Silver Bulletin e-News Magazine
Section 4: Disease News & Information
(MS) is a chronic disease of the central nervous system, which
predominantly affects young adults during their most productive
years. Viral and autoimmune etiologies are postulated. Genetic and
environmental factors are known to contribute to MS, but a specific
cause for this disease is not identified.
Pathologically, MS is characterized by the presence of areas of
demyelination and T-cell predominant perivascular inflammation in
the brain white matter. Some axons may be spared from these pathological
Disease begins most commonly with acute or subacute onset of neurologic
abnormalities. Initial and subsequent symptoms may dramatically
vary in their expression and severity over the course of the disease,
that usually lasts for many years.
Early symptoms may include numbness and/or paresthesia, mono- or
paraparesis, double vision, optic neuritis, ataxia, and bladder
control problems. Subsequent symptoms also include more prominent
upper motor neuron signs, i.e.,. increased spasticity, increasing
para- or quardriparesis. Vertigo, incoordination and other cerebellar
problems, depression, emotional lability, abnormalities in gait,
dysarthria, fatigue and pain are also commonly seen.
Neurological findings, clinical observation, results of Magnetic
Resonance Imaging (presence of areas of demyelination in the CNS),
spinal fluid examination (presence of oligoclonal bands and/or elevated
IgG index) and sometimes tests of evoked potentials constitute the
basis for diagnosis.
Differential diagnosis for MS includes other demyelinating diseases
of the nervous system, often of a viral or postinfectious origin.
Among them are encephalomyelitis, transverse myelitis, as well as
other immune-mediated conditions, which affect CNS, such as sarcoidosis,
systemic lupus erythematous, Vitamin B-12 deficiency, etc.
MS is classified according to its clinical course into several categories:
benign, relapsing-remitting (the most common variant), progressive-relapsing,
primary progressive and secondary progressive.
There is no curative treatment available for the MS. However, a
number of medications can be used to treat the disease symptomatically.
Corticosteroids are medications of choice for treating exacerbations.
Interferon▀-1B (Betaseron.) as well as Interferon▀-1a (Avonex.)
are successfully used to reduce the frequency and severity of relapses.
Copolymer 1 is now being investigated in clinical trials and also
appear to decrease the disease activity. Specific medications are
also available to treat fatigue, pain, spasticity, bladder control
In the future, medications aimed at reducing specific autoimmune
response, and, possibly, medications designed to assist in remyelination
will help improve the quality of life of MS patients
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