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NEWS ON MS
Sunday May 20, 2001
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Taken from the Parade, Beaumont Enterprise
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New Relief For Multiple Sclerosis
. .. By Dr. Isadore Rosenfeld
When Your Nerves Can't 'Communicate'
Multiple Sclerosis (MS)
is a leading cause of chronic
neurological disability in young adults,
striking one in every 1000.
Symptoms ages 20 and 50.
It's more common in women than men
and seems to run in families.
Every week, 200 new cases are diagnosed in the U.S.
. ..
Symptoms vary widely
Thanks to new treatments. MS does not
shorten life, though it dramatically effects it's quality. In advanced cases, the disorder can be disabling. A patient
may experience decreased sexual activity,
loss of boel and bladder control, and/or impairment of vision, balance,
coordination and mobility. Even so, 75% of MS patients remain ambulatory for life (with or without assisting devices).
Mental faculties typically remain intact.
. ...Why
so many different symptons?
Normally, your nerve fibers are wraped in a sheath of fatty material called myelin.
which covers and protects them (like the insulation on electracal wires) and enables the nerve to trnsmit impulses
speedily and smoothy to the rest
of the body. In MS. The body's defense mechanisms, particularly the T cells
of the
immune system, randomly attack and destroy the myelin on nerves
in the brain and spinal cord. Denuded, these nerves no
longer can send
messages normally.
. ...
Because
of the hit-or-miss involvement of nerves,the nature and severity of
symptoms depend on which areas of the nervous system
are involved.
The symptoms of MS can wax and wane unperdictably in a person. Some of my patients have had only a few
"crises" years apart, and lead virtually normal lives; some require wheelchairs.
Diagnosing MS
. ..The diagnosis of MS is difficult
because many of it's symptoms can be associated with other conditions. A careful neurological exam may reveal other
findings, such as a delayed response to visual test-stimuli. Analysis of the spinal fluid may reveal increased amounts
of protein, a sign that the myelin is breaking down. An MRI often is abnormal.
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Treatment
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There is nothing you can do to prevent MS or cure it--but patients
learn how to relieve their symptoms and to avoid anything that aggravates them.
For example, heat usually makes
matters worse. As high temperatures further slow the conduction of electrical impulses in the deseased nerves. Cold,
however, increases the velocity of impulses, so MS patients often exercise in cold water. Physical therapy and exercise
can maintain muscle strength and improve coordination, while occupational therapy helps patients cope with such daily
chores as dressing, eating and getting to work.
Medication
. ..Drugs for MS patients have two main goals: to relieve symptoms and to slow
down the progression of the disease. At present, the former are more effective. Here are some leading drugs in both
categories--but watch out for side effects.
To Relieve Symptoms
*Fatigue=amantadine (Symmetrel): pemoline (Cylert).
*Painful muscle spasms and stiffness=baclofen (Lioresal): tizanidine
(Zanaflex).
*Bladder weakness=Ditopan or Detrol.
*
Constipation=First try a bulk laxative, such as Metamucil. If that doesn't work, try
Dulcolax or Milk of Magnesia.
*Facial pain=carbamazepine (Tegretol),
phenytoin (Dilantin), amitriptyline (Elavil) and gabapentin (eurotin). If the pain persists and makes chewing difficult,
the nerves can be blocked surgically.
To slow the progress of the
disease
*Beta interferon la (Avonex) and
lb(Betaseron)=primary choices for cases that continually remit and relaps. They are belived to regulate the
immune system.
*Glatiramer (Copaxone)=another new agent with few
side effects.
*Mitoxantrone (Novatrone)=an immune-suppressing drug
given intravenously when symptoms worsen.
Research on MS is so rapid that every patient should stay in touch with a
specialist so as to receive the latest approved therapy. You also can call the National Multiple Sclerosis Society at
1-800-344-1867 or click on their logo at the top right of this page.
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