Multiple Sclerosis
• Definition
· Multiple sclerosis is the disease of lesions or scarring of nerves resulting in impaired function, affecting the brain, brain stem and spinal cord.
• Overview
· The exact cause of Multiple sclerosis is not known.
· It is believed that after an inciting event, inflammation develops around nerves leading to scarring and damage to the nerve and nervous function.
· Multiple sclerosis affects up to 350,000 Americans.
· Multiple sclerosis is more common in women than men
· There is probably a genetic predisposition in that it is more likely to occur in patients who have a family member affected with Multiple sclerosis.
· Symptoms of Multiple sclerosis generally begin between 20 and 40 years of age.
· Multiple sclerosis occurs more commonly in people who grew up in geographic areas north of 40 degrees latitude.
· Types
· Relapsing and remitting multiple sclerosis is the most common form of the disease.
This form tends to be fluctuating with episodes of worsening nerve/brain function for weeks followed by some improvement.
· Primary progressive multiple sclerosis is the least common form of the disease.
Primary progressive multiple sclerosis produces a slow but consistent deterioration in nerve function.
Primary progressive multiple sclerosis responds poorly to the traditional medical treatments.
• Symptoms
· Common presenting symptoms of multiple sclerosis include
· double vision
· loss of vision in one eye
· parasthesia; tingling or numbness
· problems concentrating
· fatigue
· difficulty urinating
· constipation
• Diagnosis
Multiple sclerosis is diagnosed with a brain MRI and lumbar spinal tap.
• Treatment
· Life style modification:
Stretching and physical therapy are helpful with uncontrolled muscle jerking and muscle stiffness.
· Drug Therapy:
Steroids such as Prednisone is helpful in decreasing the inflammatory activity.
Interferon-beta 1a is a chemical messenger that can modify inflammatory responses and has been helpful in the treatment of multiple sclerosis.
Newer medications are showing great promise in treating multiple sclerosis. Natalizumab is an antibody type treatment that interferes with the migration of inflammatory cells into the brain leading to less inflammation at the sites of the multiple sclerosis.
References
Ann Neurol. 2004;55:455-7. [PMID: 15048883]
Posted on September 24, 2008
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