When I tell a patient he or she has multiple sclerosis, I more often than not am met with a quizzical look. The patient realizes a constellation of varied symptoms has plagued him or her for some time. Blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, blindness and more symptoms are caused by MS. Any or all of these might be present when an MS patient goes to a neurologist for evaluation.
About 400,000 people in the United States have MS. Two million are thought to have the disease worldwide. Women are affected twice as often as men. MS usually strikes between the ages of 20 and 50, but there have been cases in children and older adults.
Environmental and genetic factors are implicated in the development of the disease. MS appears in greater frequency in northern latitudes farther from the equator.
Low Vitamin D levels also are suspected to play a role in the development of MS.
Multiple genes have been linked to the development of MS. Patients with a parent or sibling with MS have a one in 40 chance of developing MS versus a chance of one in 750 for the general population.
Multiple sclerosis is a disease of the central nervous system, which consists of the brain and spinal cord. In MS, the body's immune system targets a substance called myelin in both of these structures. Myelin insulates the nerve fibers to allow for smooth conduction of nerve impulses. In an MS attack, the immune cells cause injury to myelin, creating interruption in the nerve signals and resulting in neurological symptoms.
Repeated attacks create scarring and permanent disability.
Diagnosis is often difficult, and the disease can go unrecognized for several years. Evaluation by a neurologist is essential to rule out other diseases. An MRI of the brain and/or spinal cord, blood work and spinal tap are usually performed. Additionally, a second opinion from a center specializing in MS is often necessary to make a definitive diagnosis.
Treatments for MS have improved considerably during the past 15 years. Eight FDA-approved therapies are now available. The first oral medication became available last year. Three new medications are expected to be up for approval from the FDA in the coming year. Advances in therapy offer patients greater choices to tailor a medication to their needs.