Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Although its role is unclear, genetics may play a role in multiple sclerosis. European gypsies, Eskimos and African Bantu essentially do not develop
multiple sclerosis, while Native Indians of North and South America, Japanese and other Asian groups have a low incidence. The general population has less than a
one-percent chance of developing multiple sclerosis. The chance increases in families where a first-degree relative has the disease. Thus, a brother, sister, parent, or child of a person with
multiple sclerosis stands a one-percent to three percent chance of developing
multiple sclerosis. Similarly, an identical twin runs a nearly 30% chance of acquiring
multiple sclerosis whereas a non-identical twin has only a 4% chance if the other twin has the disease. These statistics suggest that genetic factors play a major role in
multiple sclerosis. However, other data suggest that environmental factors also play an important role.
What are the types of multiple sclerosis?
There are different clinical manifestations of multiple sclerosis. During an attack, a
person experiences a sudden deterioration in normal physical abilities that may range from mild to severe. This attack, sometimes referred to as an
exacerbation of multiple sclerosis, typically lasts more than 24 hours and generally more than a few weeks (rarely more than
four weeks).
About 65%-80% of individuals begin with relapsing-remitting (RR) MS,
the most common type. In this type, they experience a series of attacks
followed by complete or partial disappearance of the symptoms (remission) until
another attack occurs (relapse). It may be weeks to decades between relapses.
In primary-progressive (PP) MS, there is a continuous, gradual decline in a
person's physical abilities from the outset rather than relapses. About 10%-20% of
individuals begin with PP-MS.
Those beginning with RR-MS can then enter a phase where relapses are rare
but more disability accumulates, and are said to have secondary-progressive (SP)
MS. About 50% of RR-MS individuals will develop SP-MS within 10 years. Over
several decades, most RR-MS persons will experience progression to SP-MS. Progressive-Relapsing (PR) MS is a type of
multiple sclerosis characterized by a steady decline in abilities accompanied by sporadic attacks. There are cases of multiple sclerosis that are mild and can be recognized only retrospectively after many years and also rare cases of extremely rapid progression of
multiple sclerosis symptoms (sometimes fatal) known as malignant or fulminant (Marburg variant)
multiple sclerosis.
Multiple Sclerosis - Symptoms at Onset of DiseaseQuestion: The symptoms of multiple sclerosis can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Impotence, also known as erectile dysfunction, is a common
problem among men characterized by the consistent inability to sustain an
erection sufficient for sexual intercourse or the inability to achieve
ejaculation, or both. Impotence can have emotional causes but most often it is
due to a physical problem.
Overactive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Hydronephrosis is a condition in which the kidney swells, due to a backup of urine. Hydronephrosis generally occurs with another disease.Symptoms of hydronephrosis include nausea, vomiting, urinary tract infection, fever, painful urination, increased urinary frequency and urgency, flank pain, and swelling of the abdomen. Treatment of hydronephrosis depends on the cause.
Neuropathic pain is chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord).
Optic neuritis is inflammation of the optic nerve, the structure that connects the eye to the brain. The precise cause of optic neuritis is unknown, but it is thought to be a type of autoimmune disorder. Optic neuritis most commonly develops due to an autoimmune disorder that may be triggered by a viral infection.
There are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence, and overflow incontinence. Urinary incontinence in men may be caused by prostate or nerve problems. Treatment depends upon the type and severity of the UI and the patient's lifestyle.
Urinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection, surgery, medication, bladder stone, constipation, cystocele, rectocele, or urethral stricture. Symptoms include discomfort and pain. Treatment depends upon the cause of urinary retention.
Vitamin D deficiency has been linked with rickets, cancer, cardiovascular disease, severe asthma in children and cognitive impairment in older adults. Causes include not ingesting enough of the vitamin over time, having limited exposure to sunlight, having dark skin, and obesity. Symptoms include bone pain and muscle weakness. Treatment for vitamin D deficiency involves obtaining more vitamin D through supplements, diet, or exposure to sunlight.
People who have bladder spasms, the sensation occurs suddenly and often severely. A spasm itself is the sudden, involuntary squeezing of a muscle. A bladder spasm, or "detrusor contraction," occurs when the bladder muscle squeezes suddenly without warning, causing an urgent need to release urine. The spasm can force urine from the bladder, causing leakage. When this happens, the condition is called urge incontinence or overactive bladder.
Millions of women suffer from urinary incontinence (UI). UI occurs twice as often in women as in men. There are many types of urinary incontinence: stress incontinence, urge incontinence, overactive bladder, functional incontinence, overflow incontinence, transient incontinence, and mixed incontinence.
The term alternative therapy, in general, is used to describe any medical treatment or intervention that has not been scientifically documented or identified as safe or effective for a specific condition. Alternative therapy encompasses a variety of disciplines that range from diet and exercise to mental conditioning to lifestyle changes.
Double vision (diplopia) is a symptom that my indicate Graves' disease, myasthenia gravis, stroke, multiple sclerosis, Guillain-Barre syndrome, diabetes, cataracts, aneurysm, brain tumor, or migraine. Symptoms and signs include eye pain, droopy eyelids, nausea, headache, and a cross-eyed appearance. Treatment of double vision depends upon the underlying cause.
A nerve problem might affect your bladder control if the nerves that are supposed to carry messages between the brain and the bladder do not work properly. Such problems include urine retention, poor control of sphincter muscles, and overactive bladder. Treatment depends upon the cause of the nerve damage and resulting type of bladder control problem.
Reduction of the sense of smell is termed hyposmia. Total inability to detect odors is termed anosmia. Smell disorders have many causes. Most people who develop a smell disorder have recently experienced an illness or an injury.
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