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Multiple sclerosis

What is it?

Multiple (mull-tih-pull) sclerosis (skler-o-sis) is also called "MS." It is a long term disease of the central nervous system (CNS) which includes the brain, spinal cord, and optic nerves.

  • Nerve fibers (thread-like) in the brain and spinal cord are covered with myelin (mi-uh-lun). This is a fatty material that surrounds and protects the nerve fibers. With MS, this myelin is damaged or destroyed so nerve messages going to and from the brain are slowed down. Patches of scar tissue form over the damaged myelin. These patches may be found in many areas of the brain, spinal cord, and optic nerves.
  • MS is a disease that may have quiet and active periods. The quiet periods when you have few or no symptoms of the disease are called "remission." Remission may last months or years. The active periods when you have symptoms of the disease are called "relapse." The disease is more common in white people and it usually starts between 20 to 40 years of age. Women get MS more often than men. The disease is seen more often in colder climates than in warmer climates.

Causes:

MS has no known cause. It is an autoimmune (ah-toe-ih-mewn) disease. The immune (ih-mewn) system is the part of your body that fights infection. In MS, your body attacks itself. One or more of the following things may be possible causes of MS.

  • The disease may be genetic (something you are born with). So, you may have a greater chance of getting MS if you have a parent, brother, or sister with MS.
  • MS may be caused by an infection, such as a slow-growing virus (germ).
  • The immune system and the nervous system not working well together may also cause MS.

Signs and Symptoms:

MS affects people in different ways. Symptoms of the disease may begin slowly or quickly. You may have mild symptoms or very bad symptoms. The symptoms of MS can be divided into 2 groups. There are symptoms that affect your body and some that affect your emotions (feelings).

  • Following are the symptoms that affect your body.
  • Muscles in your body may be tight, cramp, or seem weak. This may make it hard to walk. The muscle cramps may be painful and keep you awake when trying to sleep.
  • Numbness or tingling in your arms, legs, or face.
  • Problems controlling your bladder or bowels.
  • Problems having an erection (e-rek-shun) if you are a man.
  • Slurred speech or problems swallowing.
  • Vision may be blurred, you may see double, or you may feel dizzy.
  • Your body may not seem like it is working together when you move. You may have problems with walking or balancing.
  • With time, your symptoms may get worse and it may be harder for you to care for yourself.
  • The other group of symptoms affect how you show your feelings. Caregivers call this "your affect." These symptoms are normal and your caregiver can help you work through them.
  • Affect is flat (you show no emotion).
  • Being forgetful, irritable, depressed, confused, or very anxious.
  • Feeling very tired and having no energy.
  • Having mood swings, such as going from very happy to very sad.

Wellness Recommendations:

Exercise, a healthy balanced diet, rest, and contact with others are important. Sunlight may help MS. But be sure to wear sunscreen and to stay cool. Overheating may cause your symptoms to flare.

Medical Care:

There is no known cure for MS. The disease cannot be stopped or turned around. Treatment involves controlling symptoms and reducing relapses. Medicine may be used to treat some MS symptoms.

Dietary Measures:

  • A diet low in saturated fats (animal fats) may decrease the risk of MS.
  • Eating more vegetable protein and fiber may decrease the risk of MS.
  • A diet with 20 or less grams of fat a day may prolong survival in MS patients.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Supplements:

  • Fish oil (EPA, DHA) has been used and has been studied in people who have MS.
  • Vitamin D has been used, but has not been studied in people who have MS.
  • Vitamin B12 (cyanocobalamin) may be helpful for MS and has been studied in people.

Complementary Therapies:

  • Acupuncture may be helpful in MS.
  • Biofeedback may be helpful in MS.
  • Hypnosis may be helpful in MS.
  • Massage is helpful for MS.
  • Meditation can reduce symptoms of MS, such as fatigue.

Other ways of treating your symptoms:

Other ways to treat your symptoms are available to you.

Talk to your caregiver if:

  • You would like medicine to treat MS.
  • You have chills.
  • You have burning or pain when you pass urine.
  • You are having a hard time having a BM.
  • You have more weakness than usual.
  • You are having swallowing problems.
  • You have new symptoms lasting more than 24 hours.
  • Your MS symptoms have gotten worse for more than 24 hours.
  • Your symptoms have not gone away or improved by these self-help measures.
  • You are so depressed you feel you cannot cope with your illness.
  • You have questions about what you have read in this document.

SEEK CARE IMMEDIATELY IF:

  • You are having breathing problems.
  • You are so depressed you feel like hurting yourself.

Care Agreement:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

References:

1. Dane JR: Hypnosis for pain and neuromuscular rehabilitation with multiple sclerosis: case summary, literature review, and analysis of outcomes. Int J Clin Exp Hypn 1996; 44(3):208-231.

2. Fawcett J, Sidney JS, Hanson MJ et al: Use of alternative health therapies by people with multiple sclerosis: an exploratory study. Holist Nurs Pract 1994; 8(2):36-42.

3. Freal JE, Kraft GH & Coryell JK: Symptomatic fatigue in multiple sclerosis. Arch Phys Med Rehabil 1984; 65(3):135-138.

4. Ghadirian P, Jain M, Ducic S et al: Nutritional factors in the aetiology of multiple sclerosis: a case-control study in Montreal, Canada. Int J Epidemiol 1998; 27(5):845-852.

5. Hayes CE, Cantorna MT & DeLuca HF: Vitamin D and multiple sclerosis. Proc Soc Exp Biol Med 1997; 216(1):21-27.

6. Kira J, Tobimatsu S & Goto I: Vitamin B12 metabolism and massive-dose methyl vitamin B12 therapy in Japanese patients with multiple sclerosis. Intern Med 1994; 33(2):82-86.

7. LaRiccia PJ, Katz RH, Peters JW et al: Biofeedback and hypnosis in weaning from mechanical ventilators. Chest 1985; 87(2):267-269.

8. Nordvik I, Myhr KM, Nyland H et al: Effect of dietary advice and n-3 supplementation in newly diagnosed MS patients. Acta Neurol Scand 2000; 102:143-149.

9. Steinberger A: Specific irritability of acupuncture points as an early symptom of multiple sclerosis. Am J Chin Med 1986; 14(3-4):175-178.

10. Swank RL: Multiple sclerosis: fat-oil relationship. Nutrition 1991; 7(5):368-376.


Last Updated: 4/4/2014

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