About Multiple Sclerosis

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About Multiple Sclerosis


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What is multiple sclerosis (MS)?

What are the symptoms of multiple sclerosis (MS)?

How is multiple sclerosis (MS) diagnosed?

How common is multiple sclerosis (MS)?

What treatments are there for multiple sclerosis (MS)?

What are the risks and side effects of treatment for multiple sclerosis?

What is the prognosis for multiple sclerosis (MS)?

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What is multiple sclerosis (MS)?

Multiple sclerosis (MS) is a chronic immune-mediated disease that attacks your central nervous system (CNS). The term immune mediated signifies that it is your body’s own immune system causing damage via an abnormal response that causes it to attack normal, healthy nervous tissue.

The CNS consists of your brain, spinal cord, and optic nerves. As part of the immune attack on your CNS, myelin (the layer of insulation that surrounds and protects the nerve fibers) is damaged, as well as the nerve fibers themselves. The damaged myelin forms scar tissue (sclerosis), which gives the disease its name.

When the myelin or nerve fiber is damaged, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing the variety of symptoms that can occur.

 

What are the symptoms of multiple sclerosis (MS)?

The symptoms of multiple sclerosis can vary widely from person to person, and it is not possible to make a diagnosis of MS based on symptoms alone. That being said, some of the most common symptoms of MS include:
  • fatigue
  • numbness
  • walking (gait) imbalance
  • coordination problems
  • bladder dysfunction
  • bowel dysfunction
  • vision problems
  • dizziness
  • sexual dysfunction
  • pain
  • cognitive dysfunction
  • emotional changes
  • depression
  • muscle spasms

 

Disease Patterns
In addition, not all people experience the same pattern of MS progression. There are four categories that describe the typical ways in which MS evolves over time.

  • Relapsing-remitting MS (RRMS)
    This is the most common form of MS (85% of all cases) and is characterized by times of active inflammation—often called flare ups, exacerbations, or relapses—followed by periods where you may experience little or no discomfort.

  • Secondary-progressive MS (SPMS)
    SPMS describes a case of progressive MS that develops after (or secondary to) a primary relapsing-remitting course. Most cases of RRMS will eventually evolve into SPMS.

  • Primary-progressive MS (PPMS)
    About 10% of people with MS are diagnosed with PPMS. PPMS is characterized by symptoms that worsen slowly and gradually. There may be brief periods of improvement, but the general course of the disease is defined by decreasing functionality.

  • Progressive-relapsing MS (PRMS)
    This is the least common of the four subtypes of MS. PRMS combines the progressive features of PPMS with occasional relapses over time. Recovery after an attack is sometimes, but not always noted.

 

How is multiple sclerosis (MS) diagnosed?

There is no single symptom, physical finding, or laboratory test that can determine if you have MS. Rather, there are several strategies used to determine whether or not you meet the criteria for a diagnosis of MS.

These strategies include a careful medical history, a neurological exam, and several tests, including magnetic resonance imaging (MRI), evoked potentials (EP), and spinal fluid analysis.

As part of the process, it is also necessary to rule out other possible causes of your symptoms. Your doctor will help you schedule the appropriate tests and examinations to help you rule out or confirm an alternative diagnosis.

 

How common is multiple sclerosis (MS)?

Around 2.5 million people are affected with MS around the world, including 400,000 in the United States. However, the actual number is thought to be much higher due to incorrect or missed diagnoses.

 

What treatments are there for multiple sclerosis (MS)?

There is no cure for multiple sclerosis. However, treatments that can slow your disease progression, treat exacerbations (also called relapses), manage symptoms, and improve function and safety are available.

Disease-modifying Drugs
Drugs that slow the progression of MS are known as disease-modifying drugs and include the following:

  • Aubagio (teriflunomide)
  • Avonex (interferon beta-1a)
  • Betaseron (interferon beta-1b)
  • Copaxone (glatiramer acetate)
  • Extavia (interferon beta-1b)
  • Gilenya (fingolimod)
  • Novantrone (mitoxantrone)
  • Rebif (interferon beta-1a)
  • Tecfidera (dimethyl fumarate)
  • Tysabri (natalizumab)

 

Drugs for Managing MS Relapses
Disease-modifying drugs can increase the amount of time that elapses between your flare ups, but they do not treat a flare up that is in progress. Most relapses will resolve on their own without treatment, but during a severe relapse your doctor may prescribe corticosteroids to help reduce inflammation and damage to your central nervous system. Some of the corticosteroids commonly used are:

  • intravenous Solu-Medrol (methylprednisolone)
  • oral Deltasone (prednisone)

 

Drugs for Managing MS Symptoms
Though there are limited options in terms of drugs to treat the underlying cause of your multiple sclerosis, there are a wide array of medications that can help reduce or even eliminate problem symptoms.

Giving an accurate and detailed description of all of your symptoms can help your MS doctor prescribe medications that can reduce your symptoms and improve your quality of life.

 

What are the risks and side effects of treatment for multiple sclerosis?

Because of the wide-ranging symptoms caused by MS and medications used to treat these symptoms, it may take some time for you and your doctor to find the right combination of medications that give you the most symptom relief with the fewest side effects. Some of the common side effects of MS disease-modifying drugs are:
  • Interferon medications can cause flu-like symptoms such as achiness, fatigue, a low-grade fever, soreness, and chills. These symptoms should subside within a few weeks.

  • Copaxone can cause injection site reactions and post-injection flushing and/or palpitations, which are transient.

  • Fingolimod can cause slow heart rate, headache, infections, diarrhea, back pain, and coughing.

  • Natalizumab can cause infusion site reaction, infection fatigue, headache, nausea, and dizziness. In a small number of cases, natalizumab has caused a serious and life-threatening disease called progressive multifocal leukoencephalopathy (PML). Natalizumab is tightly controlled because of this. If you are taking natalizumab, you will be watched closely for signs of any serious side effects.

  • Aubagio can cause diarrhea, abnormal liver tests, nausea, and hair thinning (alopecia).

  • Tecfidera can cause flushing of the skin and gastrointestinal events (such as diarrhea, nausea, and upper abdominal pain).

 

What is the prognosis for multiple sclerosis (MS)?

It is difficult to predict the course of MS. While the disorder varies greatly from one individual to another, most people with MS have a normal life expectancy. A few patients with very severe disability may die prematurely of infectious complications (such as pneumonia), but the overall life expectancy is 95% of normal.

 

How can we help you?

To find out more about multiple sclerosis treatment at Barrow, or to tell us about your treatment needs, please call 1-800-BARROW1 (227-7691) .
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350 W. Thomas Road
Phoenix, AZ 85013
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