Multiple sclerosis (MS) is a disease of the nerves of the brain and spinal cord. Myelin is an insulating coating of the nerves that improves conduction of impulses along the nerve. In MS, inflammation causes the loss of myelin which slows the conduction of impulses along the nerves. This damage to the nerves causes the patient to lose nerve function which affects vision, speech, walking, and memory. MS is most often diagnosed between 20 and 50 years of age, but can be found in the young and elderly. It is twice as common in Caucasians compared to other races and it is twice as common in women compared to men. About 350,000 Americans suffer from MS.

The cause of MS is unknown. It is thought that the immune system is triggered by a virus which causes the immune system to destroy the myelin. Conditions in which the body's immune system destroys its own tissues are known as autoimmune diseases. It is believed that both genetics and environment also play roles in MS.

In most cases the symptoms of MS come and go. This is known as relapsing / remitting MS. Attacks cause sudden deterioration of physical abilities and can last days to weeks. During remission, symptoms may partially or even completely disappear. Remissions can last weeks or even years between relapses. MS symptoms usually begin with visual disturbances such as blurred vision, color distortions, or loss of vision in one eye. Weakness in limbs with or without loss of coordination and balance may occur. Muscle spasms, numbness, and fatigue are common. There may also be difficulty with speech, tremors, and dizziness.

Treatment goals include improving recovery from attacks, reducing the number of attacks and trying to slow the progression of the disease. Anti-inflammatory steroids are used to control the symptoms of severe attacks. Since 1993, interferons are used to manage MS. These medications affect the immune system. The most common side effects of interferon therapy are flu-like such as fever, fatigue, chills, and headache. Interferon therapy can help to slow the progression of the disease.

Two new drugs for MS were introduced in 2010. Ampyra is the first drug for MS that is specifically to improve walking in MS patients. Loss of balance and coordination can cause injury from falls in MS. The active ingredient in Ampyra has previously only been available from compounding pharmacies as 4-aminopyridine. Patients should be sure they have not already been taking 4-aminopyridine before starting Ampyra. The most common serious side effect with Ampyra is the risk of seizures. Gilenya is the first oral medication available for MS. It is used to reduce the frequency of relapses and to slow the progression of the disease. The most important side effect is the risk of changes in heart rhythm. Patients should be observed for 6 hours after the first dose when starting the drug.

Reference: http://www.medicinenet.com/multiple_sclerosis/article.htm.

[Return to Archive Index]

[PageTop]