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Multiple
Sclerosis
What is
Multiple Sclerosis
Multiple sclerosis is a disease of unknown cause which
affects the nerves of the brain and spinal column. MS is the result of
damage to a substance called myelin. Myelin is a protective sheath
surrounding all the nerve fibres in the brain and spinal cord. It works
like insulating cable, helping to conduct electrical impulses between the
brain or spinal cord and the rest of the body, and preventing them from
being short-circuited. When myelin is healthy and functioning properly,
electrical impulses get through quickly and efficiently allowing for easy
and co-ordinated movement. When myelin is damaged, messages are slower,
distorted, or non-existent and do not get through properly. This causes
many of the symptoms of MS. Damaged areas of myelin are known as plaques
or lesions.
Symptoms
from myelin damage: - Symptoms depend on the location of plaques. Myelin
damage can affect nerves to the eyes, parts of the brain, the brain stem
and spinal cord. Damage to motor nerves can affect movement. Damage to
sensory nerves can result in numbness or tingling. There is nothing wrong
with the actual muscles or sensory organs; it is simply that not all the
right messages are getting through.
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Known Causes
The causes for multiple sclerosis remains unknown,
although several theories have been put forward including viral infection, side effects of
certain drugs, faulty immune system, injury to the brain and environmental factors.
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Symptoms
MS varies considerably from one
person to another. It can cause different symptoms, which affect various
parts of the body. Many people only experience a few of these symptoms and
no one has all of them.
It
is possible to have a variety of symptoms at different times and although
some symptoms are very common, there is not a typical set that applies to
everyone.
Symptoms
vary in severity and duration. They can be mild and short-lived, or severe
and longer lasting. Many are somewhere in between.
Some
symptoms are more common in the early stages of the disease, while others
occur later. They may be obvious to other people or hidden and ‘silent’
— difficult for people without MS to understand.
Symptoms
may start with double or blurred vision, pain at the back of the eye or
nerve pain in the face. Some people experience ringing in the ears or
hearing problems, tingling (‘pins and needles’) or numbness in the
legs, feet, arms or hands. Others experience giddiness and loss of
balance, especially in the dark. Some people also find it hard to
concentrate and may become forgetful, or experience anxiety, depression,
or other changes in behaviour.
Other
symptoms may include fatigue (especially in hot weather), weakness,
difficulty in walking, or muscle pain. Some people experience problems
with speech or with bladder or bowel control. Men may find it more
difficult to get an erection, although this can come and go like other
symptoms and both men and women may need more stimulation to stay aroused.
Without
proper diagnosis, these symptoms are not necessarily specific to MS, and
can be associated with a number of conditions. Treatments are available to
help with most MS symptoms and should be discussed with a doctor or
neurologist.
Certain
triggers can rapidly produce symptoms, especially problems with eyesight
and muscle weakness. The most common triggers tend to be overdoing it,
heat and humidity, exercise which raises core body temperature, and fever.
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How
is MS diagnosed?
MS is not easy to diagnose. There
are no tests that are specific for MS or 100 per cent conclusive. Some MS
symptoms can also point to other conditions. A GP or neurologist will not
diagnose MS until there have been at least two episodes involving at least
two areas of the central nervous system on at least two separate
occasions. These episodes must be at least one month apart and last for at
least 24 hours. This means that there is an inevitable delay between the
first symptom and a diagnosis of MS.
A
clinical diagnosis based on seeing your doctor for various MS-type
symptoms over a period of time needs to be backed up by tests. As abnormal
results from these tests can also point to other illnesses, it may be
necessary to have several tests to specifically isolate MS. A GP will
usually refer a patient to a neurologist to make or confirm the diagnosis.
The
following are the most common tests for MS, although there are others:
Neurological
examination: - This method tests for abnormalities in nerve pathways, both
motor and sensory. The neurologist looks for any changes in eye movements,
limb co-ordination, balance, sensation, speech and reflexes, as well as
any signs of weakness.
Visual
and auditory evoked potentials: - Evoked potentials test the time it takes
for the brain to receive and interpret messages. This is a totally
non-invasive and painless test. Small electrodes are placed on the head to
monitor brain waves responding to stimuli to the eyes and ears. You will
be asked to look at a screen, which is made up like a giant black and
white board. In a healthy person, the response is virtually instantaneous.
If demyelination has taken place, messages take longer to get through.
