Multiple sclerosis: disease courses and autoimmune mechanisms

Multiple Sclerosis

This is a guideline and template and is NOT to be used as a turn-in paper.

Multiple sclerosis (MS) is a chronic, often disabling, disease that attacks the central nervous system, which is made up of the brain, spinal cord, and optic nerves. The progress, severity, and specific symptoms of MS are unpredictable and vary from one person to another. Today, new treatments and advances in research are giving new hope to people affected by the disease (National Multiple Sclerosis Society).

It was Dr. Jean Martin Charcot in 1868 that first scientifically diagnosed and described MS. Dr. Charcot wrote an account of the disease and the changes in the brain that occurred. His examinations of the brain found characteristic scars or plaques. His diagnosis and definition of MS still holds true today. MS is named from the buildup of scar tissue (sclerosis) found throughout the central nervous system.

The Four Courses of MS

People with MS can typically experience one of four disease courses, each of which might be mild, moderate, or severe (National Multiple Sclerosis Society).

Relapsing-Remitting MS

People with this type of MS experience clearly defined attacks of worsening neurologic function. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.

Primary-Progressive MS

This disease course is characterized by slowly worsening neurologic function from the beginning -- with no distinct relapses or remissions. Approximately 10% of people are diagnosed with primary-progressive MS (National Multiple Sclerosis Society).

Secondary-Progressive MS

Following an initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, with or without occasional flare-ups, minor recoveries (remissions), or plateaus.

Progressive-Relapsing MS

In this relatively rare course of MS (5%), people experience steadily worsening disease from the beginning, but with clear attacks of worsening neurologic function along the way (National Multiple Sclerosis Society).

Signs and Symptoms

Symptoms vary widely, depending on the amount of damage and which particular nerves are affected. People with severe cases of multiple sclerosis may lose the ability to walk or speak. MS can be difficult to diagnose early in the course of the disease because symptoms often come and go -- sometimes disappearing for months (Mayo Clinic Staff).

Although MS can occur at any age, it most often begins in people between the ages of 20 and 40. Women are more likely to develop multiple sclerosis than are men (Mayo Clinic Staff).

MS signs and symptoms may include: Numbness, tingling, pain or weak points in one or more limbs, partial or complete loss of vision, blurred vision, or double vision can occur. A lack of coordination or unsteadiness, fatigue or lightheadedness may also occur.

Treatments

There is no cure for multiple sclerosis. Treatment typically focuses on combating the autoimmune response and managing the symptoms. Some people have such mild symptoms that no treatment is necessary and others may find comfort in the different treatments that are available.

Medications that are commonly used for multiple sclerosis include: Corticosteroids, Interferons, Glatiramer (Copaxone), Natalizumab (Tysabri), Mitoxantrone (Novantrone).

Physical therapist can help with strengthening and stretching exercises. There also are devices and equipment that can help make everyday activities easier to perform.

Procedures such as plasma exchange which is similar to dialysis as it separates blood cells from plasma. Plasma exchange can help fight severe symptoms of MS relapses.

New Treatment

The experimental drug fampridine improves walking ability in some individuals with MS. That is the conclusion of a multi-center Phase 3 clinical trial, the results of which were published in February, 2009 in the journal The Lancet (University of Rochester Medical Center).