What is multiple sclerosis?
Multiple sclerosis (MS) is a chronic, or long-term, condition that affects the central nervous system, which includes the brain and the spinal cord. In a healthy nervous system, electrical signals travel from the brain to the rest of the body with the help of myelin, a fatty substance that surrounds the nerves. In MS, the myelin becomes damaged, creating areas of sclerosis, or scar tissue. This scar tissue can slow down or even stop electrical signals from moving along the nerves, resulting in MS symptoms. The scar tissue can form in different areas, causing different symptoms.
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Is there a cure for multiple sclerosis?
Currently, there is no cure for multiple sclerosis (MS). But recent advances have led to therapies that help slow the progression of the disease. Researchers are conducting ongoing studies to learn more about what causes MS and how it might be cured.
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Who develops multiple sclerosis?
According to the National Multiple Sclerosis Society, about 400,000 people in the United States currently have multiple sclerosis (MS). The first symptoms may appear between the ages of 20 and 40, but diagnosis often comes later. Women are twice as likely to have MS as men, and MS occurs more often in whites than in any other racial group.
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Can multiple sclerosis be prevented?
There currently is no way to prevent multiple sclerosis (MS). Continuing research may produce ways to reduce the chances of developing MS.
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What causes multiple sclerosis?
Multiple sclerosis (MS) is thought to be an autoimmune disease, or a disease where the body’s immune system attacks itself. In MS, the immune system mistakenly attacks the central nervous system. Researchers have determined which immune cells launch the attack and how they function, and are currently studying ways to stop the abnormal immune response without harming normal immune cells.
What causes certain people to develop MS is not known. Researchers have studied several risk factors:
- Genes: There are some indications that MS may be caused partly by genetic factors. According to the National Institute of Neurological Disorders and Stroke, if one person in a family has MS, that person’s siblings, parents, and children have a 1 percent to 3 percent chance of developing MS. A person whose identical twin has MS has about a 30 percent chance of developing MS, suggesting that genes may be just one factor that causes MS.
- Environment: Although MS occurs worldwide, it more often affects people living in areas farther away from the equator. It is still unclear whether this pattern is caused by environmental factors or genetics.
- Hormones: Because MS occurs more often in women, researchers have suggested hormones might play a role. Studies also have shown that symptoms of MS often decrease during pregnancy, but increase after the birth of a child.
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What are the symptoms of multiple sclerosis?
Multiple sclerosis (MS) is unpredictable, and symptoms depend on where scar tissue has formed in the central nervous system. Symptoms can be different for each person, and not everyone experiences every symptom. MS symptoms can include the following:
- Fatigue and excessive daytime sleepiness, the most common symptom of MS
- Depression, which can be caused by the condition or by some MS medications
- Vision changes, such as blurred or double vision
- Cognitive changes, such as difficulty with memory, learning, focus, attention, or judgment
- Movement problems, including tremors and spasms, problems with speech or swallowing, and trouble with walking or balance
- Sexual problems, including lack of sex drive
- Bladder and bowel problems, such as the inability to control urination or bowel movement
- Pain and other sensory problems, such as burning, prickling, or “pins and needles” sensations
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How is multiple sclerosis diagnosed?
In addition to a review of medical history, several tests and procedures are used to diagnose multiple sclerosis (MS), including:
- Nervous system function tests: These tests check reflexes, balance, coordination, and vision.
- Magnetic resonance imaging (MRI): MRI offers an accurate way of viewing the brain and spinal cord without breaking the skin. MRI can also help track the progression of MS.
- Lumbar puncture (spinal tap): A small sample of spinal fluid can be tested for levels of specific immune system components that may be present in MS.
- Evoked potential tests. These tests check nerve functioning by measuring how quickly messages travel from your spinal cord to other parts of your body.
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What are relapses and remissions?
Relapses, also known as attacks or flares, are times when symptoms of multiple sclerosis (MS) become worse. Relapses may come and go without warning and may last anywhere from a few days to a few weeks at a time. Relapses are usually followed by remissions, which are periods when symptoms become less severe. Many people live a normal, full life during MS remissions.
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What is a pseudoexacerbation?
A pseudoexacerbation is a period of time when multiple sclerosis symptoms become worse. It may look and feel like a relapse. However, a pseudoexacerbation is temporary and does not cause any damage to the body. Most pseudoexacerbations are triggered by exposure to heat or a rise in body temperature.
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What are the types of multiple sclerosis?
There are four different types of multiple sclerosis (MS):
Relapsing-remitting multiple sclerosis (RRMS): This is the most common type, accounting for 85 percent of all MS diagnoses. RRMS is characterized by infrequent relapses followed by remissions that can last for a few months or years. Some individuals go into permanent remission, but most eventually develop secondary-progressive multiple sclerosis.
Secondary-progressive multiple sclerosis (SPMS): Of the all people diagnosed with RRMS, more than 50 percent will develop SPMS within 10 years; 90 percent will develop SPMS within 25 years. Irreversible nerve damage occurs gradually. Relapses and remissions are not clearly separated.
