Volume 7 Issue 298
Published - 14:00 UTC 08:00 EST 10-Nov-2005 
Next Update - 14:00 UTC 08:00 EST 11-Nov-2005

Editor: Susan K. Boyer, RN
Vidyya.
All rights reserved.

  

 




Information for patients: NINDS Multiple sclerosis page 

(10 November 2005: VIDYYA MEDICAL NEWS SERVICE) -- What is Multiple Sclerosis?

An unpredictable disease of the central nervous system, multiple sclerosis (MS) can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted. Many investigators believe MS to be an autoimmune disease -- one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, it is the nerve-insulating myelin that comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus.

Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance. These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis. Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or "pins and needles" sensations. Some may also experience pain. Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss. Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked. Depression is another common feature of MS.

Is there any treatment?

There is as yet no cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. An immunosuppressant treatment, Novantrone (mitoxantrone ), is approved by the FDA for the treatment of advanced or chronic MS.

While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients. Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile. Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue. If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help. Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used.

What is the prognosis?

A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to readily identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously wax and wane. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk. MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment.

What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Scientists continue their extensive efforts to create new and better therapies for MS. One of the most promising MS research areas involves naturally occurring antiviral proteins known as interferons. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. In addition, there are a number of treatments under investigation that may curtail attacks or improve function. Over a dozen clinical trials testing potential therapies are underway, and additional new treatments are being devised and tested in animal models.

In 2001, the National Academies/Institute of Medicine, a Federal technical and scientific advisory agency, prepared a strategic review of MS research.

Organizations

Clearinghouse on Disability Information

Special Education & Rehabilitative Services Communications & Customer Service Team

550 12th Street, SW, Rm. 5133

Washington, DC 20202-2550

http://www.ed.gov/about/offices/list/osers

Tel: 202-245-7307 202-205-5637 (TTD)

Fax: 292024507636

International Essential Tremor Foundation

P.O. Box 14005

Lenexa, KS 66285-4005

http://www.essentialtremor.org

Tel: 913-341-3880 888-387-3667

Fax: 913-341-1296

Multiple Sclerosis Association of America

706 Haddonfield Road

Cherry Hill, NJ 08002

msaa@msaa.com

http://www.msaa.com

Tel: 856-488-4500 800-532-7667

Fax: 856-661-9797

Multiple Sclerosis Foundation

6350 North Andrews Avenue

Ft. Lauderdale, FL 33309-2130

support@msfocus.org

http://www.msfocus.org

Tel: 954-776-6805 888-MSFOCUS (673-6287)

Fax: 954-351-0630

National Rehabilitation Information Center (NARIC)

4200 Forbes Boulevard

Suite 202

Lanham, MD 20706-4829

naricinfo@heitechservices.com

http://www.naric.com

Tel: 301-459-5900/301-459-5984 (TTY) 800-346-2742 Fax: 301-562-2401

National Ataxia Foundation (NAF)

2600 Fernbrook Lane

Suite 119

Minneapolis, MN 55447-4752

naf@ataxia.org

http://www.ataxia.org

Tel: 763-553-0020

Fax: 763-553-0167

National Multiple Sclerosis Society

733 Third Avenue

6th Floor

New York, NY 10017-3288

nat@nmss.org

http://www.nationalmssociety.org

Tel: 212-986-3240 800-344-4867 (FIGHTMS)

Fax: 212-986-7981

American Autoimmune Related Diseases Association

22100 Gratiot Avenue

Eastpointe

East Detroit, MI 48201-2227

aarda@aarda.org

http://www.aarda.org

Tel: 586-776-3900 800-598-4668

Fax: 586-776-3903

National Organization for Rare Disorders (NORD)

P.O. Box 1968

(55 Kenosia Avenue)

Danbury, CT 06813-1968

orphan@rarediseases.org

http://www.rarediseases.org

Tel: 203-744-0100 Voice Mail 800-999-NORD (6673)

Fax: 203-798-2291

Well Spouse Foundation

63 West Main Street Suite H

Freehold, NJ 07728

info@wellspouse.org

http://www.wellspouse.org

Tel: 800-838-0879 732-577-8899

Fax: 732-577-8644

Paralyzed Veterans of America (PVA)

801 18th Street, NW

Washington, DC 20006-3517

info@pva.org

http://www.pva.org

Tel: 202-USA-1300 (872-1300) 800-424-8200

Fax: 202-785-4452

Accelerated Cure Project for Multiple Sclerosis

300 Fifth Avenue

Waltham, MA 02451

info@acceleratedcure.org

http://www.acceleratedcure.org

Tel: 781-487-0008

Fax: 781-487-0009

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

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Last updated October 13, 2005


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