PATIENT INFORMATION

MULTIPLE SCLERO= SIS

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What is it?

M= ultiple Sclerosis is a disease of the myelin sheath – a fatty-tissue based “wrapper” that surrounds nerve fibers. Degenerating myelin shea= th is replaced with scars, or, in technical medical terms, undergoes “sclerosis”. Since this sclerosis takes place in multiple sites, hence the name of the disease – Multiple Sclerosis. This replacement = of functional myelin sheath with scar tissue robs the nervous system of a cruc= ial property – transmission of weak electrical signals along the length of the nerve fibers. Moreover, the scar tissue may constrict the nerve, further disrupting its functioning. If the electrical signals are not transmitted a= long the nerve, the muscles expecting to receive these signals cannot work norma= lly; they malfunction and this is manifested in the variety of symptoms of Multi= ple Sclerosis.

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Signs and Symptoms.

M= ultiple Sclerosis is one of the major causes of neurologic-based disability among young adults. It affects vision, leading to blurred vision, loss of true color intensity, sometimes pain and double vision. It may be accompanied by attacks of dizziness and vertigo - a feeling of spinning surroundings. It affects sensory perception, leading to numbness, tingling = or burning sensations. It affects muscle strength and leads to weakness in specific muscles or generalized feeling of fatigue, may affect gait and eas= e of walking, or bring about episodes of involuntary muscle stiffness, or spasms= . It often leads to dysfunctions of the bladder (incontinence), bowel (constipation), and even negatively affects sexual performance. Quite frequently, MS can be associated with depression, emotional changes, and cognitive dysfunction (problems with concentration, memory, thinking, etc.)= .

I= n fact, since the nervous system controls all of the functions of our body, so can = MS affect any function of our body, depending on where the scar lesion is loca= ted and what area of our body is supposed to receive a signal carried by the affected nerve fiber.

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Types of Multiple Sclerosis.=

T= here are four types of Multiple Sclerosis, so designated depending on the severity of symptoms at the onset and the development of the diseases.

T= he Relapsing-Remitting type, the most frequent type of MS, is characterized by clearly defined acute episodes (called relapses) of neurologic= al symptoms. They are followed by periods of recovery, called remissions.=

The Primary-Progressive type is characterized by a slow= but continuous worsening of their neurological symptoms from the first occurren= ce and no distinct relapses or remissions can be identified. The severity of deterioration in neuromuscular function may vary, as can the lengths or relapses and remissions or the extent of recovery during each remission.

The Secondary-Progressive ty= pe occurs when the illness starts with the relapsing-remitting type (defined a= cute onset of symptoms), followed by a steady worsening of symptoms, with or wit= hout relapses and remissions.

Progressive-Relapsing type is the rarest type of MS and is characterized by a steady worsening of symptoms fr= om the onset of disease and the presence of clear relapses, but with or without recovery of function. Unlike the relapsing-remitting MS, this type disease continues on the progressively deteriorating course even during remissions.=

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Diagnosis.=

C= learly, the diagnosis of Multiple Sclerosis is challenging because of the heterogen= eity of signs and symptoms, many of which are not specific to MS. Moreover, ther= e is not a single test that can unambiguously verify MS. To arrive at the diagno= sis, a physician needs to collect medical history, perform specialized tests on reflexes, balance, coordination, vision, cognition and check all areas that= may be numb or present unusual sensations. Magnetic Resonance Imaging (MRI) may help in visualizing any changes in the nervous system; a spinal tap (sampli= ng of the fluid surrounding the brain and the spinal cord) may help identify additional signs of disease; evoked potentials test may help evaluate how w= ell the nerve fibers respond to weak electrical stimulation. A nerve conduction study and electromyography may be performed to exclude other illnesses that h= ave symptoms similar to those of Multiple Sclerosis.