This paper provides a thorough investigation of multiple sclerosis (MS), a debilitating autoimmune disease affecting approximately 5 in 10,000 people annually, with higher prevalence in women. The paper traces the disease's history from suspected medieval cases through the modern era, examines its definition as a demyelinating disorder affecting the nervous system, identifies affected demographics (typically diagnosed between ages 20-40), describes early symptoms and disease progression, and outlines current treatment approaches including disease-modifying drugs. The paper emphasizes the relevance of MS understanding for healthcare professionals and the importance of community education and patient support.
A silent but deadly disease, multiple sclerosis can develop without immediate recognition. As one source describes, "It often starts with simply feeling extremely tired, all the time; at first, a patient may think that he or she is just getting over a minor illness or needs more sleep. But the tiredness persists. Then it is accompanied by frightening symptoms like painful migraines, tingling and temporary vision loss" (Freeman, 2011). Multiple Sclerosis is one of the most debilitating diseases affecting millions of Americans.
This paper investigates multiple sclerosis through five key areas: the definition of the term, the history of the disease, the demographics most affected, early indications and symptoms, and the treatments used to control the disease.
Multiple Sclerosis, known as the demyelinating disease, affects 5 out of 10,000 people per year and affects women more than men. According to medical literature, "The disorder is most commonly diagnosed between ages 20 and 40, but can be seen at any age. MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve impulses are slowed down or stopped. The nerve damage is caused by inflammation. Inflammation occurs when the body's own immune cells attack the nervous system. Repeated episodes of inflammation can occur along any area of the brain, optic nerve, and spinal cord."
Like many diseases, MS existed long before it had a name. The discovery of MS, like other diseases, spans many centuries. Evidence suggests the disease appeared around the Middle Ages. During this period and until the nineteenth century, doctors based their diagnoses on superstition and ancient beliefs rather than scientific evidence. Although medical diagnoses were not accurate during this time, doctors could detect that a person was suffering from the disease. Modern doctors, using medical evidence from the Middle Ages, have determined that numerous cases of MS occurred during that era.
One early suspected case is well documented: "A Dutch saint named Lidwina, who died in 1433, may have been one of the first known Multiple Sclerosis patients. After she fell while ice skating, she developed symptoms such as excruciating pain, blinding headaches, problems walking and paralysis. Her condition worsened over the course of her life, but she did have remissions" (Freeman, 2011).
Twenty years later, a major breakthrough occurred. "Dr. Jean-Martin Charcot became the first person credited with identifying multiple sclerosis as a disease. A female patient of his suffered an unusual combination of symptoms. He tried some of the typical treatments for other neurological disorders, such as electrical stimulation and injections of silver (which helped alleviate the symptoms of syphilis), but none of them worked. After his patient died, he dissected her brain and discovered brain lesions. He called the disease sclerose en plaques. Myelin was discovered shortly afterwards, although its exact significance was unknown" (Freeman, 2011).
As science improved, doctors better understood MS and other diseases. Improvements in microscopes helped doctors search to understand the disease. In 1916, a Scottish doctor named James Dawson was able to clearly describe the inflammation and demyelination after viewing brain cells of patients with MS through a microscope. At the time, doctors thought that MS was caused by a toxin or virus that entered the brain via the bloodstream, although they had no proof.
In the 1930s, laboratory studies in mice suggested the possibility that the immune system was involved, but most doctors did not take this seriously. It was not until approximately 30 years later that doctors made a crucial discovery. "A researcher at Columbia University found that people with MS had unusual protein byproducts in their cerebrospinal fluid, paving the way for today's MS testing. During this time, doctors believed that MS was caused by problems with blood flow and tried to stimulate circulation for treatment. After DNA's structure was discovered in 1953, doctors began to better understand both genetics and the immune system. The 1960s resulted in the discovery that MS was probably an autoimmune disease, and in the next decade, steroids were used to treat attacks. Scientists also developed the first disease-modifying agent" (Freeman, 2011).
As scientific technologies continue to advance, doctors and researchers are discovering many clinical trials and other tests to pinpoint better treatments for the disease.
Further research has uncovered several types of MS. As one medical expert explains, "The name 'multiple sclerosis' means that a patient has more than one sclerosis. A sclerosis is a plaque, or hardened tissue. As mentioned in the previous section, people with multiple sclerosis have these plaques, or lesions, in the white matter of the brain or spinal cord. While the gray matter contains neurons (nerve cells), white matter contains the axons (nerve fibers) that connect neurons and allow them to communicate with each other. Specifically, MS means that there has been a breakdown of the myelin sheath, which is the protective layer surrounding the axons. This breakdown is known as demyelination" (Freeman, 2007).
According to the National Multiple Sclerosis Society, there are primarily four types of MS:
Relapsing-Remitting: Most MS patients are diagnosed with this form. They have attacks followed by remissions, during which the disease does not get worse.
Primary-Progressive: A small percentage of MS patients experience a slow progression of the disease without attacks or remissions. They may temporarily improve, or the disease may stay the same for short periods of time.
Secondary-Progressive: Some patients begin with a diagnosis of relapsing-remitting MS but develop secondary-progressive MS. This means that the disease progresses more quickly, and they may or may not experience attacks, periods of recovery, or periods of remission.
Progressive-Relapsing: Patients with this rare form of MS get progressively and steadily worse and also suffer attacks, or relapses. Sometimes they recover briefly, but they never experience remission (long-term recovery) of the disease.
MS falls under the class of autoimmune diseases, which means that the immune system—which normally defends the body against foreign bodies such as viruses and bacteria—attacks the body instead.
The average age for the onset of MS is between the ages of 20 and 40 years. However, "Onset occurs in childhood (before the age of 16 years) in 0.4 to 10.5% of cases. There are few studies on the natural history of childhood-onset multiple sclerosis, and most of these studies describe either single cases or small series" (Edan, 2007).
The symptoms of MS vary based on the onset of the disease and which nerves are affected. The symptoms of MS range from extreme exhaustion to migraine headaches, depending on which nerves are damaged and affected. There are numerous other symptoms, and the severity can be excruciating.
As one medical reference explains, "Symptoms vary, because the location and severity of each attack can be different. Episodes can last for days, weeks, or months. These episodes alternate with periods of reduced or no symptoms (remissions). Fever, hot baths, sun exposure, and stress can trigger or worsen attacks. It is common for the disease to return (relapse). However, the disease may continue to get worse without periods of remission. Because nerves in any part of the brain or spinal cord may be damaged, patients with multiple sclerosis can have symptoms in many parts of the body" (Multiple Sclerosis, 2010).
Fatigue is a common and bothersome symptom as MS progresses, and it is often worse in the late afternoon. Symptoms may vary at different stages of the disease and tend to worsen during certain times of the day.
"Disease-modifying drugs and symptom management therapies"
Multiple Sclerosis does not have the ability to become an epidemic or pandemic in the United States. MS is not a contagious disease and only affects 5 out of 10,000 people annually. Based solely on genetics, the chances of the disease reaching either of those levels is slim to none. Nevertheless, there remains a duty for healthcare professionals to educate the community, patients, and their families on the disease. That education may come in the form of providing literature, holding seminars, recommending support groups, and referrals to patient programs and foundations that aid those fighting the disease.
You’re 85% through this paper. Sign up to read the remaining 1 section.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.