Information about MS

Information and explanation of MS – Multiple Sclerosis

Multiple sclerosis is an incurable, unpredictable and often disabling disease of the central nervous system system that disrupts the flow of information within the brain, and between the brain and body. Myelin – the protective coating around nerve fibers in the central nervous system – is a primary target of the immune attack in MS. When you make a comparison between the nerves and power cables, the myelin is the protective sheath that surrounds the power cable. Once this sheath is damaged, the power cable can short circuit or the signals will no longer be properly circulating. This is similar to and happening to the nerves of an MS patient. Depending on which parts of the brains and / or spinal cord have damaged myelin, controlling the body might be conflicted. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a range of signs and symptoms, including physical and mental problems.

 

 

MS types:

MS is sometimes difficult to diagnose and is especially common in young adults between 20-40 years.

 

Types of Multiple Sclerose: Short description: Percentage of MS patients:
CIS – Clinically Isolated Syndrome A first isolated episode of neurological symptoms.
Mild or benign MS Characterized by a lot of time between relapses by up to 10 years or more before the next relapse occurs. Hardly any disability. 10%
RRMS – Relapsing Remitting MS Most common form of MS characterized by a clear relapse and recovery pattern. During this course a certain degree of mobility often stays intact. 40%
SPMS – Secundary Progressive MS RRMS can eventually transition to a SPMS in which there is a progressive worsening of neurologic function (accumulation of disability) over time. Moments of relapses and recoveries will occur less or not at all. 40%
PPMS – Primary Progressive MS PPMS is characterized by worsening neurologic function (accumulation of disability) from the onset of symptoms, without early relapses or remissions. 10%
PRMS – Progressive Relapsing MS Combination of RRMS and PPMS, characterized by relapses and periods of recovery, while in the meantime also a gradual deterioration is taking place. 5%

 

 

Explanatory notes to the most common type of MS:

Relapsing Remitting MS (RRMS) is the most common type, approximately 85 percent of people with MS are initially diagnosed with thi type. RRMS is characterized by a pattern of attacks – also called relapses or exacerbations – followed by periods of partial or complete recovery (remissions). During a relapse, the protective myelin in the central nervous system is attacked, which results in new symptoms or old symptoms may flare up. By making an MRI scan, the inflammated spots will light up. The protective myelin layer will fully or partially recover again when the inflammation has dropped, resulting that the symptoms will also entirely or partially disappear. Over time, it will become more difficult for the affected cells of the myelin to recover. So over the years, more and more scar tissue and permanently damaged myelin is will result in more permanent complaints and symptoms, dependent on the locations in the brains or spinal cord that are afflicted. Most people who are diagnosed with RRMS will eventually transition to a secondary progressive course in which there is a progressive worsening of neurologic function (accumulation of disability) over time.

 

 

Known complaints in MS:

The symptoms are diverse, the course of disease is unpredictable and no MS patient is alike. One may be wheelchair bound while the other is still running a marathon but might suffer from eye problems or incontinence. Some of the symptoms are:

 

  • Vision problems (loss of vision, disturbance in color, painful eye movement)
  • Extreme fatigue
  • Insomnia
  • Dizziness and nausea
  • Muscle stiffness, muscle weakness, muscle spasms, MS hug
  • Sensory symptoms (numbness, tingling, itching, burning)
  • Uhthoff’s phenomenon (worsening of neurologic symptoms by temperature increase)
  • Lhermitte’s sign (Electrical sensation, feeling of an electrical shock)
  • Balance problems and incoordination (ataxia)
  • Incontinence and constipation
  • Speech disorders (dysarthria: inability to correct pronunciation, paraphasia: exchange of words, agnosia: can not find the name for objects)
  • Cognition problems (memory impairment, personality changes, thought disorders, mood disorders)

 

 

Disease-modifying therapies for MS

There are several products on the market which can slow disease activity of multiple sclerosis. The diagnosis of MS will be a shock to every patient. Lots of information and questions will come to mind and depending on the type of MS it will be a personal choice whether or not to start with inflammatory drugs, and the next question, “which one?” The available disease-modifying therapies used to treat MS are approved by the U.S. Food and Drug Administration (FDA) to treat “relapsing forms” of MS, which include RRMS as well as progressive MS in those individuals who continue to experience relapses. At the present time, we do not have therapies that have been approved to treat PPMS without relapses. Scientists around the world are actively working to find effective treatments for progressive forms of MS. The neurologist will most likely advise to start suppressive medication as early as possible to minimize physical deterioration long term.

 

Overview and comparison of MS medications

To get a good overview, a comparison table with MS medications is created. This will simplify the comparison on i.e. efficacy, effectiveness, and side effects. It is intended as a handy tool to start the conversation with your neurologist and ask him the right questions.

Continue reading Overview of MS medications.

 

 

Other specific information:

For more specific and detailed information on Multiple Sclerosis the following websites might be interesting:

checklist

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