MULTIPLE SCLEROSIS

Physicians use a neurological examination and take a medical history when they diagnose a person they suspect may have multiple sclerosis. Imaging technologies such as MRI, which provides an anatomical picture of lesions, and MRS (magnetic resonance spectroscopy), which yields information about the biochemistry of the brain. Physicians also may study patients' cerebrospinal fluid and an antibody called immunoglobulin G. No single test unequivocally detects MS. A number of other diseases produce symptoms similar to those seen in MS.

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a life-long chronic disease diagnosed primarily in young adults. During an MS attack, inflammation occurs in areas of the white matter of the central nervous system (nerve fibers that are the site of MS lesions) in random patches called plaques. This process is followed by destruction of myelin, which insulates nerve cell fibers in the brain and spinal cord. Myelin facilitates the smooth, high-speed transmission of electrochemical messages between the brain, the spinal cord, and the rest of the body.

Symptoms of MS may be mild or severe and of long duration or short and appear in various combinations. The initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance.

Most people with MS also exhibit paresthesias, transitory abnormal sensory feeling such as numbness or "pins and needles." Some may experience pain or loss of feeling. About half of people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and judgment. Such impairments are usually mild, rarely disabling, and intellectual and language abilities are generally spared. Heat may cause temporary worsening of many MS symptoms.

What is the Treatment for Multiple Sclerosis?

There is as yet no cure for MS. Until recently, steroids were the principal medications for MS. While steroids cannot affect the course of MS over time, they can reduce the duration and severity of attacks in some patients. The FDA has recently approved new drugs to treat MS. The goals of therapy are threefold: to improve recovery from attacks, to prevent or lessen the number of relapses, and to halt disease progression.

What is the Prognosis?

The cause of MS remains elusive, but most people with MS have a normal life expectancy. The vast majority of MS patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk.

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