Multiple sclerosis (MS) is a chronic neurological
disorder that affects the central nervous system (brain
and spinal cord). The disease process results in inflammation and damage to myelin (insulation for nerve fibers) and other cells within
the nervous system. Because myelin aids the conduction of nerve signals, damage
to myelin results in impaired nerve signaling and may impair normal sensation,
movement, and thinking. This damage occurs in patches that appear as distinct
lesions on magnetic resonance imaging (MRI)—the use of magnetic fields to create detailed images of
the body. The patches cause different symptoms, depending on their location
within the nervous system.
Multiple sclerosis primarily affects adults, with an age of onset typically
between 20 and 50 years, and is more common in women than in men. The cause
of this disorder is not known, but environmental, viral, and genetic factors
are thought to play a role. The January 26, 2005, issue of JAMA includes an article reporting that exposure during early childhood
to infant brothers and sisters is associated with a reduced risk for MS in
later life, possibly due to alterations in immune functions.
Visual disturbances, which may include eye pain, distortion or
loss of vision in one eye, or impairment of color perception
Difficulty walking or performing tasks that require coordination
Loss of sensation
Fatigue and/or weakness
Loss of bowel or bladder control
In addition to a complete medical history and physical examination including
a detailed neurological examination, your doctor may order blood tests and
refer you to a neurologist (a doctor with specialized
training in diseases of the nervous system). Your doctor may also order an
MRI scan of your head and/or spinal cord to look for the characteristic patches
of MS and may perform a lumbar puncture ("spinal
tap")—sampling of the cerebrospinal fluid (the
fluid that surrounds the brain and spinal cord)—to analyze for proteins
associated with the disease.
Currently there is no cure for MS. However, there are treatments available
that may slow its progression and alleviate associated symptoms.
Drug therapies. Medications that target
the body's immune system may decrease the frequency and duration of attacks.
These medications can be used on a long-term basis and also to treat specific
attacks. Additional medications may be prescribed for other symptoms such
as pain or depression.
Additional therapies. Because MS may
affect the patient's ability to perform self-care and other activities of
daily living, treatment may also include referral to specialists for physical
and occupational therapy.
National Institute of Neurological Disorders and Stroke 800/352-9424 http://www.ninds.nih.gov
American Neurological Association 952/545-6284 http://www.aneuroa.org
National Multiple Sclerosis Society 800/344-4867 http://www.nationalmssociety.org
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com.
Source: National Institute of Neurological Disorders and Stroke
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TOPIC: NEUROLOGICAL DISORDERS
Ringold S, Lynm C, Glass RM. Multiple Sclerosis. JAMA. 2005;293(4):514. doi:10.1001/jama.293.4.514