The progression and pathology of multiple sclerosis

Multiple sclerosis is an inflammatory disease. It affects the brain and spinal cord, and damages the covers that insulate the nerve cells. When these covers are damaged, the nervous system experiences a breakdown in communication. This causes a wide range of symptoms and signs that can affect numerous areas of the body. Mental and physical problems appear, along with a host of psychiatric issues in some patients. Multiple sclerosis can affect people very differently, and take more than one form. In most people, neurological problems occur and become permanent, although symptoms may come and go in the earlier stages of the disease.

Description of the Disease

In people with multiple sclerosis, the covers of the nerve endings become inflamed and damaged. This can be caused by infections and other environmental factors, but genetics have been believed to play a role, as well (Ascherio & Munger, 2007). Signs and symptoms of multiple sclerosis include physical, mental, and psychological difficulties, as well as the emotional issues that can come with those changes. Most people who have multiple sclerosis find that they have "attacks" where they have trouble with various bodily systems for a period of time. Then those problems resolve, and it is easier for the person to function what would be considered to be more normally. However, each time these attacks occur, there are more issue for the person to face (Lublin & Reingold, 1996). The damage that is caused every time eventually begins to build up, and that can take its toll on the person in many different ways. Over time, the disease will progress, and that means the attacks will get worse and recovery from them will not be as successful (Weinshenker, 1994).

Those who have multiple sclerosis typically have a lifespan that is between five and 10 years shorter than what would be considered average (Balak, et al., 2012). That is not true for everyone with the disease, however. Each person reacts to it differently, and that can affect whether a person lives a "normal" life with the disease, or whether it takes its toll much faster than would be expected based on statistics. While it is not considered to be a disease that is passed down from one person to another, there are genetic factors that are commonly seen in those who have or will be likely to develop multiple sclerosis. Signs and symptoms that are presented, as well as various medical tests, are typically what are used in order to diagnose a person with multiple sclerosis (Comi, 2009). A diagnosis of multiple sclerosis can come at any age, although younger people are more commonly affected (Comi, 2009).

Current Statistics on MS

Multiple sclerosis is the most common of the autoimmune disorders that affect a person's central nervous system (Ascherio & Munger, 2007). There are between two million and two and one-half million people afflicted with multiple sclerosis throughout the world (Nakahara, et al., 2012). The numbers are vastly different based on region, with people further from the equator being affected in much larger numbers than those who are closer to the equator (Comi, 2009). Different "types" of people are also affected in different ways and at different rates. The genetic makeup of different ethnic groups may be a large part of the reason for the wide range of people who have multiple sclerosis and how the disease is seen much more commonly in certain groups when compared to others (Compston & Coles, 2008). Women are diagnosed with multiple sclerosis twice as commonly as men, with the onset of the disease most often coming between the ages of 20 and 50 years old (Killestein, Rudick, & Polman, 2011).

However, people younger than 20 and older than 50 can end up with a multiple sclerosis diagnosis, depending on the symptoms they have and the results of medical testing. The number of people being diagnosed with multiple sclerosis each year is remaining very stable, indicating that the disease is not progressing in that it is becoming more commonly seen (Nakahara, et al., 2012). Fortunately, that protects larger numbers of people from acquiring the disease, and indicates that those who are developing it are still seeing it in the same way past generations were experiencing it. New treatments are being used for multiple sclerosis, as well, even though there is still no cure for the disease (Ascherio & Munger, 2007). With the new treatments used and better ways of diagnosing multiple sclerosis faster, there is an opportunity for those who struggle with the disease to ensure that they can have continuing help and hope well into the future.

Medications and Treatments

There is no cure for multiple sclerosis, which is a fatal disease in that people who have it typically die five to 10 years sooner than those who are not affected with it (Ascherio & Munger, 2007). However, there are a number of treatments that can be used in order to help the multiple sclerosis sufferer live a better life. When an attack is taking place, intravenous corticosteroids are often administered (Balak, et al., 2012). Oral corticosteroids are also a good choice, and can be easier for some sufferers to take (Balak, et al., 2012). As with any medication, there can also be adverse events that will occur, but the treatments are generally well-tolerated by most people who need them (Ascherio & Munger, 2007). Alternative treatments are used by some people, as well, but there is no clear evidence that these are effective, or that they provide any benefit to the sufferer (Comi, 2009). The goal of the treatment is to ensure that people are able to work through an attack and have their functioning restored as much and as quickly as possible (Weinshenker, 1994).

As the attacks become worse and more damage is done, the treatments are less effective and recovery takes longer (Comi, 2009). That recovery also may not be quite as complete as it was in the earlier stages of the disease (Compston & Coles, 2008). There are nine different medications that have been approved for use in sufferers of multiple sclerosis, including fingolimod, natalizumab, mitoxantrone, alemtuzumab, and others, but whether they are cost effective as a treatment is still up for debate (Nakahara, et al., 2012). These medications generally decrease the number of attacks a person with relapsing-remitting multiple sclerosis has, and can help restore normal functioning as much as possible as the disease progresses (Nakahara, et al., 2012). For primary progressive multiple sclerosis, there is no effective treatment that will change the course of the disease (Comi, 2009).