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The Mysteries Of Multiple Sclerosis

Posted Apr 01 2009 2:47pm

Multiple Sclerosis (MS) is a disease that occurs with sudden onset- normally when one is in their early 30s of their lifespan.   The fact that the disease presents itself after decades of their lives already completed adds further mystery to MS.  

First observed in Holland nearly 600 years ago, a French neurologist was the first to recognize MS in the 1800s.   MS can take the forms of being mild with the symptoms from MS, or MS can be quite brutal for a few with MS.

While the average age of initial acquisition of MS is when one is in their early thirties, however MS has been known to be diagnosed from those as young as 2 years old, and those at the age of 75 years old as well.

Ms affects mostly white females, and the disease is most prevalent in Northern America, but not in the Southern part of the United States.   In the U.S., about 200 new cases of MS are diagnosed every week.  

MS is also frequent with others in Northern Europe, Australia, and New Zealand.   About two and a half million people in the world have MS.

MS is a chronic and slowly progressive neuro-dengenerative disorder, and believed to be an autoimmune disease that at times results in serious physical and cognitive disabilities of the MS patient in time.   This means that the one who has MS has a defect with their immune system, likely, and this immune system determines aspects of their physiology to be foreign invaders, and as a result, attacks such tissues.

  There are 4 classifications of MS that exist, along with 7 different forms of MS.   The most common is the type is the remission followed by relapse of MS.   Remission occurs due to remyelination that occurs after the destruction of the myelin sheath by the immune system of the MS patient, it is believed.   This is ultimately followed by an increase in disease progression with MS.   About half of all MS patients develop increased disabilities within ten years of the initial onset of the disease.

With MS, the myelin sheath that is the covering of their neurological make-up as with others composed of lipids and proteins is attacked by auto antibodies of the immune system of the MS patient, it is believed.   As a result, and in time, the myelin sheath is destroyed, and replaced with scar tissue.   This is what is called scoliosis.   The process that occurs during this destruction is called demylenation.   The nerve damage that occurs as a result is due mainly to inflammation from this process.

The cause of MS is unknown, which makes an accurate or likely prognosis for the MS patient nearly impossible.   Suspected etiologies for this disease have been viral infections, the Epstein-Barr virus in particular, as well as a genetic dysfunction.  

Smoking is believed to increase the risk of acquiring MS.   Vitamin D deficiency has been suspected as the cause of MS as well. Also, damage to what is known as the blood/brain barrier in humans has been suggested as a cause of MS. The duration of MS lasts about 20 years with most who have the disease.

The disease is at times difficult to diagnose, and MS has been mistaken for a psychological disorder in the past. The initial episode of the onset of MS involves the development of brain lesions, as well as optic neuritis.  

A MRI performed on one suspected to have MS patient clearly shows lesions in the brain of a MS patient at multiple sites.   In addition to at least two separate MRIs performed on the suspected MS patient.   Often, a lumbar puncture may be performed on the patient as well, to obtain cerebral spinal fluid for analysis to confirm the diagnosis of MS.

  Such similar diagnostic evidence can occur in what is known as clinically isolated syndrome as well.   Yet half of all patients with this syndrome progress to the disease state of MS.   And after the initial symptoms of MS, after about 10 years pass, MS patients experience neurological damage that progresses more rapidly.

The first symptoms that the MS patient experience often include visual dysfunctions, and extreme fatigue, in most cases.   The MS symptoms are both sensory and motor in nature as well.   As the disease of MS progresses in the MS patient, other additional symptoms may occur, such as affective disorders, cognitive dysfunction, muscle spasms, as well as bowel dysfunction and voiding abnormalities due to the damage of their nervous system by MS.

Depression is present with most patients with MS.   And suicides are unfortunately frequent with the MS patients as well.

Part of the MS disease process, normally, is alternating between episodes of much welcome relief in the form temporary remission- followed by MS relapses that can last from days to months.  

As far as the extent of treatment efficacy offered to MS patients, it falls between intuitive and empirical selections for treatment options, which are various pharmacological agents.   Yet treatment should be initiated as early as possible for the MS patient to delay the progression of their disease.   And often multiple medications are needed to control the symptoms of the MS patient.

Treatment with corticosteroids is standard with MS patients.   Interferon is another selection for management of the MS patient as a therapeutic option.   Interferon has been believed to be effective in only about half of MS patients Overall, immunomodulary or immunosuppressive agents should be selected and given to the MS patient, primarily.  

Other treatments evolving for MS patients include an antibiotic called doxycycline, which has been shown to slow the progression of MS.   Remarkably, parasitic hookworms, which can be damaging to humans when they reside in the human intestines, which leads to anemia, actually may be beneficial for the MS patient as well, as these parasites have been shown to decrease the activity of the immune system of the MS patient that is responsible for the damage it causes the MS patient.

Daily niacin injections have been shown to be advantageous for the MS patient by offering protection from the inflammation that occurs, which causes both damage and pain for the MS patient.

Some biologic agents, such as Compath which is an agent often used for Leukemia patients, have been shown to decrease and delay the progression of MS, and relapse episodes as well.   Tysabri is another beneficial biologic agent for MS patients that is given intravenously once a month for MS patients.   Tysabri decreases the frequency of the symptoms of MS patients, it has been observed by others who have used this biologic for MS treatment.

SSRI antidepressants and statin drugs, which are prescribed for high cholesterol mostly, have been shown to decrease the progression of MS.   Testosterone therapy for men with MS has been linked with decreased brain degeneration in this MS patient population.  

Overall, treatment of the MS patient is rather expensive, with the biologic agents in particular.

Presently, there are many promising treatments for MS that will be available in the future.   This would include bone marrow stem cell transplantation, which has been proven to reset the immune system of the MS patient to within normal limits, as well as improves their neurological state.

Fortunately, most MS patients have a fairly mild expression of this disease, and are quite capable of living normal lives, with a normal human lifespan.   Most MS patients do not become severely disabled as well.   If death occurs with the MS patient, it typically is due to secondary complications.

For over a decade, I’ve done what is called the MS-150, which is a two day bicycle ride with thousands of others to raise money for multiple sclerosis.   And we ride 150 miles in those two days.   I did not know much about this disease until recently, and I hope improved treatment options become available for MS patients,

 

Dan Abshear

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