, and Russian is available. International...

What are oligos

Myelin on the nerve fibers (axons) is arranged like beads on a necklace. The cells that make myelin are called oligodendrocytes. Each of these oligodendrocytes sends up to two dozen tentacle-like arms to jelly roll-like nodes of myelin separated by little gaps. Myelin is very important because it helps fibers save 99 of the energy that they would otherwise have to expend. Damage to myelin alone results in messages becoming blocked at the site of damage. Inflammation itself can damage the nerve...

What is the importance ofHSV6 in MS

Currently, a great deal of interest is in the newly recognized family of viruses known as HSV-6. This virus family is distantly related to HSV-1 (the cold sore virus) but is very closely related to the EBV and yet another family of viruses called HSV-7. Both HSV-6 and another closely related virus HSV-7 share two thirds of their DNA structure with the EBV virus. Cross-reactivity of antibody to these viruses might be one explanation of the finding of antibody to EBV in MS. Both HSV-6 and HSV-7,...