Multiple sclerosis, a chronic, slowly progressive disease of the central nervous system, is characterized by patchy destruction and scarring of myelin, the fatty sheath surrounding nerves in the spinal cord and brain. In time, the sclerosis interferes with transmission of nerve signals, producing a wide range of symptoms that vary from person to person. These commonly include numbness, weakness, tremor, poor coordination, an abnormal gait, loss of bladder and bowel control, and impotence in men. Vision and hearing may be impaired and there might be memory loss, confusion, and speech problems. Symptoms lessen or disappear during periods of remission, but relapses occur in which old problems worsen and new ones develop. About 250,000 Americans have MS, with women outnumbering men about two to one. The cause is unknown, but some researchers theorize that a slow acting virus may be responsible; others believe that MS is an autoimmune condition in which the immune system attacks healthy tissue. Still others think that a combination of factors, including genetic susceptibility, may be involved.
Diagnostic Studies And Procedures
There is no specific test to detect multiple sclerosis, so diagnosis entails investigating and eliminating other possible causes of symptoms. In addition to a physical examination and blood and urine analyses, studies may include a neurological work up that tests reflexes, equilibrium, sensory function, and emotional stability. A sample of cero brospinal fluid may also be obtained. As the disease progresses, MRI is used to locate lesions along nerve paths.
Betaseron, a genetically engineered form of human beta interferon, is the only medication to date that reduces the frequency and severity of MS attacks. When the drug was approved for general use in 1993, demand for it far exceeded production. A lottery system was set up to select patients to receive the drug until supply catches up with the demand. Otherwise, treatment is directed to alleviating symptoms. During a flare up, ACTH, a synthetic hormone normally produced by the pituitary gland, sometimes induces a remission. It is given intravenously in high doses at first, then in smaller intramuscular injections. After a few weeks, the hormone is tapered off and stopped. Relatively few patients respond to this treatment, however, and side effects such as intestinal bleeding and edema generally limit its use. Corticosteroid drugs may also be used, but they do not always help; even when they do, they are not recommended for long term treatment. Antibiotics may be prescribed to treat or prevent bladder infections, a common problem in multiple sclerosis. Depending upon the specific problem, devices such as a hearing aid, special eyeglasses, and leg braces or a wheelchair may be needed.
Individuals with multiple sclerosis can be helped by a variety of alternative therapists, who can also teach appropriate approaches to self treatment.
There is some evidence that the progression of MS can be slowed by limiting intake of saturated fats to less than 5 percent of total calories, or about 10 grams a day, while increasing corn, safflower, canola, and other polyunsaturated oils to 40 to 50 grams a day, or 20 to 25 percent of calories. Having several servings a week of mackerel, salmon, and other fatty cold water fish, which are high in omega 3 oils, is said to help maintain nerve function. Increasing fiber and fluid intake can alleviate constipation, a common problem with MS. Full strength cranberry juice protects against cystitis, which is another frequent complication. Patients who have difficulty chewing or swallowing may need liquid nutritional supplements.
Stretching exercises, moderate physical activity, massage, and manipulation help sufferers retain muscle strength. Canes, braces, orthotics, and other devices can stabilize gait, although the occasional use of a wheel chair may be advisable to conserve energy. Recent studies show that horse back riding, or equine therapy, carried out under the supervision of a specially trained physical therapist can improve both gait and strength.
Practical ways for simplifying self care to conserve energy are taught by these specialists. Speech and bowel therapists may be enlisted to deal with special problems.
Yoga and Meditation
Deep breathing exercises, visualization, and relaxation therapies not only alleviate the stress of living with this chronic, debilitating disease, but they may also strengthen the immune system and prevent some complications of MS.
Specialists agree that active involvement in self care is the best way to maintain a positive attitude. Start by adopting a realistic view of your capabilities so that you can set achievable goals. Whenever possible, seek out enjoyable new experiences that expand your horizons without increasing physical demands; for example, consider learning a foreign language or a new craft. A support group can provide an invaluable outlet for your feelings of frustration as well as practical pointers in self sufficiency.
Other Causes of Progressive Paralysis
Amyotrophic lateral sclerosis, or Lou Gehrig’s disease, may be mistaken for multiple sclerosis. Hereditary diseases such as muscular dystrophy produce progressive muscle weakness, as can infections like chronic Lyme disease.