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Frequently
Asked Questions
about Multiple Sclerosis
What is multiple
sclerosis?
Multiple Sclerosis, also referred to as
"MS," is a neurological disorder affecting the nerves of the
brain and spinal cord. MS is thought to be an "autoimmune"
disease, which means that a person's own immune system is
attacking his or her body. This attack damages the protective
covering to the nerves (myelin) and eventually the nerves
(axons) as well.
MS is most often diagnosed in young
adults, and symptoms can range from visual changes, numbness,
and vertigo, to bladder and bowel problems, weakness, and
spasticity (muscle tightness), among other symptoms. Individuals
may also experience emotional difficulties, such as depression,
or cognitive issues, such as forgetfulness. For most people with
early MS, symptoms tend to flare up ("exacerbation") and subside
("remission") for long periods of time.
What causes MS?
An exact cause of MS has not been
identified, however, most researchers believe that more than one
factor is involved in the development of this disease. One
popular theory involves a slow-acting virus, such as
Epstein-Barr virus (EBV) or measles, which could remain dormant
(inactive) for many years before contributing to the development
of MS in genetically susceptible people. Genes appear to play a
role as well.
Additionally, researchers are now
looking at a vitamin D deficiency (vitamin D may be derived from
both sunshine and diet), along with the types and amounts of fat
intake in one's diet, as possible contributing factors of MS.
While cigarette smoking has already been shown to increase the
rate of progression of one's MS, studies now suggest that
smoking may also increase the risk of developing MS. MS is not
contagious.
Is MS fatal? Can MS be
treated?
Most people with MS have a normal life
expectancy. Only a very small percentage of patients experience
a rapidly progressive type of MS which may cause more
significant health issues early in the disease. With various
adjustments made along the way, most individuals with MS may
look forward to a fulfilling and productive lifetime.
As for anyone, other health factors
play a role in determining one's quality of life as well as life
expectancy. Examples of such health factors include smoking,
diet, exercise, and family history of disease.
While no cure for MS has been found,
six FDA-approved drugs are now available for the long-term
treatment of MS. These have been shown to reduce the number and
severity of MS flare-ups, along with possibly delaying disease
progression. Many more MS therapies are being studied in
clinical trials, and these may lead to even greater treatments —
and possibly a cure — for MS.
How is MS Diagnosed?
Being a neurological condition, MS is
usually diagnosed and treated by a neurologist. Other
professionals specializing in neurology in conjunction with
another area of medicine — such as radiology (neuroradiologist),
ophthalmology (neurophthalmologist), and psychology (neuropsychologist),
may also assist with one's diagnosis and ongoing treatment plan.
Because the symptoms of early MS can
come and go, and because a single test is not available to
determine if one has MS, getting a diagnosis is often difficult.
Several appointments and tests (to exclude other conditions) may
be necessary.
Tools used to help diagnose and
evaluate MS include:
- magnetic resonance imaging (MRI)
- magnetic resonance spectroscopy (MRS)
- lumbar puncture (spinal tap)
- evoked potentials (EP) tests
- Expanded Disability Status Scale (EDSS)
- Functional System (FS) scale
- MS Functional Composite (MSFC) scale
For descriptions of these diagnostic
and evaluative tools, please visit the "Health and Wellness"
column from the summer 2007 issue of The Motivator.
Who gets MS? How many
people have MS?
Most people with MS experience their
first symptoms and are diagnosed between the ages of 15 and 50.
Previously, MS in younger children was extremely rare. Referred
to as "Pediatric MS," the diagnosis of MS at a young age is on
the rise. Researchers do not know if this is an indication of
people developing MS at an earlier age, or if this is a result
of greater disease awareness and more sensitive diagnostic
procedures.
Women are two to three times more
likely to develop MS versus men. Caucasians, especially those of
European or Scandinavian ancestry, are at a much greater risk of
MS than those of African heritage.
Individuals growing up in regions
closer to the equator have a lower incidence of MS. The rate of
MS increases as distance from the equator increases. This
environmental factor may relate to diet, exposure to sunshine,
and/or other lifestyle traits.
Estimates of MS populations vary, and
specific numbers are difficult to confirm through healthcare
organizations. Many groups estimate that between 350,000 and
400,000 individuals in the United States have MS, although this
number could be much higher. Additionally, estimates range from
one to two-and-a-half million for people living with MS
throughout the world.
Is it safe to get
pregnant?
Many of those diagnosed with MS are
young women with plans of having children at some point in their
future. The good news is that MS does not affect fertility, and
pregnancies progress "normally" (that is, having the same
benefits and risks as someone without MS).
For most women with MS, MS symptoms
often stabilize or improve during pregnancy. Unfortunately,
20-to-40 percent of women have a relapse following delivery, so
new mothers will need to plan for more rest and assistance
during the first few months. Disease progression and long-term
risk of additional relapses are not affected by pregnancy.
Some of the medications taken for MS
can increase the risk of miscarriage and are transmitted in
breast milk. Women considering pregnancy should discuss their
medications with their neurologist in advance. Some medications
may need to be discontinued a few months before attempting to
become pregnant.
Having a child is an important decision
for any person or couple. With MS, parents need to consider that
fatigue and other symptoms may well affect the amount of
activity the mother may be able to perform with the child or
children in their younger years. Assistance from others — such
as family and friends — may be needed at certain times. Before
making the commitment, individuals and couples may want to
discuss the different issues with their healthcare provider.
Can I inherit MS?
Many people ask if MS may be inherited.
While MS in not hereditary, individuals may be "genetically
susceptible," increasing their risk of MS. This risk is slight,
however, with only a three-to-four percent chance of a child
(with a parent who has MS) being diagnosed with MS sometime in
his or her future.
Researchers believe that genetics are
only one piece to the puzzle, and other factors (such as common
viruses, environment, diet, etc.) are also necessary to develop
MS. Furthermore, MS research is making great strides toward
identifying causes and fine-tuning effective treatments.
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