Who is at high risk for multiple sclerosis?
The cause of multiple sclerosis (MS) is not known. But scientists believe that a combination of various factors may put an individual at a higher risk for MS. These factors include:
- Immunologic factors: Abnormal responses by the body’s immune system that may cause inflammation and damage in the central nervous system.
- Environmental factors: Exposure to some environmental toxins before puberty may predispose a person to develop MS later in life.
- Vitamin D: Low vitamin D levels in the blood due to less exposure to sunlight have been proposed to trigger the development of MS.
- Smoking: Smoking can cause MS to become more severe and progress rapidly.
- Obesity: Obesity in childhood and adolescence increases the risk of later developing MS.
- Infectious factors: Evidence suggests that previous infection with Epstein-Barr virus contributes to the risk of developing MS.
- Genetic factors: About 200 genes have been identified that play a role in developing MS.
- Female gender: Women are twice as likely as men to develop MS particularly during childbearing years and during the early postpartum period.
Environmental allergies, exposure to household pets, exposure to the heavy metals, and consumption of the artificial sweetener aspartame do not play any role in causing MS.
How do you diagnose multiple sclerosis?
Diagnosis of multiple sclerosis (MS) takes a very long time to diagnose because many times the symptoms stay for a short time, go away, and take several months or years to come back. It takes time for the signs of MS to show up in any diagnostic test and there is no single test that can prove that a person has MS.
Many conditions have symptoms similar to MS and MS may be mistaken for another disease initially.
The doctor who specializes in treating MS (neurologist) will order a few tests to see if the brain and spinal cord are working as they should. These include:
- Magnetic resonance imaging (MRI): This imaging test lets the doctor check for any inflammatory changes of MS in the deep parts of the brain or spinal cord.
- Lumbar puncture: Doctors draw out a small amount of fluid known as cerebrospinal fluid (CSF) from the spinal cord and send it to the laboratory for its analysis.
- Evoked potentials: The doctor will place wires on the patient’s scalp to check if the brain's response to certain things is altered as happens in MS.
- Blood tests: Blood tests may help the doctor support the MS diagnosis and rule out other conditions.
QUESTION
What kind of disease is multiple sclerosis? See AnswerWhat is the best medicine for MS?
More than a dozen disease-modifying therapies are available that are approved by the U.S. Food and Drug Administration (FDA) to treat MS. The best medicine for MS varies among patients. Research is ongoing all around the world to find more effective therapies for MS.
Although doctors are not unsure of the underlying or triggering mechanism for MS and MS attacks, several drugs have been shown to have beneficial effects in people with MS. These drugs fall under two categories: immunomodulatory therapy (IMT) for the underlying autoimmune disorder and therapies to relieve symptoms.
Some of the immunomodulatory medications include:
- Interferons
- Glatiramer acetate (Copaxone)
- Natalizumab (Tysabri)
- Methylprednisolone
- Immunoglobulin
General treatment to relieve the symptoms of MS includes:
- Methylprednisolone (Solu-Medrol)
- Plasma exchange or plasmapheresis (a method to remove autoantibodies from the blood)
- Dexamethasone
The FDA recently approved the drug ocrelizumab (Ocrevus) to treat adult patients with RRMS and PPMS. Stem cell therapy, though not approved by the FDA, is available for MS, which offers a promising option for some of the patients with MS.
Other drugs are used as required to relieve the specific symptoms in MS such as pain, sexual inability, eye problems, bladder/bowel problems, depression, and so on. Examples include:
- Tricyclic antidepressants
- Anticonvulsants
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Acetaminophen (Tylenol)
- Sildenafil (Viagra)
- Amantadine
- Fluoxetine (Prozac, Sarafem)
- Modafinil (Provigil)
- Baclofen (Lioresal),
- Gabapentin
- Tizanidine (Zanaflex)
- Prednisone
- Injecting Botox into the bladder
- Stool softeners
- Serotonin reuptake inhibitors (SSRIs)
- Cladribine (Mavenclad) is an oral medication used in people with MS who have failed to respond to all other therapies.
What happens with untreated MS?
- More than 30% of untreated patients with MS develop physical disability within 20-25 years.
- In 50 to 60% of deaths from MS is usually due to complications, such as kidney or lung problems.
- RRMS is generally associated with a better treatment outcome and chances of survival than PPMS.
- Another variant of MS—the Marburg variant—can lead to coma or death within days.
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MS (Multiple Sclerosis) vs. ALS (Amyotrophic Lateral Sclerosis)
ALS (amyotrophic lateral sclerosis, Lou Gehrig's disease) and MS (multiple sclerosis) are both diseases of the nervous system (neurodegenerative). ALS is a disease in which the nerve cells in the body are attacked by the immune system, although it's not considered an autoimmune disease by some scientists. MS is an autoimmune disease in which the insulated covering of the nerves (myelin sheath) in the CNS (central nervous system) degenerate, or deteriorate.
Scientists don't know the exact cause of either problem. However, they have discovered that mutations in the gene that produces the SOD1 enzyme were associated with some cases of familial ALS. Scientists also theorize that multiple sclerosis may be caused by infection or vitamin D deficiency. ALS occurs between 50-70 years of age (the average age of occurrence ALS is 55), and mostly affects men. While MS occurs between 20-60 years of age, and mostly affects women. About 30,000 people in the US have ALS, and an average of 5,000 new diagnoses per year (that's about 15 new cases per week). Worldwide, MS affects more than 2.3 million people, with about 10,000 new cases diagnosed each year (that's about 200 new diagnoses per week).
