Category Archives: About MS
How Multiple Sclerosis Can Affect Your Cognition
Since the central nervous system (CNS) is the center of multiple sclerosis attack, it is inevitable that the patient’s cognitive ability is also affected; although, this aspect was not recognized in the past. But recent surveys show that of those people suffering from multiple sclerosis, about 60 percent experiences mild cognitive problems; others may have mild to moderate temporary impairment, and the rest develop a more serious cognitive condition.
Specifically, cognitive abnormalities manifest in the patient’s inability to retain attention and concentration; impaired memory, especially of recent events; decreased speed on information processing; difficulty in abstract reasoning, problem-solving, and executive functions; impaired visual-spatial abilities, and; difficulty with verbal fluency, which makes it laborious for them to find the appropriate words to communicate. MS sufferers who used to have good memories may now have difficulties remembering appointments and other events. Those who have relatively mild cognitive problems are conscious about their situation. But those who have severe cognitive condition or “cerebral MS”, usually lose their insight into the problem. They often encounter difficulties in planning and problem-solving that usually leave them inflexible to generate alternative solutions. But they are often unaware of this situation. Because of this, those with cerebral MS may have a hard time comprehending the impact of their behavior on other people. Mood disorders are also a common occurrence among MS sufferers.
Since people with multiple sclerosis have different levels of cognitive changes, it is important to deal with them with love and patience. Family, friends, and care providers have crucial roles in helping the MS sufferer minimize his cognitive problems. To better understand and adjust to these people, it is advisable to first identify and gauge their level of difficulties by testing. This is done by a speech pathologist or by a neuropsychologist. In addition, there are certain techniques that can help alleviate their situation and manage their cognitive problems. Besides, cognitive problems due to multiple sclerosis do not worsen over time.
Make a list and calendar of appointments. Since an MS sufferer has problems with his memory, it is very helpful to prepare lists of things to do, shopping, appointments, and other important events.
Memory notebook. This is necessary in keeping track with daily events, reminders, and messages of family and friends. The MS sufferer may get a loose-leaf or an electronic personal organizer that he can carry wherever he may go.
Recorder. A tape recorder can be of great help to remind the MS sufferer of his activities.
Simple directions. It is also helpful to ask people to keep directions simple for easy memory retention.
Repeat information. Aside from asking for simple direction, it can also be helpful to repeat information given and write down important points during discussion.
Stay calm. In the event when memory fails, it is best to take a few minutes to calm down before proceeding with any activity or conversation.
Organize. One of the best things to do is to avoid a cluttered environment. It is very helpful to organize and arrange things to maintain a familiar setting. For example, an MS sufferer, with the help of family or care provider, may set a particular place for storing frequently used things, like wrist watch, mobile phones, car keys, and other important items.
Conducive setting. To help the MS sufferer concentrate and maintain focus, it is advisable to engage them in conversation in a quiet place to avoid environmental distractions.
Eye contact. Remember to establish good eye contact during conversation.
More techniques can be learned as one goes along the journey with a multiple sclerosis patient having cognitive problems.
Common Problems Related to Multiple Sclerosis
Since multiple sclerosis’ primary targets are the brain, spinal cord, and the optic nerves, it is not surprising that problems consequently arise from those parts of the body that are directly or essentially linked with these vital organs. Once the damage blocks the signals from traveling between the brain and the others parts of the body, MS symptoms start to manifest, hitting multiple sites, wherever nerve loss occurs. Symptoms may come in the form of slurred speech, numbness, blurred vision, poor sense of balance, loss of coordination, tremors, impaired memory, and concentration. However, no two people develop exactly the same MS symptoms. Some of them may experience all of the aforementioned symptoms; others may only have a few; while there are also those who do not show any of the symptoms, at all.
Particularly, the cognitive ability of the person is one of the most heavily affected. In fact, statistics reveal that of the multiple sclerosis sufferers, there are approximately 60 percent who experience mild cognitive problems, while others may have either mild to moderate temporary impairment. But only about 10 percent of whom may develop into a more serious cognitive problem. Nevertheless, cognitive alterations may be as devastating, or even worse, than physical alterations. The most common cognitive problems that an MS sufferer experiences include: impaired memory; decreased speed on information processing; inability to retain attention and concentration; difficulty in abstract reasoning, problem-solving, and executive functions; impaired visual perceptual skills, difficulty with verbal fluency, and general intelligence.
