MULTIPLE SCLEROSIS

MS is a chronic, inflammatory disease of the central nervous system [CNS], which is the brain and spinal cord. Many physicians believe that MS is an autoimmune disease. This term refers to a group of diseases in which the immune system goes awry and attacks certain tissues of the body. The cause of MS is unknown, but viral infection has been considered as a possible triggering factor. The end result, it seems, is that components of the immune system target the myelin sheath covering the nerve fibers of the CNS, leaving plaques or lesions on the myelin, which is an important fatty substance. Indeed, the name multiple sclerosis refers to the multiple patches of scar tissues appearing on the nerve fibers. Myelin shields certain nerve fibers, providing a form of electrical insulation. So when myelin breaks down, electrical impulses may be completely blocked, or they may short-circuit to adjacent nerves, producing an abnormal impulse. And because damage can occur anywhere in the CNS, no two patients have exactly the same symptoms. One patient may even have different symptoms with each attack, depending on which part of the CNS is affected. Still, symptoms often include fatigue, weakness, numbness in the extremities, walking difficulties, blurred vision, tingling, burning, and disturbances of bladder and bowel function as well as inattention and impaired judgment. On the positive side, however, many patients “do not become severely disable,” says The National Multiple Sclerosis Society in the United States. As in TOLA case, diagnosis may be difficult early on because symptoms may fit a number of disorders. But once a history of recurrent episodes is established, physicians can usually make a more accurate assessment. Worldwide, about 2.5 million people have MS. That figure includes approximately 50,000 Canadians and 350,000 residents of the United States, where about 200 people are diagnosed with the disease every week. “With the exception of trauma, [MS is] the most frequent cause of neurologic disability in early to middle adulthood,” states one medical reference. And it affects nearly twice as many women as men, with the onset of symptoms usually occurring between the ages of 20 and 50. MANAGING MS Because MS is still incurable, doctors try to manage the disease by arresting or slowing its progress and by managing the symptoms. Medications designed to arrest or slow the progress of MS and to lessen the severity of attacks include at least two forms of interferon [a natural protein made by immune cells] and a drug called glatiramer acetate. Doctors also prescribe drugs called corticosteroids for some patients, in order to suppress inflammation and to speed up recovery when relapses occur. However, “long-term corticosteroid treatment is rarely justified and can cause numerous medical complications including osteoporosis, ulcers, and diabetes,” says the medical publication The Merck Manual. Furthermore, steroid therapy may not alter the long-term course of the disease. Hence, some doctors prefer not to treat a mild attack. Recent studies show that between 50 and 60 percent of people with MS take vitamins, minerals, and herbs, and other dietary supplements. Although some of these may be harmless to MS sufferers, others may be counterproductive or even dangerous. So before patients take any additional therapies or dietary supplements, they should consider the potential risks. Taking a different approach, some researchers are studying ways to restore damaged myelin. In laboratory studies they have identified certain progenitor, or ancestral, cells that can give rise to mature myelin-producing cells. If they learn how to encourage this process, they may be able to stimulate the body to repair damaged nerves. THE FOUR MAIN TYPES OF MS 1. RELAPSING-REMITTING: This is the classic form of the disease, and it affects 70 to 80 percent of patients at the onset of symptoms. Relapses, or flare-ups, are clearly distinguished from periods of remission, during which symptoms resolve or partially resolve. Between relapses there is no sign of disease progression. 2. SECONDARY PROGRESSIVE: Of patients who initially have the relapsing-remitting form, about 70 percent go on to develop secondary progressive MS. They may continue to have relapses, but they also experience a slow, steady loss of neurological function. 3. PROGRESSIVE-RELAPSING: Affecting about 10 percent of patients, this form of MS steadily worsens from its onset. Patients have acute relapses with or without recovery. Unlike the relapsing-remitting form, the disease progresses between flare-ups. 4. PRIMARY PROGRESSIVE: This form of MS affects 10 to 15 percent of patients. From its onset it progresses almost continuously, without distinct relapses and remissions. However, the rate of progression may vary over time with temporary minor improvements. It is more common in people who develop MS after the age of 40. BLOOD AND M.S