More is being learned about multiple sclerosis and how to better diagnose and treat the disease that affects over 350,000 people in the United States. Multiple sclerosis, a disease of the central nervous system, involves the nerves of the spinal cord and brain. Multiple sclerosis symptoms, whether mild or severe, can include loss of muscle control or coordination. The disease affects each patient differently.
What is Multiple Sclerosis?
Multiple sclerosis is a chronic, sometimes disabling disease of the central nervous system. Multiple sclerosis symptoms range from mild ones — such as slight numbness of the limbs — to the more severe, such as loss of vision and paralysis.
The causes of multiple sclerosis is not yet known but scientists theorize that it is the result of a virus or autoimmune condition in which the body becomes allergic to itself.
In people with multiple sclerosis, malfunctioning T-cells (immune system cells that patrol the body for invaders) mistakenly attack the protective covering of nerve cells and expose bundles of long nerve fibers. That damage makes it difficult for the brain to transmit messages. Damage can result in various symptoms of the disease, depending on where in the central nervous system it occurs.
Multiple Sclerosis Symptoms:
- Vision impairment
- Tingling and numbness of the skin and limbs
- Loss of coordination
- Difficulty with walking
- Weakness and exhaustion
- Stiff muscles
- Memory loss
- Dizziness
- Depression
Patients with multiple sclerosis can go into remission, experiencing none of the typical symptoms of multiple sclerosis, and function normally for long periods of time. Other patients continually experience symptoms in varying degrees. Multiple sclerosis is not a fatal disease but its symptoms can greatly impact the person's quality of life.
Who is at Risk?
Considered a lifelong disorder, the disease most often strikes between the ages of 20 and 30 and affects women twice as many times as men. Between 20 and 35 percent of all patients have a mild form of the disease and experience few, if any, symptoms. Another three to 12 percent of the patients have rapidly progressive multiple sclerosis while the majority of patients are somewhere in between the two extremes.
You are at higher risk for multiple sclerosis if:
- You are a woman
- You are white and of northern European descent, Scottish in particular
Although not considered a hereditary disease, a family history of multiple sclerosis may make you more susceptible to the illness.
Multiple Sclerosis Diagnosis
Diagnosis of multiple sclerosis can be difficult because the symptoms of the disease can be very mild or non-existent and are similar to those of many other diseases. Multiple sclerosis diagnosis is often done through a review of the patient's health history, a physical evaluation and various laboratory tests.
Multiple Sclerosis Treatments
Multiple sclerosis treatments can include medications, chemotherapy or even a new MRI devoted to neurological imaging. There are approved drugs for multiple sclerosis treatment. Generally speaking, most physicians prescribe steroid medications to patients with multiple sclerosis to reduce the inflammation of the nerve tissue. For certain patients, chemotherapy can be used as a treatment to interfere with the immune system that is attacking itself. New horizons in multiple sclerosis treatments and research advances are being made as research efforts reveal more information about multiple sclerosis.
An exciting development in the area of multiple sclerosis treatment is the use of magnetic resonance imaging (MRI) for the neurological imaging of the disease.
A new MRI, devoted primarily to the neurological imaging of multiple sclerosis patients, was recently installed at the Center for Neurological Imaging — a joint venture between the Radiology and Neurology Departments of Brigham and Women's Hospital and a part of the Partners Multiple Sclerosis Center. Unlike many medical centers using two-dimensional imaging, the physicians are using three-dimensional imaging that goes beyond determining whether a patient's condition is worsening.
Three-dimensional imaging, which is created by stacking two-dimensional images, allows physicians to actually measure the volume of a multiple sclerosis lesion or damaged area to determine if it is growing and at what rate. This will lead to more successful strategies for measuring the progression of the disease and its treatment.
Other Brigham and Women's Hospital Research Includes:
- Trying to find elements, called markers, in the blood that indicate multiple sclerosis is becoming active. Discovering the marker in a common blood test will enable physicians to diagnose and treat the disease in its earliest stages.
- The commonly used medications for multiple sclerosis are self-injected drugs. Because many patients find this difficult to do for the long-term, or at all, many skip doses and find it hard to stay with the treatment program. Researchers are now testing oral versions of the medications that, if proven to be effective, will make it easier for patients to take their medicine and get the proper treatment.
- Researchers will be conducting upcoming trials on medications designed to control the malfunctioning T-cells that attack the covering of the nerve fibers resulting in multiple sclerosis. Medications that can control the T-cells will stop the development of the disease.
Over the last five to 10 years there have been major advancements in the care of patients with multiple sclerosis. Research into better diagnosis and treatment of the disease will continue as well as working toward a cure.
Howard Weiner, MD is a neurologist and Director of the Partners Multiple Sclerosis Center, a joint collaboration between Brigham and Women's Hospital and Massachusetts General Hospital.
If you have questions about multiple sclerosis, speak with your doctor.
If you need a new primary care physician, call our referral coordinators at 1-800-BWH-9999 between 8 a.m. and 5 p.m., Monday through Friday, for our free guides to primary care physicians.
Multiple Sclerosis Center: Leading the Way in Treatment and Research
The Partners Multiple Sclerosis Center is a leader in its field with advancements in such areas as genome research and the development of new medications.
"The creation of this kind of Center is unique. This is probably the most advanced Multiple Sclerosis Center in the world," says neurologist Howard Weiner, MD, Director of the Partners Multiple Sclerosis Center.
Weiner explains, "We have the clinical treatment center that includes an on-site infusion program where patients receive intravenous drug therapy. The immunology laboratories perform multiple-sclerosis blood tests and are involved in developing new tests that will detect multiple sclerosis activity. The neurological imaging section will use MRI to track the disease."
The Center has just begun a new long-term study to observe the natural progression of multiple sclerosis.
"Similar to the Nurses' Health Study and the Framingham Heart Study, it is a major effort that will observe 1,000 patients over the next 10 to 20 years," Weiner says.
"This is a crucial juncture — we are starting a new era in research and learning more about multiple sclerosis."
The Multiple Sclerosis Center is located at Brigham and Women's Hospital. If you would like to schedule an appointment, call 1-800-BWH-9999.
