Understanding Multiple Sclerosis

By Jon Konzen, DO
Neurology, Chippewa Valley Neurosciences, Eau Claire

Multiple Sclerosis (MS) is a neurological problem that affects 250,000 to 350,000 Americans and up to 1.25 million people world wide. The first descriptions of MS go back over 600 years. Since that time there has been increased understanding of the disease, some treatment for the symptoms that accompany MS, but no cure.

Multiple Sclerosis is a disease that damages the nerves of the brain and spinal cord. If you think of nerves as electrical extension cords, then MS causes the insulation covering of the cords to come off and damages the wires under the insulation. This damage is produced when the body's own infection fighting cells, called lymphocytes, become active. Instead of attacking infecting bacteria, the cells attack one's own healthy nerve cells. It is not known why the lymphocytes begin to attack their own body. But, it is likely due to a combination of one's genetics and environmental factors.

Certain groups of people may be more prone to MS. Women are more likely then men to develop MS. Families that have a close relative with MS have increased risk of other members in the family developing the disease. Yet, in identical twins, if one twin has MS, the other identical twin has only a 30% chance of developing MS.

People of European decent are more likely to develop the disease then those of Asian. Also, where people live geographically and where they move to and from can affect the chances of developing MS. In the United States there are five times as many people with MS in northern states as compared to southern states, yet, no single infective agent has ever been found to account for this.

The clinical effects of MS vary widely. MS can cause vision loss, weakness, fatigue, numbness and tingling in the arms and legs, problems with bowel and bladder function and walking problems due to poor balance and coordination. Symptoms will come and go and are called attacks or relapses. Attacks typically occur about once every two years, arising over a period of hours to days and continue for an average of 2 to 6 weeks. The symptoms may resolve completely; but as often as 40% of the time, they leave the patient with some long lasting problems. Some patients may have severe symptoms, others only mild symptoms of fatigue or numbness and tingling. Overall, about 75% of patients with MS will experience some limitations in their activities of daily living. Yet, estimates suggest that 20% of people diagnosed with MS may have no active symptoms at all. Making the diagnosis of MS usually involves having a set of symptoms that have come and gone at least twice over time. The symptoms also have to suggest a problem in the brain or spinal cord. To help make the diagnosis, certain tests may be ordered, including an MRI scan. The MRI looks at the brain and/or spinal cord and can show areas of change in the brain called plaques. These appear on the MRI as "spots". Another test that is sometimes done is a lumbar puncture or "spinal tap". This looks for specific proteins that are present with MS.

Once a diagnosis of MS is established, there are various medications that can be used to help keep the disease under control and lessen the time that a person is experiencing symptoms. These medications are designed to suppress the immune system to avoid further damage to the insulation covering. Other medications may be used to help with symptoms of fatigue, numbness and tingling.

More information on Multiple Sclerosis can be obtained from the Multiple Sclerosis Society web site at www.nmss.org . For more information or to schedule an appointment with Dr. Jon P. Konzen » 715.831.0811, Chippewa Valley Neurosciences, Eau Claire.