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What is Multiple Sclerosis?

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What is MS?
Multiple sclerosis (or MS) is a chronic, often disabling disease that attacks the central nervous system (brain and spinal cord). Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. The progress, severity, and specific symptoms of MS vary among individuals and are unpredictable. Today, new treatments and advances in research are giving new hope to people who are affected by the disease.

MS is thought to be an autoimmune disease. The body’s own defense system attacks myelin, the fatty substance that surrounds and protects the nerve fibers of the brain, optic nerves, and spinal cord (the central nervous system). The damaged myelin may form scar tissue (sclerosis). Often the nerve fiber is also damaged. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain are distorted or interrupted. MS is not a fatal disease. Individuals with MS have near-normal life expectancies. Most people with MS
learn to cope with the disease and are able to live productive lives.

What are its symptoms?
The symptoms of MS may include tingling, numbness, painful sensations, slurred speech, and blurred or double vision. Some people experience muscle weakness, poor balance, poor coordination, muscle tightness or spasticity, tremors, or paralysis which may be temporary or permanent. Problems with bladder, bowel, or sexual function are common. Fatigue is a major concern for many. MS can cause forgetfulness or difficulty concentrating. It can also cause mood swings and may make people more susceptible to depression. Symptoms may come and go, appear in any combination, and be mild, moderate, or severe.
Can MS be treated?
Yes. Today, there are six medications approved by the Food and Drug Administration (FDA) to treat MS. Four of them—Avonex®, Betaseron®, Copaxone®, and Rebif®—are immunomodulating drugs (meaning that they modulate or alter the immune system) that are given by injection. These drugs have been shown to be effective in modifying the natural course of relapsing and secondary-progressive MS.

The National MS Society recommends that treatment with one of these “disease modifiers” be considered as soon as possible following a confirmed diagnosis of MS with a relapsing course.

In some circumstances, treatment with a disease-modifying drug may be recommended before an individual is definitely diagnosed if the person experienced one attack and has evidence of MS lesions as seen by MRI scanning.

Tysabri®, another immunomodulating drug that has recently been approved by the FDA, is delivered by infusion. It is recommended for patients who have an inadequate response to, or are unable to tolerate, alternate MS therapies.

The sixth drug, Novantrone®, is a powerful immune system suppressor shown to be effective in slowing down MS that is rapidly worsening or becoming progressive.

Steroids may be used to shorten acute attacks. Many other therapies are being clinically tested, and researchers are hopeful that more treatments for MS will be available in the near future.

There are also many medications to relieve or moderate MS symptoms such as spasticity, bowel and urinary distress, pain, fatigue, or depression. Physical therapy, exercise, vocational and cognitive rehabilitation, attention to diet, adequate rest, and counseling are often valuable for maintaining independence and quality of life. Prompt management of symptoms is vital and should be discussed with a knowledgeable physician.

Who gets multiple sclerosis?
An estimated 400,000 Americans have MS. Most are diagnosed between the ages of 20 and 50, and about two thirds are women. The disease is more frequently found among people raised in colder climates. Studies indicate that genetic factors make certain individuals susceptible to the disease, but there is no evidence that MS is directly inherited.
What are the general patterns?
MS is an unpredictable disease. Symptoms vary greatly from person to person and vary over time in the same person.

Periods of active MS symptoms are called attacks, exacerbations, or relapses. These can be followed by quiet periods called remissions.

The disease ranges from very mild and intermittent to steadily progressive. Some people have few attacks and little, if any, disability accumulating over time. At diagnosis, most people have relapsing-remitting disease. This means they have attacks followed by periods of partial or total remission, which may last months or even years. Others experience a progressive disease course with steadily worsening symptoms. The disease may worsen steadily from the onset (primary-progressive MS) or may become progressive after a relapsing-remitting course (secondary-progressive MS).

Because MS affects individuals so differently, it is difficult to make generalizations about disability. Statistics suggest that 2 out of 3 people with MS remain able to walk over their lifetime, though many of them will need a cane or other assistive device. Some will choose to use a scooter or wheelchair to conserve energy. Others will require a wheelchair to maintain mobility.

The “disease-modifying” treatments mentioned earlier, and in use only since the 1990s, may favorably alter this projection.

Is it easily diagnosed?
MS is not always easy to diagnose because symptoms may come and go. In addition, other diseases of the central nervous system have some of the same symptoms. No single neurological or laboratory test can confirm or rule out MS.

Medical imaging, particularly MRI (magnetic resonance imaging), helps to clarify diagnosis. A conclusive or definitive diagnosis requires evidence of multiple patches of scar tissue in different parts of the central nervous system and evidence of at least two separate attacks of the disease. A definitive diagnosis can take several months. Sometimes it takes years.

Can MS be cured?
The answer is no—not yet. The cause and the cure of MS are the subject of intensive worldwide research. Over 300 research grants and fellowships are funded by the National MS Society each year. Knowledge about MS is expanding and many clinical trials are in progress.
The National MS Society fights MS
Information, local referrals, publications, programs, and volunteer opportunities are available from the National Multiple Sclerosis Society and our 50-state network of chapters. To reach the chapter nearest you, call 1-800-344-4867. Visit nationalmssociety.org.

The Society is comprised of people who want to do something about MS now—people with MS, their family members, concerned friends and neighbors, and health-care professionals. As the world’s largest private funder of MS research, the Society supports local, state, and national advocacy programs, and serves as the voice for people with MS.

Avonex®xis a registered trademark of Biogen Idec.
Betaseron® is a registered trademark of Bayer HealthCare Pharmaceuticals, Inc.
Copaxone® is a registered trademark of TEVA Pharmaceutical Industries Ltd.
Novantrone® is a registered trademark of EMD Serono, Inc.
Rebif® is a registered trademark of Serono Pfizer.
Tysabri® is a registered trademark of Biogen Idec and Elan Pharmaceuticals, Inc.

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  Last updated August 17, 2007