March is Multiple Sclerosis Awareness Month, which always reminds me of my Aunt Rebecca, who was diagnosed with the disease as a newlywed young adult.
One of the most private people I have ever known, I watched her struggle physically for years. Ultimately, my aunt passed away from the disease, but not before living a full life while fighting hard to do so and keeping her health battles private.
Multiple Sclerosis is an autoimmune illness that attacks the central nervous system and spinal cord leading to lesion growth on the sufferer’s brain. These lesions then cause signals to get crossed when reporting back to the brain.
Having an autoimmune disease of the spinal cord and central nervous system means your immune system mistakenly attacks the brain, the spinal cord and optic nerve.
There are two different types of Multiple Sclerosis: relaxing and remitting or progressive. My aunt battled the latter, which means her symptoms never went away and her “feel good days” meant only marginal improvement.
For those with relaxing and remitting MS, symptoms wax and wane. Most sufferers fit into this disease category.
Because multiple sclerosis affects the spinal cord and nervous system, outward signs and symptoms of the disease are often prevalent such as tremors, inability to regulate internal temperature, unusual sensory sensations, vision changes, muscle twitches and weaknesses, as well as spastic muscles and reflexes.
Regardless of the form, MS patients typically see a neurologist, or a doctor who specializes in diagnosing and treating disorders of the brain and nervous system.
When diagnosing MS, there are specific tests the doctor will run to confirm the presence of disease activity. One of the first tests to usually be run is an in-office reflex and sensory test similar to an officer administered field sobriety test. Patients may be asked to walk in a straight line, balance on one leg, follow the doctor’s finger or flashlight beam with their eyes only, or see if they can feel the touch of a feather or prick of a pin.
Should the patient fail to do well on these tests, a neurologist will usually order an MRI, preferably with contrast. A special dye, the MRI contrast, is typically gadolinium-based and used to visibly highlight and enhance the tissues, blood vessels, or any abnormalities that might be present on the brain such as the lesions occurring in MS. Lesions rarely show up overnight, though the damage they cause is often felt sooner than a lesion is seen, and another MRI may need to be performed at a future date. If lesions are discovered, and the patient is diagnosed with MS, they will need to continue having their disease activity monitored, and additional future MRIs will probably need to be conducted.
A MS diagnosis is determined after a comprehensive review of the patient’s medical history, physical exam, MRI and spinal tap results.
Because diseases like Multiple Sclerosis are caused by a malfunctioning immune system, there is no cure for the disease, but there are treatment options available. Treatment in MS focuses on reducing the severity of symptoms and slowing the damage caused by the disease.
Corticosteroids like oral prednisone and intravenous methylprednisolone are often a physician’s first line of defense against autoimmune conditions causing systemic inflammation, and Multiple Sclerosis is no different.
MS patients are also often treated to plasma exchange, or a treatment that removes the liquid part of the blood, the plasma, mixing it with a protein solution called albumin and then pumping it back into the body. This treatment option is typically only used when the patient’s diagnosis is new, severe, and symptoms are not responding to steroids.
For more detailed information on the symptoms and treatment options available to Multiple Sclerosis sufferers, please visit www.mayoclinic.com
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