Multiple sclerosis (MS) is a chronic, unpredictable inflammatory disease of the central nervous system. In MS the body’s own immune system attacks and damages the myelin sheath that surrounds, insulates and protects the axons of brain and spinal cord. This leads to demyelination, a process that compromises the ability of the nerve cells to transmit messages for a desired action from the brain to various parts of the body through the spinal cord. As the nerve coverings are damaged due to demyelination, the nerve impulses either slow down or stop. MS is a progressive disease where the nerve damage will worsen over time leading to a permanent loss of axons and nerve cells.
Though the exact cause is unknown it is most likely that MS results from a combination of genetic, environmental and infectious factors. Epidemiological studies have shown different possible causes of MS, but none have proven to be definitive. Although the tissue damage in MS is primarily due to inflammation, the factors that trigger inflammation are not known.
MS is a difficult disease to diagnose because its signs and symptoms may be similar to several other neurological diseases. There are no tests that can determine if a person has MS or is likely to have MS in the future. Currently a combination of both clinical evidence i.e., history & neurological exam and paraclinical evidence i.e., lumbar puncture (spinal tap), MRI, etc are used for a definite diagnosis of MS (Multiple Sclerosis Foundation, 2009).
Relapsing – Remitting MS
Symptom flare-ups followed by recover; stable between attacks.
Secondary – Progressive MS
Second Phase of RMSS; treatments may delay this phase.
Primary – Progressive MS
Gradual but steady accumulation of neurological problems
Progressive – Relapsing MS
Progressive course from onset; combined with symptom flare-ups.
Rapidly progressive disease course
- Blurred Vision
- Lack of concentration
- Osteoporosis or thinning of bones
- Urinary tract infections, etc.
Most people with MS have a normal or near to normal life expectancy. In very rare cases MS progresses rapidly with few remissions and leads to significant health problems early in the disease. Various health factors like smoking, diet, exercise, family history, etc., play a major role in determining the quality of life and life expectancy of the patient.
There is currently no cure for MS. Several Food and Drug Administration (FDA) approved drugs help to decrease the frequency and severity of MS symptoms, reduce the accumulation of lesions, and may be slow the progression of the disease. However, many people choose to go without therapy because many of the approved drugs often have side effects and carry significant risks (NINDS – NIH, 2010).
In the United States there are approximately 400,000 people with MS – and more than 200 more people being diagnosed every week (CDC, 2010). As the Center of Disease Control and Prevention (CDC) does not require U.S physicians to report new cases of MS, the numbers are just estimates. There are over 2.5 million people living with MS around the world. The risk of developing MS in general population is 1/750, but having a close relative with MS increases the risk to 1/40 (NINDS – NIH, 2010). As in other auto-immune diseases MS is significantly more common in women than men. Though most cases of MS are diagnosed between the ages 20-50, it can appear in teens and also in older individuals.