MS is Thought to be an Autoimmune DiseaseThe body’s own defense system attacks myelin, the fatty substance that surrounds and protects the nerve fibers in the central nervous system. The nerve fibers themselves can also be damaged. The damaged myelin forms scar tissue (sclerosis), which gives the disease its name. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing the variety of symptoms that can occur.
Most people with MS learn to cope with the disease and continue to lead satisfying, productive lives.
The Four Courses of MSPeople with MS can typically experience one of four disease courses, each of which might be mild, moderate, or severe.
- Relapsing-Remitting MS
People with this type of MS experience clearly defined attacks of worsening neurologic function. These attacks—which are called relapses, flare-ups, or exacerbations —are followed by partial or complete recovery periods (remissions), during which no disease progression occurs. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.
- Primary-Progressive MS
This disease course is characterized by slowly worsening neurologic function from the beginning—with no distinct relapses or remissions. The rate of progression may vary over time, with occasional plateaus and temporary minor improvements. Approximately 10% of people are diagnosed with primary-progressive MS.
- Secondary-Progressive MS
Following an initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, with or without occasional flare-ups, minor recoveries (remissions), or plateaus. Before the disease-modifying medications became available, approximately 50% of people with relapsing-remitting MS developed this form of the disease within 10 years. Long-term data are not yet available to determine if treatment significantly delays this transition.
- Progressive-Relapsing MS
In this relatively rare course of MS (5%), people experience steadily worsening disease from the beginning, but with clear attacks of worsening neurologic function along the way. They may or may not experience some recovery following these relapses, but the disease continues to progress without remissions.
What is multiple sclerosis?Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (the brain, optic nerves, and spinal cord). It is thought to be an autoimmune disorder. This means the immune system incorrectly attacks the person's healthy tissue.
MS can cause blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more. These problems may be permanent or may come and go.
Most people are diagnosed between the ages of 20 and 50, although individuals as young as 2 and as old as 75 have developed it. MS is not considered a fatal disease as the vast majority of people with it live a normal life-span. But they may struggle to live as productively as they desire, often facing increasing limitations.
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Who gets MS?Anyone may develop MS but there are some patterns. More than twice as many women as men have MS. Studies suggest that genetic factors make certain individuals more susceptible than others, but there is no evidence that MS is directly inherited. MS occurs in most ethnic groups, including African-Americans, Asians and Hispanics/Latinos, but is more common in Caucasians of northern European ancestry.
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How many people have MS?Approximately 400,000 Americans have MS, and every week about 200 people are diagnosed. World-wide, MS affects about 2.5 million people. Because the Centers for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, and because symptoms can be completely invisible, the numbers can only be estimated.
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What are the typical symptoms of MS?Symptoms of MS are unpredictable, vary from person to person, and from time to time in the same person. For example: One person may experience abnormal fatigue and episodes of numbness and tingling. Another could have loss of balance and muscle coordination making walking difficult. Still another could have slurred speech, tremors, stiffness, and bladder problems.
Sometimes major symptoms disappear completely, and the person regains lost functions. In severe MS, people have symptoms on a permanent basis including partial or complete paralysis, and difficulties with vision, cognition, speech, and elimination.
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What causes the symptoms?MS symptoms result when an immune-system attack affects myelin, the protective insulation surrounding nerve fibers of the central nervous system (the brain and spinal cord). Myelin is destroyed and replaced by scars of hardened "sclerotic" tissue. Some underlying nerve fibers are permanently severed. The damage appears in multiple places within the central nervous system.
Myelin is often compared to insulating material around an electrical wire; loss of myelin interferes with the transmission of nerve signals.
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Is MS fatal?In rare cases MS is so malignantly progressive it is terminal, but most people with MS have a normal or near-normal life expectancy. Severe MS can shorten life.
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Does MS always cause paralysis?No. Moreover, the majority of people with MS do not become severely disabled. Two-thirds of people who have MS remain able to walk, though many will need an aid, such as a cane or crutches, and some will use a scooter or wheelchair because of fatigue, weakness, balance problems, or to assist with conserving energy.
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Is MS contagious or inherited?No. MS is not contagious and is not directly inherited. Studies do indicate that genetic factors may make certain individuals susceptible to the disease.
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Can MS be cured?Not yet. There are now FDA-approved medications that have been shown to "modify" or slow down the underlying course of MS. In addition, many therapeutic and technological advances are helping people manage symptoms. Advances in treating and understanding MS are made every year, and progress in research to find a cure is very encouraging.
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What medications and treatments are available?The National Multiple Sclerosis Society recommends that a person consider treatment with one of the FDA-approved "disease-modifying" drugs as soon as possible following a definite diagnosis of MS with active or relapsing disease. These drugs help to lessen the frequency and severity of MS attacks, reduce the accumulation of lesions (areas of damage) in the brain, and may slow the progression of disability.
In addition to drugs that address the basic disease, there are many therapies for MS symptoms such as spasticity, pain, bladder problems, fatigue, sexual dysfunction, weakness, and cognitive problems. People should consult a knowledgeable physician to develop a comprehensive approach to managing their MS.
