Multiple Sclerosis

What is it?
Multiple sclerosis (MS) is a disorder of the central nervous system characterized by inflammation of the fatty covering of the nerve fibres that join the nerve cells in the brain and spinal cord. The inflammation destroys this covering, the myelin sheath, leaving scar tissue . The affected nerve cells cannot transmit or receive impulses, so there are a variety of effects on muscle function and sensation.

The exact cause is unknown, but it seems likely that MS is an autoimmune condition in which white blood cells called T-cells attack the myelin sheath of the merve fibres. It may be slightly more common in certain family groups suggesting an inherited predispositionl, and it may be triggered by a viral infection.

MS occurs most often in young adults between the ages of 20 and 40 years, with a higher incidence among women. In the UK about 50 new diagnoses are made each week.

The symptoms may come and go, relapses and remissions, lasting from days to months. The signs of MS are many and varied. Some of the more common symptoms include pain, weakness, paralysis, or tremor of any of the extremities; numbness or tingling in any area, facial pain, vision problems, difficulty walking and loss of balance.

Tests
In addition to a history of two or more relapses and remissions, and the presence of neurologic signs, tests that may indicate the presence of MS include:

Head and spine MRI scans showing scarring or a lesion (This is a non-invasive procedure that produces a picture of the area being filmed using magnets and radio waves but no radioactivity. Pictures or “slices” are taken at specified intervals. These pictures are in colour and may be three-dimensional, showing details of the nerves.)
Lumbar puncture showing two or more protein bands in the spinal fluid. A needle is inserted into an area of the spine, between vertebrae, and a small amount of fluid is withdrawn. A number of tests may be run on this fluid, including an immunoelectrophoresis to detect the presence of oligoclonal protein bands.)

Treatment
Treatment options include injection of drugs that can help protect the covering of the nerve cells and steroids to lessen the severity of an attack. Physical, speech, and occupational therapy may be helpful as the condition progresses.