Taking a Closer Look at Multiple Sclerosis, Part I

As the first in our series of web logs on various illnesses and conditions that change people’s lives, we set our sights on MS. The National Mulitple Sclerosis Society has a publication called Just The Facts. In it they summarize the key truths about MS. Here are a few of them:

• MS is a chronic, unpredictable neurological disease that affects the central nervous system.
• MS is not contagious and is not directly inherited.
• Most people with MS have a normal or near-normal life expectancy.
• The majority of people with MS do not become severely disabled.
• There are now FDA-approved medications that have been shown to "modify" or slow down the underlying course of MS.
  

MS is thought to be an autoimmune disease, one where the body stops recognizing parts of itself as crucial for healthy functioning and instead identifies those parts as somehow endangering. In the case of MS, the disease attacks the myelin, a fatty tissue surrounding the nerves of the central nervous system (brain, spinal cord, optic nerves), designed to help conduct electrical impulses. When the myelin is damaged, it creates scarring or sclerosis, and loses its ability to transmit those electrical impulses to and from the brain successfully. This leads to the array of symptoms that can occur with MS, from problems with balance, to incontinence, to blurred vision, just to name a few. There are several types of MS that have been identified and it may happen that one type might move onto another course over time.

• Relapsing-Remitting MS occurs with the most frequency, especially at time of initial diagnosis. Approximately 85% of cases reported are of this type. People with this type of MS experience clearly defined episodes or flare-ups (also called relapses, attacks, or exacerbations). These flare ups represent acute worsening of neurologic function and are often followed by partial or complete recovery periods (remissions) free of disease progression.
• Primary-Progressive MS is relatively rare, approximately 10% of cases. People with this type of MS experience a slow but nearly continuously worsening condition from the onset, with no distinct relapse or remission periods. However, there are variations in rates of progression over time, occasional plateaus, and temporary minor improvements.
• Secondary-Progressive MS affects nearly 50% of those with relapsing-remitting MS within 10 years of their initial diagnosis. Now that there is a plethora of drugs on the market designed to inhibit progression of the disease, there will be new clinical studies to understand whether this number reduces drastically. People with this type of MS experience an initial period of relapsing-remitting MS, followed by a steadily worsening disease course with or without occasional flare-ups, minor remissions, or plateaus.
• Progressive-Relapsing MS is also relatively rare, affecting approximately 5% of those diagnosed with MS. People with this type of MS experience steadily worsening symptoms from the onset but also have clear acute relapses (attacks or exacerbations), with or without recovery. In contrast to relapsing-remitting MS, the periods between relapses are characterized by continuing disease progression.
  

In subsequent blogs, we will look at symptoms of MS, treatments and tools to help you live as independently as possible with MS. Please comment or contact us with your story about living with MS.