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Spinal Cord Injury Paralysis Resource Center

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Multiple Sclerosis

Multiple Sclerosis (MS) is a disorder of the brain and spinal cord involving decreased nerve function associated with scar formation on the covering of nerve cells. In many cases, MS symptoms include various stages of paralysis.

Multiple sclerosis involves repeated episodes of inflammation that destroy the myelin sheath that covers nerve fibers, leaving multiple areas of scar tissue (sclerosis) along the covering of the nerve cells. This results in slowing or blockage of nerve impulse transmission in that area.

MS often progresses with episodes that last days, weeks, or months alternating with times of reduced or no symptoms (remission). Recurrence (relapse) is common.

The exact cause of MS is unknown. Studies indicate an environmental factor may be involved. There is a higher incidence in northern Europe, northern United States, southern Australia, and New Zealand than in other areas of the world. There may also be a familial tendency toward the disorder.

MS is believed to be a type an abnormal immune response directed against the central nervous system (CNS). The exact antigen -- the target the immune cells are sensitized to attack -- remains unknown. In recent years, researchers have identified which immune cells are mounting the attack, how they are activated to attack, and some of the sites, or receptors, on the attacking cells that appear to be attracted to the myelin to begin the destructive process.

Theories about the cause of MS include the role of a virus-type organism, an abnormality of the genes responsible for control of the immune system, or a combination of both.

MS affects approximately 1 out of 1,000 people. Women are affected more commonly than men. The disorder most commonly begins between 20 to 40 years old but can happen at any age.

MS symptoms include weakness of one or more extremities, paralysis of one or more extremities, tremor of one or more extremities, muscle spasticity (uncontrollable spasm of muscle groups), movement dysfunction, numbness, tingling, pain, loss of vision, loss or coordination and balance, incontience, loss of memory or judgment and fatigue.

Symptoms may vary with each attack. Fever can trigger or worsen attacks, as can hot baths, sun exposure, and stress.

MS varies greatly from person to person and in the severity and the course of the disease. Some people have few attacks and little disability. Others have "relapsing-remitting" MS which means they have a series of attacks (exacerbations) followed by periods of recovery (remissions).

Some have what is called "progressive" disease that can be "primary" or "secondary." People with primary-progressive MS have steady worsening (or progression) from onset with only minor recovery. Secondary-progressive MS begins with a series of relapses and recovery but becomes steadily progressive over time with continued worsening. Most people with MS have the relapsing-remitting or secondary-progressive forms.

There is no known cure for multiple sclerosis. There are promising new therapies that may decrease exacerbations and delay progression of the disease. Treatment is aimed at controlling symptoms and maintaining function to give the maximum quality of life.

Patients with a relapsing-remitting course are now placed on immune modulating therapy that requires injection under the skin or in the muscle once or several times a week. This may be in the form of interferon (such as Avonex or Betaseron) or another drug called glatiramer acetate (Copaxone). They are all similar in their effectiveness and the decision on which to use depends on one’s side-effect profile.

Steroids are often given to decrease the severity of an attack. Other common MS medicines include baclofen, tizanidine or diazepam may be used to reduce muscle spasticity. Cholinergic medications may be helpful to reduce urinary problems. Antidepressant medications may be helpful for mood or behavior symptoms. Amantadine may be given for fatigue.

Physical therapy, speech therapy or occupational therapy may improve the person’s outlook, reduce depression, maximize function, and improve coping skills. A planned exercise program early in the course of MS helps to maintain muscle tone.

Attempts should be made to avoid fatigue, stress, physical deterioration, temperature extremes, and illness to reduce factors that may trigger an MS attack.

The expected outcome is variable and unpredictable. Although the disorder is chronic and incurable, life expectancy can be normal or nearly so, with a life span of 35 or more years after diagnosis occurring commonly. Most people with MS continue to walk and function at work with minimal disability for 20 or more years.

Here is a good slideshow overview on WebMD.

Sources: National Institute of Neurological Disorders and Stroke (NINDS), National Multiple Sclerosis Society, Consortium of MS Centers

A Reeve Foundation Fact Sheet on Multiple Sclerosis (PDF)

The Consortium of Multiple Sclerosis Centers/North American Research Committee on MS (CMSC/NARCOMS)The CMSC website is a vehicle with that develops and shares information and knowledge among members of CMSC and the health care community for the benefit of those with MS.

Computer Literate Advocates for MS (CLAMS)A web site bringing those with MS out of isolation and into a web community for support, companionship and information. Also has good links to other sites.

Dragon SystemsVoice activation at its finest, the Dragon Systems technology is used not only to operate laptops and pda's but can even control multimedia centers, navigation systems, mobile phones and much more.

Multiple Sclerosis Association of AmericaMSAA features news, information and local connections.

Multiple Sclerosis International FederationThe Multiple Sclerosis International Federation offers research suggesting that sexual concerns among men with MS range from 7% to 91%, with the most frequent concern being erectile dysfunction. Orgasmic dysfunction, loss of sexual desire, and fatigue are also concerns that are reported frequently. From the home page search under Sexual.

Multiple Sclerosis FoundationA great source of information about MS. Web site has interactive, multimedia MS library and online forum. Publishes MSFocus, a complimentary quarterly magazine and the MS Foundation newsletter.

Multiple Sclerosis Complementary and Alternative Medicine (MS-CAM) An internet community site run by the Rocky Mountain MS Center. The goal is to provide accurate unbiased reviews regarding complementary and alternative medicine (CAM) therapies in multiple sclerosis, and to measure the experiences of the MS community with particular therapies and other subjects of interest. Visitor registration is requested; an annual subscription fee is requested.

MswatchSponsored by Teva Marion Partners, is a website dedicated to managing MS. Patients have the ability to keep a diary on the site, ask an expert a question, and communicate via the message boards.

Multiple Sclerosis Comprehensive Care A multimedia resource for MS professionals. Produced by the publishers of Neurology Reviews and supported by Novartis Pharmaceuticals Corporation, this web site features video interviews, interactive digital publications, self-assessment quiz questions, patient education tools, professional resources, and more. All our content is devoted to improving the care of patients with MS and helping those who deliver that care.

The National Multiple Sclerosis SocietyProvides information on living with MS, treatment, scientific progress and support.

The National MS SocietyThe National MS Society is a collective of passionate individuals who want to do something about MS now -- to move together toward a world free of multiple sclerosis. MS stops people from moving. We exist to make sure it doesn't.

Paralysis Resource Center The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm ET. You may also schedule a call or send a message online.

Reeve Foundation Online Paralysis Community Connecting people living with paralysis, families, friends and caregivers so we can share support, experience, knowledge, and hope.

Quality of Life Grants DatabaseFind resources within the PRC Quality of Life Grants Database. Search by Zip Code, State or an Entire Category.

Library Books and VideosFind resources within the PRC library catalog.

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The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm Eastern U.S. Time. International callers use 973-467-8270. You may also schedule a call or send a message online.

This project was supported, in part by grant number 90PR3002, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship areencouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.