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Why is MS so difficult to diagnose?In early MS, symptoms that might indicate any number of possible disorders come and go. Some people have symptoms that are very difficult for physicians to interpret, and these people must "wait and see." While no single laboratory test is yet available to prove or rule out MS, magnetic resonance imaging (MRI) is a great help in reaching a definitive diagnosis.
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Understanding How MS Affects the Mind and EmotionsMS can affect your emotions as well as important cognitive functions like memory and concentration. Read about helpful coping and treatment strategies and find some tips for managing the emotional ups and downs of everyday life.
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Prayer appears to benefit individuals with multiple sclerosis - Letter to the EditorAccording to the first comprehensive, nationwide survey in the USA of complementary and alternative medicine (CAM) use among individuals with multiple sclerosis (MS), prayer was rated as the most effective intervention."The survey results are interesting," comments Allen C. Bowling, MD, PhD, Medical Director, Rocky Mountain Multiple Sclerosis Center, Englewood, Colorado. "Certainly prayer and spirituality seem important and helpful for many MS patients, but formal clinical trials are needed to get a definitive answer."
Primary investigator Sangeetha Nayak, PhD, assistant professor, Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Newark, New Jersey agrees that further studies are required since this type of efficacy self-reporting doesn't constitute clinical evidence. (1) Nevertheless, she says that the subjective experience of having been helped, especially when compared to over 57 other possible therapies, is a signal to biomedical professionals that prayer should be examined closely.
Although there is little information on the role of prayer and spirituality on health, the majority of Americans believes faith can having healing effects. (2,3) For example, there is a dramatic personal account of a woman, Rita Klaus, who has MS and reportedly improved significantly through prayer and religious devotion. (4,5) Some researchers have examined the effect of spirituality on diabetes, which is, like MS, a chronic disease with an unpredictable course and multiple possible symptoms. One study's results indicated that religious devotion was associated with less psychological distress and decreased uncertainty. (6)
From the responses of the 3,140 adults with MS who returned the survey, Dr. Nayak and her colleagues found that 57% of them have tried at least one CAM modality. They also discovered that the longer people had MS and the less satisfied they were with conventional health care, the higher the probability of using CAM therapies. In fact, the most common reason for using CAM was the desire to use holistic health care--treatments that recognize the interrelatedness of mind, body, and spirit. Another study concurred that the most important motivation in looking for alternative medicine was the aim to participate actively in the healing process. (7)
Multiple sclerosis is a slowly progressive central nervous system (CNS) disease characterized by disseminated patches of demyelination in the brain and spinal cord, resulting in multiple varied neurological signs and symptoms, usually with remissions and exacerbations. (8) The most common presenting symptoms are paresthesias in one or more extremities, in the trunk, or on one side of the face; weakness or clumsiness of a leg or hand; or visual disturbances, e.g., partial blindness and pain in one eye, dimness of vision, or scotomas.
There is no cure for MS, but therapies are available that slow down the disease process. Much of the disease management is directed at symptoms, which arise variably in the course of the condition. Such problems as urinary incontinence, sexual dysfunction, cramps and spasms, tremor and trigeminal neuralgia can often be helped to some extent using conventional therapies. However, these treatments are not effective for everyone, or they cause unacceptable side-effects. (9) There are no generally accepted treatments for some commonly reported symptoms, such as fatigue or emotional lability. Therefore, knowledge of CAM therapies can benefit individuals with MS.
The investigators found that vitamins, prayer, and herbs were the most frequently used CAM modalities by MS patients (44.8%, 27.3%, and 26.6%, respectively). Moreover, prayer had been used for an average of 9.53 years, the longest duration of all the modalities covered in the survey. Furthermore, exercise was considered more effective than all other CAM therapies, except prayer, despite being used by a small proportion of the sample (about 5%).
Approximately 74% of MS patients predominately use CAM treatments for symptom relief, followed by slowing down the progress of MS, relapse prevention, and inducing remission. Pain, fatigue, and stress were the most frequently listed symptoms treated with alternative techniques.
The fact that prayer was rated as the most effective of all CAM interventions is not something that would be expected by most conventional healthcare providers, says Dr. Nayak. She suspects prayer affects individuals at the psychological or emotional level by reducing stress, a known factor that exacerbates MS symptoms. This is probably the same reason why other mind-body therapies such as yoga, relaxation techniques, and massage were also given fairly high effectiveness ratings.
Dr. Nayak's findings are consistent with another survey's results. These findings are posted on the Rocky Mountain Multiple Sclerosis Center's website on MS and CAM therapies (see http://www.ms-cam.org). As of August 15, 2003, 1,038 users have taken the survey. One interesting finding is that of the 946 individuals who answered the question, "Would you like your physician or other conventional healthcare provider to pray with you?" 23% replied 'Yes,' while another 20% were unsure.
Federal government employees and members of the U.S. Military Forces can support the National MS Society through the Combined Federal Campaign (CFC) by selecting the designated code number: 11409
Tributes and MemorialsMake a gift in memory or in honor of a loved one.
- Give a one-time gift
- Create a Fund with a personalized web page that lets other make a donation on their behalf
- Donate to an existing Fund
- Learn more about creating a Fund (.pdf)
*Tribute Funds are accessible across all National MS Society Chapter Web sites. Chapter-specific Funds can be created to ensure the money raised in a Fund is designated to a specific chapter. Chapter-specific Funds must be created on the chapter Web site.