Q. What is multiple sclerosis?
A. Multiple sclerosis (MS) is a chronic, often disabling disease that randomly attacks the central nervous system (brain and spinal cord). Multiple sclerosis is believed to be an autoimmune disease where the body's own immune system attacks the protective material (myelin sheath) which surrounds the nerve fibers. The progress, severity and specific symptoms of the disease cannot be predicted. Symptoms may range from tingling and numbness to paralysis and blindness. MS is a devastating disease because people live with its unpredictable physical and emotional effects for the rest of their lives.
Q. What are the typical symptoms of MS?
A. Symptoms of MS are unpredictable and vary greatly from person to person and from time to time in the same person. They may include: abnormal fatigue, impaired vision, loss of balance and muscle coordination, slurred speech, tremors, stiffness, bladder and bowel problems, difficulty walking, short-term memory loss, mood swings and, in severe cases, partial or complete paralysis.
Q. What causes these symptoms?
A. Symptoms result when inflammation and breakdown occur in myelin, the protective insulation surrounding the nerve fibers of the central nervous system (brain and spinal cord). Myelin is destroyed and replaced by scars of hardened "sclerotic" patches of tissue. Such lesions are called "plaques," and appear in "multiple" places within the central nervous system. This can be compared to a loss of insulating material around an electrical wire, which interferes with the transmission of signals.
Q. Who gets MS?
A. Twice as many women as men have MS, with the onset of symptoms occurring most often between the ages of 20 and 40. Studies indicate that genetic factors may make certain individuals more susceptible to the disease, but there is no evidence that MS is directly inherited. It occurs more commonly among Caucasians, especially those of northern European ancestry, but people of African, Asian and Hispanic backgrounds can also develop MS.
Q. How can I tell if I have MS?
A. MS is a very difficult disease to diagnose and must be diagnosed by a physician. There is no one laboratory test which can tell you if you have MS. The peculiar nature of MS makes the diagnostic process complex. Elusive symptoms that come and go might indicate any number of possible disorders. 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) has greatly aided in definitive diagnosis.
Q. What causes MS?
A. While the precise causes of MS are not yet known, much scientific research indicates that a number of factors in combination are probably involved. These are the major scientific theories about the causes of MS:
IMMUNOLOGIC"—"It is now generally accepted that MS involves an autoimmune process, an abnormal immune response directed against the central nervous system (CNS). The exact antigen, the target the immune cells are sensitized to attack, remains unknown. In recent years, however, researchers have been able to identify which immune cells are mounting the attack, how they are activated to attack, and some of the sites, or receptors, on the attacking cells that appear to be attracted to the myelin to begin the destructive process. The destruction of myelin (the fatty sheath that surrounds and insulates the nerve fibers) causes the nerve impulses to be slowed or halted and produces the symptoms of MS.
ENVIRONMENTAL"—"Migration patterns and epidemiologic studies, those that take into account variations in geography, socioeconomics, genetics, and other factors, have shown that people who are born in an area of the world with a high risk of MS and move to an area with a lower risk, acquire the risk of their new home, if the move occurs prior to adolescence. Such data suggest that exposure to some environmental agent encountered before puberty may predispose a person to develop MS later.
VIRAL"—"Since initial exposure to numerous viruses occurs during childhood, and since some viruses are known causes of demyelination and inflammation, it is possible that a virus is the triggering factor in MS. More than a dozen viruses including measles, canine distemper, and herpes (HHV-6) have been investigated to determine if they are involved in the development of MS, but it has not yet been definitively proven that any one virus triggers MS.
GENETIC"—"While MS is not hereditary, having a first-degree relative (parent or sibling) with MS increases an individual's risk of developing the disease several-fold above the risk for the general population. Studies have demonstrated a higher prevalence of certain genes in populations with high rates of MS. Common genetic factors have also been found in some families where there is more than one person with MS. Some neurologists theorize that MS develops because a person is born with a genetic predisposition to react to some environmental agent, which, upon exposure, triggers an autoimmune response. Sophisticated new techniques for identifying genes may help answer questions about the role of genetics in the development of MS.
Q. Is MS fatal?
A. No. MS is not a fatal disease. People who have MS can be expected to have a normal or near-normal life expectancy. With modern medicine and technology, they can live 90-95 % of the normal life span.
Q. Is MS contagious?
A. No. MS is neither contagious nor directly inherited, although studies indicate that genetic factors may make certain individuals more susceptible to the disease.
Q. Where can I get more information about MS?
A. We recommend talking to your doctor about MS if you have concerns about your health. If you would like more general information about MS, you access web site of the National MS Society at http://www.nationalmssociety.org/or contact them by phone at 1-800-FIGHT MS, or, 1-800-344-4867. Their mailing address is:
National Multiple Sclerosis Society
733 Third Avenue
New York, NY 10017
SOURCE: National Multiple Sclerosis Society web site at http://www.nationalmssociety.org/.