In the United States, it is estimated that about 400,000 people are affected by Multiple Sclerosis (MS). MS damages the central nervous system (CNS) of the body, causing muscle weakness, cognitive impairments, vision problems, and pain, among other symptoms. These symptoms arise due to the immune system attacking a fatty substance in the body called myelin. Myelin coats the neurons throughout the central nervous system, protecting them and helping them transmit signals effectively. When the immune system attacks myelin, it causes scar tissue around the CNS, resulting in symptoms. Little is known about exactly how the immune system attacks myelin, making MS a difficult condition to understand. March is National Multiple Sclerosis Awareness Month, during which many organizations are hoping to raise awareness about current knowledge of the condition and its treatments.
There are four different types of MS:
- The most common type of MS is called Relapsing-Remitting MS (RRMS), and occurs in about 85% of individuals diagnosed with MS. RRMS is characterized by relapses of MS symptoms, which are short periods of time during which symptoms flare up or new symptoms arise. When patients are not relapsing, they are considered to be in a period of remission, during which symptoms are under control or not present.
- Patients diagnosed with RRMS often eventually transition into Secondary-Progressive MS (SPMS). SPMS is characterized by MS symptoms that worsen steadily over time, with or without relapse periods.
- Primary-Progressive MS (PPMS) is characterized by MS symptoms that worsen steadily over time without any relapse or remission periods. PPMS is a rare form of MS, occurring in about 10% of diagnosed individuals.
- Progressive-Relapsing MS (PRMS) is the rarest form of MS, characterized by MS symptoms that worsen steadily over time with periods of relapse, but no remission.
Earlier this month we spoke with Dr. Ann Bass, president of the Neurology Center of San Antonio. Dr. Bass practices in an MS clinic, caring for about 1,500 MS patients. These patients are often referred to Dr. Bass after they experience vision problems, numbness of the arms or legs, or worsening weakness that causes mobility issues. These three symptoms are the MS symptoms that most commonly cause people to seek treatment.
Dr. Bass emphasises the importance of confirming an MS diagnosis early, and beginning treatment as soon and as aggressively as possible. Studies have shown that MS causes more damage to the body within the first year of onset than in later years, making early intervention so critical. Currently, there is no single test that can officially diagnose MS. Instead, health care professionals use information from several tests such as MRIs, neurologic exams, or spinal fluid analyses to make the diagnosis.
A common misconception about MS is that the condition is life-threatening. Dr. Bass commented on this misconception, saying she would like to see more health professionals assure patients that this is not true. Although the condition is lifelong, there are several options for treating MS symptoms that allow patients to maintain a good quality of life. Dr. Bass encourages patients to consider each option, determining which one fits their lifestyle and unique needs the best. For example, patients may choose to take medication orally, by intramuscular injection, or venous injection. If a patient is uncomfortable with needles, they can choose to take oral medication in order to be most comfortable while treating the condition.
Treatment options for MS are constantly improving, as researchers continue to study the condition. Currently, it is believed that both genetic and environmental factors play a role in the development of MS, making it difficult to predict if a patient will develop the condition in the future. Some risk factors of MS include gender, race, age, and genetics. MS affects women three times more than men, and is most commonly diagnosed among Caucasians. MS is most commonly diagnosed in people between the ages of 20-50, although it can be diagnosed at any age. Individuals with family members who have MS are also more likely to be diagnosed with the condition.
The stigma of disability associated with MS can causes people affected to keep their condition a secret. Dr. Bass and many MS organizations encourage patients to join support groups and use available resources to involve their family and friends in their MS management. For more information about MS, visit the National Multiple Sclerosis Society’s page. Be sure to make some time this month to learn a little more about Multiple Sclerosis!