Primary-progressive multiple sclerosis (PPMS): Approximately 10 to 15 percent of MS diagnoses are PPMS. Symptoms and disability worsen over time without any relapses or remissions. In the most severe cases, a person can have a rapid form of MS, leading to death in just a few months. This diagnosis is more common later in life.
Progressive-relapsing multiple sclerosis (PRMS): Only about 5 percent of people with MS have PRMS. Symptoms grow worse from the beginning, and the condition continues to progress in the time between serious relapses.
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How is multiple sclerosis treated?
Major advances have been made in treating multiple sclerosis (MS) and improving the quality of life for people with MS. The primary goals of MS treatment are:
- Slowing the progression of the condition and preventing disability
- Decreasing the frequency and severity of relapses
- Improving recovery from relapses
- Providing relief from symptoms
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What medications are used to treat multiple sclerosis?
Avonex® (interferon beta-1a), Betaseron® (interferon beta-1b), Rebif® (interferon beta-1a), and Copaxone® (glatiramer acetate) are the most common medications used to slow the progression of multiple sclerosis (MS).
Avonex, Betaseron, and Rebif are synthetic interferons. Interferons are usually produced by cells in the body’s immune system to help fight viral infections and regulate the immune system.
Copaxone® (glatiramer acetate) is a medication believed to prevent the immune system from attacking myelin.
Novantrone® (mitoxantrone) reduces disability and the frequency of relapses in several forms of MS. It is the first medication approved for people with secondary-progressive MS.
Tysabri® (natalizumab) is used in relapsing forms of MS to delay the accumulation of physical disability and reduce the frequency of clinical exacerbations. Tysabri increases the risk of a serious brain infection called progressive multifocal leukoencephalopathy (PML) and is therefore generally recommended for people who have not responded to, or who are unable to tolerate, other MS treatments. Due to the risk of PML, Tysabri is only available through a special restricted-distribution program called the TOUCH™ Prescribing Program. In order to receive treatment with Tysabri, people who take this medication, their doctors, and infusion sites must be registered in this program.
Oral and injectable corticosteroids, or steroids, such as prednisone, are frequently used to decrease the severity of MS relapses. Many other medications are used to help eliminate or reduce the severity of MS symptoms. Muscle, bowel and urinary problems, pain, fatigue, depression, and other problems can be eased with medication and other types of therapy.
Many people with MS may take several medications at a time, which might increase the chance of a drug interaction. It is a good idea to get all medications from the same pharmacy, which will allow the pharmacist to check all medications for any possible drug interactions.
Some people sometimes find it difficult to take MS medications as prescribed, often because of side effects, fatigue, depression, or psychological or emotional effects of the disease. Not taking medication as prescribed can cause symptoms to return and may advance the progression of the disease. People having difficulty taking medications should talk to their doctor or pharmacist for guidance.
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What are other ways to manage multiple sclerosis?
In addition to taking medication, there are several ways to manage multiple sclerosis (MS) and its symptoms, including the following:
- Follow a healthy diet
- Get enough rest
- Make time for physical activity
- Find social support
Following a balanced diet that includes eight to 10 glasses of noncaffeinated fluid and 25 to 30 grams of fiber a day can help you feel better and help minimize problems with bladder and bowel problems that are common in MS.
Getting enough rest and setting priorities each day will help you conserve your energy and reduce stress. It’s important to try not to do too much, and plan activities for when you have the most energy. Aim to get seven to eight hours of sleep each night, and talk to your doctor if you are having trouble getting enough sleep.
Physical activity is an important part of managing MS. Cardiovascular activities such as walking, stretching, and range-of-motion exercises such as gentle yoga, can help you feel better. Choose activities you enjoy that are within your abilities. Try to stay cool while exercising by drinking plenty of fluids before, during, and after physical activity. Exercises performed in a cool swimming pool are especially helpful because water supports the body, and cool water reduces heat. Work with your doctor to create a plan for physical activity that works best for you.
Many people with MS can benefit from physical and emotional support from family, friends, and healthcare providers.
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How can I find a support group?
Ask your doctor whether there are any groups in your area. The National Multiple Sclerosis Society (NMSS) can also connect you with local support groups of patients and others who might share your thoughts and concerns about MS. Contact NMSS at 800-FIGHT MS or 800-344-4867, or visit their web site at www.nmss.org.
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How can Walgreens Specialty Pharmacy help?
It is important to find a pharmacy that understands the medications and treatments for multiple sclerosis. Our specially trained pharmacists join your treatment team, working together with your doctor and other healthcare providers, to support their services and help you get the most from your therapy.
To take advantage of Walgreens Specialty Pharmacy’s patient support services, call us toll free at 888-782-8443, or complete our online form.
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Where can I find more information about multiple sclerosis?
The more informed you are, the better you can manage your health. The sites listed below are considered highly reliable.
The National Institute of Neurological Disorders and Stroke
www.ninds.nih.gov
The National Multiple Sclerosis Society
www.nmss.org
Multiple Sclerosis Association of America
www.msassociation.org
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