Multiple Sclerosis

About Your Diagnosis
Multiple sclerosis is a slowly progressive disease of the central nervous system affecting at least 300,000 young Americans. This results from multiple areas of damage or destruction of the protective covering (demyelination) of nerve fibers. Each nerve is covered by a protective myelin coating. The myelin is much like the insulation covering of an electrical wire. If it is damaged or partially stripped away, an electrical signal cannot be transmitted without being interrupted. With nerves, the interruption of the impulse causes symptoms such as numbness, tingling, or weakness in the extremities, dizziness, unsteady gait, changes in vision, and difficulty with speech. Symptoms vary among individuals. Some individuals may have only one mild symptom, whereas others may have numerous severe symptoms. Although there are many theories about the cause, no cause is definitively known. Multiple sclerosis is more common in women than men, and in temperate climates as compared with the tropics. In most cases, patients are seen between the ages of 20 and 40 years with one or more symptoms, depending on the sites of initial demyelination. Most patients have symptoms that develop slowly and improve with treatment. They may be without symptoms for a long period (remission) and later have a recurrence (exacerbation). The remissions and exacerbations are unpredictable. Some individuals have a more severe form of multiple sclerosis that progresses despite treatment. Multiple sclerosis is most often diagnosed by obtaining a medical history and performing a physical examination; results of a magnetic resonance imaging (MRI) scan of the brain can assist in establishing the diagnosis. Talk with your physician about what you should expect with remissions and exacerbations.

Living With Your Diagnosis
Living with multiple sclerosis can be a challenge because the symptoms are unpredictable and variable. It is important to practice a healthy lifestyle and make the most of the periods of remission. Although there are no dietary restrictions for patients with multiple sclerosis, it is advisable to maintain a
normal weight for your height. Adequate rest and a regular exercise program, such as daily walking, will help to maintain muscle strength, tone, and energy. Always check with your physician before beginning any exercise program.

Treatment
Although currently there is no known cure for multiple sclerosis, there are many treatments available. Exacerbations are often treated with steroid medications. These medications are often given through an intravenous line, which may require a hospital stay. Other medications, such as a hormone (ACTH) and beta-interferon have also been used for both the remission and exacerbation phase. Many centers are currently researching new medications and treatments for multiple sclerosis.

The DOs
• Get plenty of rest.
• Participate in a regular exercise program approved by your physician.
• Maintain a healthy diet.
• Tell your physician about any new or worsening symptoms.
• Continue to work and participate in activities you enjoy.
• Contact local or regional support groups.
• Keep all follow-up appointments with your physician for reassessment.
• Take all medications as prescribed.

The DON’Ts
• Don’t ignore worsening changes in your symptoms, especially visual changes, because these sometimes can be arrested if medication is begun promptly.
• Don’t begin any new medications without your physician’s approval.

When to Call Your Doctor
• If you have any problems associated with your medication.
• If you have facial weakness or weakness of a limb, partial blindness, and/or pain in one eye.

Websites:
http://www.cnsonline.org
http://www.nmss.org