Multiple sclerosis

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Overview

Multiple sclerosis (MS) is a chronic autoimmune, inflammatory neurological disease of the central nervous system (CNS). MS attacks the myelinated axons in the CNS, destroying the myelin and the axons to varying degrees.

The course of MS is highly varied and unpredictable. In most patients, the disease is characterized initially by episodes of reversible neurological deficits, which is often followed by progressive neurological deterioration over time.

From 250,000 to 350,000 patients in the U.S. have MS, and 50% of patients will need help walking within 15 years after the onset of the disease.

Twice as many women are affected as men, and persons of Northern European descent appear to be at highest risk for MS.2,7 The disease is diagnosed on the basis of clinical findings and supporting evidence from ancillary tests, such as magnetic resonance imaging (MRI) of the brain and examination of the cerebrospinal fluid (CSF). MS typically presents in adults 20 to 45 years of age; occasionally, it presents in childhood or late middle age.


Symptoms

fatigue.

vision problems.

numbness and tingling.

muscle spasms, stiffness and weakness.

mobility problems.

pain.

problems with thinking, learning and planning.

Causes

The cause of multiple sclerosis is unknown. It's considered an autoimmune disease in which the body's immune system attacks its own tissues. In the case of MS, this immune system malfunction destroys the fatty substance that coats and protects nerve fibers in the brain and spinal cord (myelin).

Myelin can be compared to the insulation coating on electrical wires. When the protective myelin is damaged and the nerve fiber is exposed, the messages that travel along that nerve fiber may be slowed or blocked.

It isn't clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible.

Risk factors

These factors may increase your risk of developing multiple sclerosis:

Age. MS can occur at any age, but onset usually occurs around 20 and 40 years of age. However, younger and older people can be affected.

Sex. Women are more than two to three times as likely as men are to have relapsing-remitting MS.

Family history. If one of your parents or siblings has had MS, you are at higher risk of developing the disease.

Certain infections. A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis.

Race. White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.

Climate. MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe.

Vitamin D. Having low levels of vitamin D and low exposure to sunlight is associated with a greater risk of MS.

Certain autoimmune diseases. You have a slightly higher risk of developing MS if you have other autoimmune disorders such as thyroid disease, pernicious anemia, psoriasis, type 1 diabetes or inflammatory bowel disease.

Smoking. Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS.

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Complications

Muscle stiffness or spasms.

Paralysis, typically in the legs.

Problems with bladder, bowel or sexual function.

Mental changes, such as forgetfulness or mood swings.

Depression.

Epilepsy.

Prevention

Quit smoking.

Get adequate sun exposure and supplement with vitamin D (5,000 IU per day in winter)

Eat a healthy diet low in saturated fat, and supplement with flaxseed oil.

Keep your stress levels down and exercise regularly.