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| General
Illness Information |
Medical
Term: |
Multiple
Sclerosis |
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Common Name: |
None Specified |
| Description: |
Chronic,
slowly progressive, neurological disease characterized by myelin
loss in the brain and spinal cord, causing neurological symptoms.
Myelin is the tissue that covers the brain and the spinal cord. It
usually begins in young adulthood (ages 20 to 40), is more common in
females, and is more prevalent in cooler climates. A third of all
affected patients have mild disease, another third have moderate
disease, and a final third have severe disease, with rapid
progression.
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| Causes: |
The
underlying cause is unknown. However, auto-immune, genetic and
viral causes are suspected.
The
basic pathological defect is patchy degeneration of the white matter
(myelin) in the brain and the spinal cord. The result is an
inability to conduct impulses.
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| Prevention: |
Cannot
be prevented at present, but relapses can be shortened by
therapy.
Avoid
infections, and treat any infection early. Infections may trigger
relapses.
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| Signs
& Symptoms |
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| Risk
Factors |
 |
Family
history of disease |
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Children
and adolescents raised in cool climates. Moving to a warmer
climate later does not affect the course or natural
history. | |
| Diagnosis & Treatment |
| The
diagnosis is indirect, and usually suspected from
clinical and laboratory features. Many other diseases, which
are treatable, must be ruled out.
If the diagnosis is not clear-cut, CT scans,
MRI and cerebrospinal fluid examination may be
required.
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| General
Measures: |
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Emotional
support, encouragement, and reassurances are necessary to help
avoid a hopeless outlook. |
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Try
to lead as normal a life as possible, but avoid
fatigue. |
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Avoid
warm surroundings, even a hot shower. Heat can temporarily
worsen symptoms. |
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No
specific therapy. Remissions occur spontaneously and make
treatment evaluations difficult. |
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Catheterizations
for inadequate bladder emptying (indwelling catheter may be
necessary in a few patients). |
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Hospitalization
or nursing-home care may be necessary, depending on the
severity of the disease. | |
| Medications: |
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Cortisone
drugs during periods of relapse or when symptoms
worsen. |
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Muscle
relaxants to control muscle spasms. |
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Betaseron, or Avonex, or
Copaxone may be tried in prevention of
relapses. |
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Intravenous immunoglobins are under
investigation. |
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Methotrexate may be used to prevent
relapses and progression of disease. |
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Newer treatments are being
evaluated, and close supervision by a neurologist is
necessary. | |
| Activity: |
|
Take
regular rest periods.
A
regular program of physical exercise and mental activity is
essential. Obtain physical therapy with mechanical devices
(wearing braces, use of a cane or walker) to overcome physical
handicaps.
Swimming
is an ideal form of exercise, because of the buoyant support
and coolant effects that it
provides. | |
| Diet: |
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Eat
a normal, well-balanced diet. | |
| Possible
Complications : |
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Urinary-tract
infections. |
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Pressure
sores from prolonged bed rest. |
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Constipation
caused by inactivity. |
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Depression. | |
| Prognosis |
| Though medications help
to allay the severity of relapses, and also to delay relapses,
there is still no cure for the disease.
The course is highly variable, and
unpredictable, and progressively downhill. At first,
months or years may separate episodes, but inevitably the
intervals grow shorter, and eventually the patient becomes
disabled.
The life span in most cases is not markedly
affected, and the average illness lasts over 25
years.
In a small number of patients, the course is
rapidly downhill, and occasionally fatal within one or two
years. | |
| Other |
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