MRI
scan: - The MRI (Magnetic Resonance Imaging) scanner is a high-tech piece
of equipment, linked to a computer, which takes detailed pictures of the
brain and spinal cord. It is very accurate and can pinpoint the exact
location and size of plaques. Over 90 per cent of people with MS have
plaques that show up on MRI scans. Despite this, it is not a conclusive MS
test. Some people who are diagnosed with MS do not reveal any myelin
damage on MRI scans. The MRI scanner is now used in most areas of the
country to diagnosis MS.
Lumbar
puncture: - This is a test that has been used for many years in the
diagnosis of MS. A needle is inserted into the lower back, under local
anaesthetic, and a small sample of cerebrospinal fluid (which flows around
the brain and the spinal cord) is taken from the spinal cord. This fluid
is tested for particular antibodies.
Other
tests: - Conditions that mimic MS can be ruled out using other tests.
These include CT (Computer Axial Tomography) scans which give a
cross-sectional image of the brain; tests to reveal certain antibodies in
the blood and inner ear tests to check balance.
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Types
of MS?
MS shows up differently in each
person. Many people with MS are only mildly affected throughout their
lives. At the other extreme a few people deteriorate rapidly from the
beginning and can have a shortened life span. Most people with MS
experience something in between these two scenarios.
There
are four main types of MS, and a great deal of variability within each of
them.
Benign
MS: - This type starts with a small number of mild attacks followed by
complete recovery. It does not worsen over time and there is no permanent
disability. The first symptoms are usually sensory.
It
is only possible to classify people as having benign MS when they have
little sign of disability 10 to 15 years after the onset of the disease.
However, occasionally disability may develop even after many years of the
disease remaining inactive. Around 20 per cent of people with MS have the
benign form.
Relapsing-remitting
MS: - Most people with MS start with the relapsing-remitting type. This
means they have attacks followed by remissions. During remission they have
fewer or no symptoms.
Relapses
(also known as attacks or exacerbations) tend to be unpredictable and
their causes are unclear. During a relapse new symptoms may occur or
previous symptoms may return. A relapse may last for hours, days, weeks or
months and vary from mild to severe. At their worst, acute relapses may
require hospital treatment.
Remissions
are periods of recovery. They can last any length of time - often years.
No one knows exactly what makes the disease process, go into remission.
Even during remission there will still be plaques visible on MRI scans.
In
the early stages of relapsing-remitting MS, people are generally
symptom-free during remissions. However after several attacks, and as
demyelination progresses, there may be some residual damage, resulting in
the person being slightly more affected than before the relapse. Around 25
per cent of people with MS have the relapsing-remitting form.
Secondary
progressive MS: - This type starts in the same way as relapsing-remitting
MS but after repeated attacks the remissions stop and the MS moves into
what is known as the progressive phase.
Around
40 per cent of people develop secondary progressive MS. The time it takes
to move into the secondary progressive phase varies. It usually happens
within 15 to 20 years of the first onset of MS.
Primary
progressive MS: - Some people with MS never have distinct relapses and
remissions. From the start they experience steadily worsening symptoms and
progressive disability. This may level off at any time, or may continue to
get worse.
Around
15 per cent of people with MS have the primary progressive form of the
disease, which is also known as chronic progressive.
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Conventional
treatment
Conventional medical treatments centre around drug therapy
to help alleviate the symptoms.
In holistic medicine, causes for nervous disorders are
thought to relate to the individual's lifestyle, diet, upbringing, stress, and possibly
even as long-term side effects of vaccinations. Certainly, there is a great deal of
evidence in the available research to suggest that there are important considerations
relating to these diseases which have been neglected by conventional medicine. For
instance, cow's milk is known to predispose people to nervous disorders in later life
because it has only one fifth as much linoleic acid (essential for building up nerve
tissue) as does human breast milk.
Heavy metals such as lead and mercury poisoning produce
symptoms similar to MS & MND when found in toxic amounts in the body. Some authorities
have suggested that mercury in fillings can have this affect and there are reports of
people making miraculous recoveries from nervous disorders after their mercury fillings
have been replaced.
What is certain is that in the history of medical science
no single chronic disease has been successfully prevented or cured without recourse to
nutritional or environmental factors. When one reviews the available literature and
research, it becomes clear that there are many alternatives open to sufferers of nervous
disorders.
Source:
The Multiple Sclerosis Society
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