Frequently Asked Questions
MS is a chronic central nervous system (CNS) inflammatory demyelinating disease that often leads to disability. Your nerves are covered by a protective coating or sheath called myelin. This is a fatty material that acts like insulation around your nerve fibers. What happens in MS is that your body’s immune system attacks the myelin and causes lesions in the brain or spinal cord. When the myelin is damaged electrical impulses are not conducted effectively along the axons that lead to clinical symptoms and possibly disability.
There are no known causes for multiple sclerosis but scientists have many speculations that are being researched: genetic susceptibility, environmental triggers, including viral and bacterial infections, and immune dysregulation that leads to pathological autoimmune responses.
Multiple sclerosis affects women 50% more often than men. It is most often diagnosed between the ages of 20 and 40, and is rarely diagnosed in people younger than 12 or older than 55. It is most common in the Caucasian population, but also affects African American and Asian populations.
Research indicates there may be a genetic component that makes certain individuals more susceptible to the disease, but thus far there is no evidence that the disease is directly inherited.
The diagnosis of MS is established based on the patient’s clinical history and neurological examination. The most useful tool for diagnosing MS is Magnetic Resonance Imaging or MRI. Spinal fluid analysis positive for oligoclonal bands and elevated IgG index is also indicative of the CNS inflammatory disease. There are generally two requirements to diagnose MS:
- At least two separate attacks at least one month apart. An attack (also called exacerbation, flare, or relapse) is the sudden onset or worsening of new or existing symptoms that are persistent for at least 48 hours.
- On MRI there is more than one area of demyelination (damage to the myelin sheath surrounding the nerves) visualized as a signal abnormalities with specific size, shape and distribution within the brain and spinal cord. There cannot be evidence of any other disease process that could cause the demyelination.
There is no cure for MS, but there are several disease-modifying therapies that have been shown to significantly reduce new lesion formation, the number of relapses, and the long-term progression of permanent disability.
No. Multiple Sclerosis is not a fatal disease. A person can be expected to live a normal or near normal life span. In fact, the majority of people with MS do not become severely disabled. Although the life span is not significantly affected by MS, the unpredictable physical and emotional effects from MS can alter quality of life in some individuals.
The most common symptoms include: numbness and tingling or weakness in arms and legs, difficulties with walking, or loss of vision. Others include: tremor, lack of coordination, cognitive difficulties, fatigue and urinary symptoms.
The general category of medicines for MS is called Disease Modifying Therapy. In this category there are different FDA approved drugs. They include interferons (IFNs); IFN beta-1a (Avonex, Rebif) and IFN beta-1b (Betaseron); an immune modulator; glatiramer acetate (Copaxone); an anti-adhesion molecule (VLA-4) monoclonal antibody; Natalizumab (Tysabri); and a chemotherapy agent; Mitoxantrone (Novantrone). These treatments are either self-injections or given via IV access.