Multiple Sclerosis

by Partha Nandi, MD

The content expressed on this page are the views of the advertiser and not of Deadline Detroit.

Today I’d like to discuss a disease that affects 2.5 million people throughout the world, multiple sclerosis.  In multiple sclerosis, your own immune system attacks the protective sheath covering the nerves.  This makes it difficult for communication between the brain and the rest of the body.  Almost any neurological symptom can be seen:  Here are some examples:

1. Weakness or numbness in one or more arm or leg. Usually, this occurs on one side of your body or on the bottom half of the body
2. Vision loss usually affecting one eye at a time
3. Tingling or pain in multiple parts of the body
4. Tremor
5. Lack of coordination or unsteady gait

Several types of multiple sclerosis are described, based on how the disease progresses:

1. Relapsing remitting:  unpredictable relapses followed by long times of remission
2. Secondary progressive:  approximately 65% of relapsing remitting patients go to this form.  Progressive neurologic decline occurs between acute attacks
3. Primary progressive:  patients do not have remission after the first attack 10-15%
4. Progressive relapsing: least common; neurologic decline and clear superimposed attacks

What causes multiple sclerosis? We don’t know.  We feel that MS is an autoimmune disease.  In this disorder, the body’s immune system attacks the coating of nerve fibers.  However, there are risk factors:

1. Genetic:  risk of acquiring MS is higher in relatives of a person with disease. With first degree relative you have 1-3% chance of getting MS
2. Geographic:  more common in Europe, northern US, southern Canada, New Zealand and southeastern Australia
3. Sex:  Females twice as likely as men to develop multiple sclerosis
4. Race:  Caucasians are at highest risk.  Asians, African and Native American have lowest risk 
5. Other autoimmune disease:  thyroid disease, Diabetes, or inflammatory bowel disease can increase risk

So how do you diagnose multiple sclerosis?

There is no specific test.  The following are typical tests done to diagnose MS:

1. Blood tests:  can exclude other inflammatory diseases
2. Spinal tap:  can find abnormalities noted in multiple sclerosis and rule out other infections
3. MRI: this can show lesions of MS but non-specific. Other conditions have these lesions including lupus or lyme disease.

Once diagnosed, what are the treatment options?

The goal is to return to function after an attack and prevent new attacks and importantly, prevent disability.

1. For acute attacks:  steroids are used. Plasma exchange
2. To modify the course of disease: multiple treatments, including biologic agents, are available to modify the course

Other treatments included:     

1. Physical therapy
2. Muscle relaxants may be helpful
3. Exercise and adequate rest
4. Eat a balanced diet and reduce stress

What is the prognosis for patients with MS?

Life expectancy is 5-10 yrs lower than the general population.  2/3 of deaths with MS are related to the disease itself.  Suicide rates are higher as well.

Partha’s Prescriptions for MS

1. If you suspect any symptoms suggestive of Multiple Sclerosis, please see your doctor. This is especially true if you have a family history. Early diagnosis and treatment can be crucial.
2. Stop smoking and have a balanced diet.  This is a good idea for your general health but also for MS.  
3. Control your stress.  With MS, stress may trigger or worsen symptoms. Please use techniques such as yoga or meditation as examples to decrease your stress.
4. Exercise regularly.  Aerobic exercises may benefit mild to moderate multiple sclerosis. Your strength and balance can improve significantly as well as your mood.
5. Join the MS Society. This organization can help you cope with MS and give you helpful information on new treatment, research and activities to maintain your physical and mental heath.  Go to www.nationalmssociety.org for details.