MULTIPLE SCLEROSIS (MS)

General Information

DEFINITION--A chronic disorder affecting many nervous-system functions. One-third of patients have mild, non-progressive disease. Another third worsen slowly. The rest worsen rapidly.

BODY PARTS INVOLVED--Central nervous system (brain and spinal cord).

SEX OR AGE MOST AFFECTED--Younger adults (ages 20 to 40) of both sexes, but more common in women.

SIGNS & SYMPTOMS

Early stages:

• Vague eye problems, such as intermittent blurred or double vision.
• Weakness; difficulty with walking or balance.
• Vague loss of sensation; numbness; tingling.

Late stages:

• Marked weakness; tremor; speaking difficulty.
• Loss of bladder or bowel control.
• Extreme mood swings.
• Sexual impotence in men. Signs and symptoms vary widely between persons. Sometimes they are mistakenly attributed to emotions or "nerves."

CAUSES--Unknown. Research suggests multiple sclerosis may be caused by an autoimmune disorder or slow-acting virus.

RISK INCREASES WITH

• Children and adolescents raised in cool climates. Moving to a warmer climate later does not help.
• Family history of the disease.

HOW TO PREVENT--Cannot be prevented at present, but relapses can be shortened by therapy. Avoid infections, which trigger relapses.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and physical exam by a doctor. Consultation with a neurologist is often valuable.
• No specific test is available to diagnose MS. Testing may include CT scan, MRI (See Glossary for both), visual evoked response or VER (electrical response to stimulation of a sensory system), lab studies of spinal fluid.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Self-catheterizations for inadequate bladder emptying (indwelling catheter may be necessary in a few patients).
• Hospitalization or chronic-care facility, depending on the severity of the disease.

POSSIBLE COMPLICATIONS

• Urinary-tract infections caused by bowel and bladder disorders.
• Pressure sores from prolonged bed rest.
• Constipation caused by inactivity.

PROBABLE OUTCOME--Spontaneous recovery sometimes occurs. In most cases, however, multiple sclerosis is incurable. Symptoms can be relieved or controlled, and the condition often remains stable for months or years. Survival of 20 to 30 years is common. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• Emotional support, encouragement, and reassurances are helpful in coping.
• Lead as normal a life as possible; avoid fatigue.
• Avoid warm surroundings, even a hot shower. Heat can temporarily worsen symptoms.
• Have frequent massages, which help prevent contractures (shortening of muscles).
• Avoid stress, which may aggravate symptoms.
• When there is a remission in your symptoms, it is sometimes difficult to determine if it was due to a particular treatment or spontaneous.
• Some unethical medical practitioners offer unproven treatments of no value. Discuss any unconventional treatment with your medical team before investing your money.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Cortisone drugs during periods of relapse or when symptoms worsen.
• Cyclophosphamide, which helps blunt the immune system's response.
• Muscle relaxants to control muscle spasms.
• Interferon and other treatments are under investigation.

ACTIVITY--

• A regular program of physical exercise and mental activity is essential. Obtain physical therapy and muscle retraining if needed.
• Take regular rest periods.
• Remain sexually active, if possible. Sexual counseling may be helpful.

DIET--Eat a normal, well-balanced diet that is high in fiber to prevent constipation.

Call Your Doctor If

The following occurs during treatment: Breathing or swallowing difficulty. Sudden increased weakness. Chills and fever or other signs of infection.