Some of the signs and symptoms of both diseases include muscle weakness, muscle spasms, problems walking, fatigue, slurred speech, and problems swallowing. ALS signs and symptoms that are different from MS include problems holding the head upright, clumsiness, muscle cramps and twitches, problems holding objects, and uncontrollable periods of laughing or crying. MS signs and symptoms that are different from ALS include vision problems, vertigo and balance problems, sexual problems, memory problems, depression, mood swings, and digestive problems.There is no cure for either disease, however the prognosis and life expectancy are different. Multiple sclerosis is not a fatal condition, while ALS progresses rapidly and leads to death.
Alternative Treatment (CAM) for MS
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.
Baclofen Pump
The medication baclofen treats symptoms of spasticity in patient with MS. Side effects of baclofen include sleepiness, dizziness, nausea, headache, and confusion.
Botox to Treat Multiple Sclerosis (MS)
Botulinum toxin is a muscle-relaxing medication used to decrease spasticity related to multiple sclerosis and other neurological conditions. Botulinum toxin is derived from the bacterium Clostridium botulinum. There are three types of botulinum toxin available for therapeutic use.
How Is a Lumbar Puncture Procedure Done?
In a lumbar puncture (LP) procedure, or spinal tap, a hollow needle is inserted near the spinal cord to collect a small amount of cerebrospinal fluid (CSF), which can then help diagnose infections (meningitis), hemorrhage, multiple sclerosis, and tumors.
Is Multiple Sclerosis (MS) Contagious?
Multiple sclerosis, or MS, is a degenerative disease of the covering around the nerves in the central nervous system (CNS). Researchers and doctors don't know the exact cause, but many theorize that it may be due to environmental triggers, an autoimmune disease, and viruses (infections). Symptoms and signs of MS include vision changes, paralysis, vertigo, heat intolerance, slurred speech, sexual dysfunction, and urinary incontinence (the inability to urinate). There's no vaccine or cure for MS, but the progression and symptoms of the disease can be treated.
Multiple Sclerosis (MS) Symptoms and Treatments
Multiple sclerosis (MS) symptoms vary from person to person and can last for days to months without periods of remission. Symptoms of MS include sexual problems and problems with the bowel, bladder, eyes, muscles, speech, swallowing, brain, and nervous system. The early symptoms and signs of multiple sclerosis usually start between ages 20-40. MS in children, teens, and those over age 40 is rare. Treatment options for multiple sclerosis vary depending on the type and severity of symptoms. Medications may be prescribed to manage MS symptoms.
Multiple Sclerosis (MS)
Multiple sclerosis or MS is an autoimmune disorder in which brain and spinal cord nerve cells become demyelinated. This damage results in symptoms that may include numbness, weakness, vertigo, paralysis, and involuntary muscle contractions. Different forms of MS can follow variable courses from relatively benign to life-threatening. MS is treated with disease-modifying therapies. Some MS symptoms can be treated with medications.
Making an MS Friendly Home
Adults with multiple sclerosis may be at risk for injuries, hazards, and falling at home. Some simple home modifications can protect your health and safety and facilitate fall prevention. Reduce your risk of accidents and prevent hazards with these tips.
Multiple Sclerosis (MS) and Pregnancy
Multiple sclerosis or MS is a central nervous system disease in which the immune system attacks the myelin sheath (the protective coating around nerves). Symptoms of MS include pain, sexual problems, fatigue, numbness and tingling, emotional changes, and depression.Women who are pregnant and have multiple sclerosis may have more difficulty carrying a pregnancy. Multiple sclerosis does not affect ability to conceive, and does not seem to affect fertility. MS symptoms during pregnancy may stay the same or get better; however, they may worsen after giving birth. Pregnancy decreases the number of relapses, but flares increase in the first 3-6 months after delivery. Pregnant women with MS may carrying a pregnancy more difficult to tell when labor starts, and there is an increased need to use forceps or vacuum to assist with delivery or b7 C-section (Cesarean birth) increases.
Some treatment MS drugs may be safe to use during pregnancy; however, some drugs should not be taken, for example, baclofen (Gablofen, Lioresal), fluoxetine (Prozac, Sarafem), or solifenacin succinate (VESIcare), and most disease-modifying therapies (DMTs).
Talk with your healthcare team about vitamins, supplements, and medications that you are taking if you are pregnant and have MS.
MS Quiz
Multiple Sclerosis is a debilitating neurological condition. Take the MS Quiz to test your knowledge of the causes, symptoms, risks and treatments.
MS Slideshow
MS is an autoimmune disease that attacks the nerves of the central nervous system. Learn about multiple sclerosis (MS) causes, symptoms, and treatment, along with diagnosis and life expectancy.
Famous Faces of MS
Learn about celebrities, such as Montel Williams and Jack Osbourne, who are living with multiple sclerosis.
Multiple Sclerosis Symptoms Picture
Symptoms of multiple sclerosis may be single or multiple and may range from mild to severe in intensity and short to long in duration. See a picture of Multiple Sclerosis Symptoms and learn more about the health topic.
What Does an MS Attack Feel Like?
Multiple sclerosis (MS) is an autoimmune disorder in which your own antibodies (autoantibodies) start attacking and destroying the nerve cells of your body. This disease affects the central nervous system, which is responsible for various functions including, balance, and coordination. An MS attack can include tingling and numbness, cramps and tightness in the muscles, fatigue, dizziness, a triad of abnormal speech, abnormal eye movement, and hand tremor; problems with balance and coordination, visual disturbances, bladder problems, bowel incontinence, face pain, pain, and intolerance to heat.