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Multiple sclerosis affects twice as many woman as men, and most are stricken between the ages of 16 and 36. No one knows what causes MS, though people who spend their formative years in a tropical climate are less likely to contract the disease than those who live in a moderate climate. Scientists speculate that MS might be hereditary and lie dormant until some factor activates it. Although severe forms of multiple sclerosis can be devastating, on average the disease only shortens life expectancy by five years.
Multiple sclerosis is an auto-immune disease, one in which the body attacks itself, and the swelling and scarring of tissue in the brain and spinal cord causes the symptoms one experiences. The swelling breaks down the thick covering of the nerves, or myelin. This is called demyelination. Multiple sclerosis gets its name because hardening of the nervous system tissue often follows the demyelination. The hardening, or sclerosis, is caused by scar tissue forming in the central nervous system.
Healthy myelin helps a nerve cell to send electrical impulses along at high speeds, which is critical for performing activities such as walking and eating.
As multiple sclerosis progresses and causes more of the nerve sheath to be stripped away, the impulses from the nerves advance even more slowly and symptoms become more severe. Any nerve in the body can be affected at any time. Common symptoms of the disease are fatigue and loss of strength. Patients often have increased muscle stiffness and may have facial pain. Depending on which nerves are involved, severe or mild symptoms occur. A person may have symptoms as benign as having a tingling sensation in their arm, or they might be paralyzed and confined to a wheelchair.
Neurologists divide multiple sclerosis into two types. The first, known as relapsing-remitting, is distinguished by abrupt changes in nerve function. A person with MS will have periods of illness with myriad symptoms, followed by complete recovery, although as the disease progresses, mild symptoms will remain even during periods of remission.
The second form of the illness is called chronic progressive disease, and has no periods of temporary recovery.
There are two basic strategies for treating multiple sclerosis. One is to reduce the swelling around the nerves and stop the body’s attack against its own immune system. The other treatment concentrates solely on relieving symptoms.
People with relapsing-remitting multiple sclerosis often take a pituitary hormone known as ACTH to treat their disease. It stimulates the body to produce its own steroids that reduce swelling. Synthetic steroids may be given on top of the ACTH to further attack swelling.
People who have chronic progressive multiple sclerosis are harder to treat. The drugs used are often very strong and have serious side effects. Some doctors believe that the risks of using these drugs outweigh their advantages. Others believe that multiple sclerosis should be treated aggressively.
One of these strong drugs is called Cytoxan. Only about a third of people who receive this drug show improvement. The rest who take it either remain stable, or their disease progresses at roughly the same rate it would if they took nothing at all.
Drugs that might reduce swelling with fewer side effects than steroids are in the early stages of research. Another promising drug being studied is called copolymer-1, and it appears to have very few side effects.
Another procedure recently tested in multiple sclerosis patients is total lymphoid radiation. This means radiation of the entire immune system, and has been used for 20 years in treating early stages of a cancer called Hodgkin's disease. Studies suggest that it may help stabilize people severe multiple sclerosis for as long as four years. A large clinical trial is planned.
Doctors have had better results treating the symptoms of MS instead of the disease itself, and both pain medications and muscle relaxants are commonly used. MS patients are often still in severe pain, thought, and sometimes a section of a nerve is surgically removed or blocked. People who undergo this procedure will have numbness in the area. A surgeon first chemically blocks the nerve to give the patient an idea of what to expect. For some, the loss of feeling is more disturbing than the pain.
All of the various forms of therapy and medication have helped to provide multiple sclerosis patients greater independence. People with MS are now leading happier, more productive lives and all the research being conducted promises even better treatments for multiple sclerosis in the future.
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