Imagine that you have thousands of tiny insulated electrical cords buried deeply beneath your skin, each one carrying tiny zaps of electrical current to different parts of your body. They’re in your hands, legs, arms, face, and in your spine, and you’ve noticed that occasionally, you feel a little jolt, as if the insulation had a crack in it. With time, the little jolts get stronger and more widespread throughout your body. Over time, the tingling in your hands, arms, legs, and feet is constant, until finally, you begin losing sensation in those areas, confining you to a wheelchair most of the time.
Welcome to the world of an Multiple Sclerosis patient. There are roughly 400,000 Americans with some form of MS, a progressive neurological disorder that strikes more than twice as many women as men. For unknown reasons, it is more common among people with northern European heritage, and appears to be more prevalent in temperate regions of the world than in the tropics. MS is diagnosed most often in people between the ages of 20 and 50, although children and senior citizens have been diagnosed with MS as well.
MS is an immune system disease, and symptoms seem to occur when the immune system “turns against” a person’s own body. This causes inflammation and, ultimately, destruction of the insulating material, called myelin, which is wrapped around the nerve fibers of the brain and spinal cord. Without myelin, signals transmitted throughout the central nervous system are not sent properly and symptoms develop. Nerve fibers are damaged as well.
Symptoms vary from one person to another but commonly include the following:
- Fatigue (also called MS lassitude to differentiate it from tiredness resulting from other causes)
- Problems with walking
- Bowel and/or bladder disturbances
- Visual problems
- Changes in cognitive function, including problems with memory, attention, and problem-solving
- Abnormal sensations such as numbness or “pins and needles”
- Changes in sexual function
- Depression and/or mood swings
Forms of MS
There are several forms of MS that are characterized by how the symptoms present themselves. Often, MS can lie dormant for weeks, months, or years without a flare up. When it does become active, it can do so in several ways:
Relapse Remitting Flare Up
The patient experiences partial or total recovery (remission) after attacks (relapse).
When the degree of disability persists and/or worsens between attacks. Further relapses may or may not still occur. 30-50% of MS patients who initially have the relapsing-remitting form develop secondary-progressive MS within 10 years.
Primary-progressive MS course
Unfortunately, this is the most common course of MS, and the patient experiences relatively immediate disability and symptoms worsen continuously right from the start, without attacks and without interim remission of impairment.
Benign MS Course
The patient lives without essential constraints in everyday life for more than 15 years after being diagnosed. This form of MS does not worsen with time. After initially one or two attacks the patient completely recovers and no permanent disability is experienced.
At this time, there is no cure for MS, but there are a number of therapies to there are various strategies available to modify the disease course, treat exacerbations, manage symptoms, and improve function and safety. In combination, these treatments enhance the quality of life for people living with MS.