Multiple sclerosis

There are a host of diseases whose names get bounced around a lot, but with which very few are extremely familiar.  Fortunately, many of these diseases are relatively rare, but they can be devastating for those who suffer from them.  One such disease is multiple sclerosis (MS).

Multiple sclerosis is a disease of the nervous system.  Nerves are the body’s electrical cables.  Information from the brain is relayed to the rest of the body through nerves and vice versa.  For example, if you want to move your fingers to type on your keyboard, your brain sends an impulse through the nerve to the fingers’ muscles causing the muscles to contract and your fingers to move.  Just as important, when you touch something hot, the nerves in your finger send a message to your central nervous system, which in turn sends an impulse back to the muscles to move the finger away from the heat.

The wiring of our nervous system necessitates that certain nerve cells traverse very long distances in the body, some sending projections from the brain all the way down the length of the spinal cord.  The impulses have to be sent very quickly from one part of the body to another; otherwise, for example, it would take us several seconds to move our hand from a hot stove.  Impulses can be transmitted very fast through these nerves because they are coated with a fatty sheath or coating called myelin.  

In multiple sclerosis, this sheath is damaged by inflammation, a degenerative process referred to as demyelization.  Disruption of the nerve’s “insulation” interferes with transmission of nerve impulses.  The signals slow down or even stop and this is what causes the symptoms of MS.  

What starts the inflammation is not known.  It may be genetic, a virus, an environmental factor or a combination of any of these.  Regardless, the body begins to fight against itself (an autoimmune reaction) and the myelin is damaged.  Any myelinated nerve could be affected from the head to the toes.  Common symptoms include double vision and vision loss; muscle weakness, spasms, tremor, imbalance and impaired movement of limbs; bowel and bladder dysfunction; difficulty speaking; memory problems and depression; and pain or numbness.  Fever, heat and stress can trigger or worsen an attack.

Multiple sclerosis affects more women than men.  It can be seen at any age, but is commonly diagnosed between the ages of 20 to 40 years.  It is difficult to diagnose because many of its symptoms are similar to other neurologic diseases.  In addition, some individuals may find that symptoms simply come and go.  Examination and testing is done to rule out specific diseases and may include blood work, MRI, nerve stimulation tests, and a spinal tap.  

Unfortunately, there is no cure for MS.  However, there are therapies that may slow the progression of the disease.  Most of these medications are aimed at preventing the body’s fight against itself, so-called immune modulators.  Medicines can also be used to combat muscle spasms, fatigue, bowel and bladder dysfunction and other common symptoms.  Exercise and physical therapy also are very important modalities in the fight against this disease.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.        

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