Sclerosis are "scars" such as plaques or lesions in the brain and spinal cord.
Multiple Sclerosis is a progressive disease in which scattered patches of the
protective myelin sheath covering of the nerve fibers in the brain, spine and optic
nerve are damaged or destroyed.
Myelin is a fatty material around nerves that acts like the insulation around
electrical wires. When the myelin sheath is damaged, the electrical impulses along
the nerves are disrupted. This disruption affects many functions of the body.
MS typically begins in early adulthood and symptoms vary from person to person.
MS occurs in women twice as often as in men. Although it is most commonly diagnosed
in those between the ages of 20 and 50 years, it is occasionally diagnosed in
children and older persons.
Most cases are found in people living in areas farthest from the equator. But
some groups living in these geographic locations, such as the Japanese, have an even
lower incidence of the disease than other groups in the same areas.
MS occurs in all ethnic groups but is most common in Caucasians, especially those
from northern Europe, southern Australia, and the middle part of North America.
Although researchers have not pinpointed a reason for this geographic preference,
genetic factors and environmental conditions are likely factors. While the number of
people diagnosed with MS has remained stable, it has been increasing in some
geographic areas and decreasing in others.
The average age of onset is 28 and the average age of diagnosis is 33. However,
the gap between the onset of symptoms and diagnosis is shortening. This is due, in
part, to greater awareness of the disease and improved diagnosis. Most people with
Multiple Sclerosis are diagnosed between the ages of 20 and 40.
There are numerous symptoms associated with MS. Not all people experience the
same symptoms. Quite often MS symptoms mimic those of other conditions or diseases which is why
it sometimes takes so much time for a diagnosis. A lot of
ruling other things out. Problems with walking (gait) and balance are common in people with MS. In 13% of
people diagnosed with MS, these problems are the first signs of the disease. About
half of people with progressive disease report shaky movements, unsteady gait or
intention tremors, or uncontrollable shaking when trying to touch a target. Muscle
weakness, numbness, dizziness, and vision problems can all contribute to problems
with balance and coordination.
People with balance problems may or may not have dizziness. Sometimes people become
dizzy when they change their position, such as when first standing up. Such episodes
of dizziness may make people with MS feel nauseated or cause them to fall.
Balance problems without dizziness tend to be more constant, causing people with
MS to sway or stagger while walking.
Coordination problems and shaking tremors may affect the hands or feet, causing
clumsiness. When the nerve pathways to muscles are disrupted, movement can become stiff and
slow. The control of movement relies on a delicate balance between muscles
contracting and relaxing. In spasticity, there is an increase in muscle tone, and
certain muscle groups tend to be more affected than others. This is an initial
symptom in 30 to 40 percent of people diagnosed with MS. It occurs in 60 percent of
people with progressive disease.
People with spasticity complain of heaviness, stiffness, and pain in the arms and
legs. Muscles feel tight and limb movements are slower. Over time, range of motion
can be lost and spasms can also occur.
It requires more work and energy to walk and perform everyday activities.
Vision problems are caused by damage to the myelin surrounding the nerves
that supply the eyes (optic nerves). It is the first symptom in 15 to 20 percent of
people diagnosed with MS. It rarely involves both eyes at the same time, but can
appear on one side followed by the other. Eye problems usually begin with blurred
vision, followed by vision loss in one spot. Sometimes the entire field of vision is
affected. Common vision complaints include:
Dimming of vision
Decrease in clear vision (visual acuity)
Poor light contrast
Problems distinguishing colors
Jerky eye movements (nystagmus)
Pain that is aggravated by eye movement
Some people experience vision problems after exercise, which is caused by a
sudden increase in body temperature (a type of Uthoff's phenomenon, meaning a rise
in body temperature during exercise, a hot shower, or another activity, causes
vision problems). Vision usually returns to normal once the body has cooled down.
It may take a while for vision to return to normal.
It is not uncommon for people to have one attack of optic neuritis and be diagnosed
with MS many years later.
Twenty percent of people who have vision problems develop a "definite" diagnosis of
MS within two years and 45 to 80 percent within 15 years.
Fatigue is the single most common complaint in people with MS. It is often one of
the most debilitating of all possible symptoms. It occurs in as many as 80 percent
of people with MS and interferes with most activities of daily living. Fatigue can
be associated with an increase in activity, but it can also appear without cause.
Although most people look normal during episodes of fatigue, they feel unusually
exhausted.
Fatigue generally surfaces late in the afternoon when body and outside temperatures
rise. It often subsides in the evening when temperatures fall. It can also occur
after periods of intense activity, such as after a long walk, and is often relieved
by a cooling down period and rest.
Sometimes, low energy in MS patients can be due to depression, which needs to be
treated differently than does fatigue.
Symptoms that affect sensation are often the first to appear. Numb, tingling,
tickly, itchy, or tight-band feelings occur because the myelin in the nerves
responsible for the sensory pathways from the spinal cord and brain are damaged.
These complaints occur in 20 to 55 percent of people with multiple sclerosis (MS).
Numbness may be experienced on the surface of the skin, including the face. There
may be a decreased sensitivity to light touch or a pinprick, or it may be much
deeper, such as the inability to feel a toe or a finger being moved. People with MS
often describe a feeling similar to a belt being tightened around the arms, legs, or
trunk. Another complaint is that of an electrical sensation that travels down the
back and sometimes into the arms or legs when the head is bent forward. This is also
known as Lhermitte's sign.
Small increases in body temperature may activate old symptoms or cause new ones to
emerge (called Uthoff's phenomenon). Body temperature typically rises when the body
is fighting an infection, the temperature outdoors is high, or during exercise. Some
people with MS notice changes in energy after sunbathing or taking a hot shower or
sauna. Symptoms are usually temporary and usually improve once they cool off and
their body temperature returns to normal. Emotional changes may be related to the stress of being ill or the direct result of
lesions located in thinking areas of the brain. More than half of all patients with
multiple sclerosis experience changes in thinking, memory loss, difficulty in
processing information, and mood swings. Forty percent of people diagnosed with MS
report mild problems, and 10 percent, severe problems. Many physicians inexperienced
in diagnosing MS often dismiss cognitive and emotional symptoms as "psychological."
This is more likely to happen to women than men. But clearly, cognitive problems
frequently occur in MS patients as a result of brain lesions.
Pain can have many causes and take on many forms. People with MS may experience pain
caused by muscle spasms, cramps, and injury to sensory nerve fibers. Some people
experience excruciating facial pain on one side that feels like a knife stab.
Increased sensitivity to touch and tight muscles can also cause pain. Not all pain,
however, can be attributed to Multiple Sclerosis (MS). People with MS still have
normal aches and pains of everyday life, including headaches and joint pain.
Fighting MS--John Latecki
Fighting MS--Link page
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