Impaired memory. Once affected by multiple sclerosis, individuals who used to have good memory may now find themselves forgetting appointments and recent events.
Decreased speed on information processing. MS sufferers may now need considerable time, or even repetition of messages, in keeping up with incoming information, as their ability to process them has remarkably weakened.
Inability to retain attention and concentration. MS sufferers now get easily distracted by interruptions or competing stimuli, and they can hardly focus on anything; thus, finding it tedious to multi-task.
Difficulty in abstract reasoning, problem-solving, and executive functions. Individuals who used to be highly-organized and endowed with problem-solving skills may now be caught in a dilemma about planning and trouble-shooting issues, as they can no longer generate alternative solutions. They lose their mental agility to move from one concept to the next. Unfortunately, they are not even aware of this situation.
Impaired visual perceptual skills. They usually lose, or lessen, their sense of direction and orientation of space. These problems prevent them to effectively do their usual routine like driving, or reading a map, for example.
Difficulty with verbal fluency. Affected individuals may now find it difficult to find the appropriate words to say during conversation as their speech has slowed.
General intelligence. Literally, this particular aspect is usually not affected. But since the individual functions that comprise general intelligence, such as memory, reasoning, and perceptual skills, have weakened, the risk of getting lower intelligence quotient, or IQ, becomes high in the long run.
Moreover, aside from cognitive alterations, multiple sclerosis sufferers may also experience physical changes, such as: fatigue, bladder/bowel problems, urinary tract infection, constipation, pain, and muscles problems.
Having a loved one or family member with multiple sclerosis could be a challenging matter, and this is where the humanitarian aspect in everyone should prevail; meaning adjustments have to be made. It is important to deal with MS sufferers with love and patience. Recognizing and learning to adapt to certain impairments can largely lessen misunderstanding about a member’s carelessness, seeming indifference, inattention, and forgetfulness. It could also be helpful to build an open communication among family members, including the affected individual, so everyone may be able to adjust accordingly.
The Attack of Multiple Sclerosis
To get a deeper understanding about the inflammatory disease that is called multiple sclerosis, or MS, it is important to have a general idea of how the central of nervous system works.
Central nervous system (CNS) is a composite term for the brain, spinal cord, and the optic nerve; although the latter is often not mentioned in most definitions. CNS is further composed of two specialized cells, namely, the neurons and the glia. The billions of nerve cells called neurons are responsible for the basic information processing and communication of the CNS; while glial cells, or neuroglia, serve as the support structure for the neurons. Among the many functions of glia include holding the neurons in place, providing them nutrition, facilitate in the maintenance of homeostasis, and participating in signal transmission in the nervous system.
Furthermore, CNS is composed of two different regions, namely: the grey matter, and the white matter. Grey matter, also known as cerebral cortex, refers to the outer layer of human brain. It is formed by the closely packed neuron cell bodies, and contains the specialized regions inside the brain that are responsible for the muscle control and sensory perceptions. While white matter, on the other hand, refers to the neuronal tissue that contains the myelinated axons. Also known as diencephalon, white matter is located between the cerebellum and brainstem, and is responsible for relaying sensory messages from any of the body part to cerebral cortex, and in controlling the unconscious functions like body temperature, blood pressure, and heart rate. There are also particular cores of white matter that are responsible for the human emotion expression, the releasing of pituitary gland hormones, and water and food intake coordination.
Central nervous system (CNS) is the center of attack of multiple sclerosis (MS), a chronic and debilitating condition that has affected more than 2.5 million people worldwide. MS is particularly an inflammatory disease that usually affects the white matter tissue, upon which patches of damage known as plaques or lesions encroach; and, where there are patches, myelin is lost. Myelin is that fatty substance that encloses and protects the nerve fibers of the CNS. The type and severity of MS symptoms depend largely on which areas it encroaches. Its symptoms may range from as mild as numbness in the limbs, to severe, which may lead to paralysis and/or loss of vision.
One of the most salient characteristics of MS is that no two people get it in the same way, and its progress, severity, and specific symptoms have varying degrees. Doctors find it difficult to diagnose multiple sclerosis because of certain factors, namely: the disease displays numerous MS symptoms that elicit different reactions from its patients; many, if not most, of the symptoms imitate conditions that are typical of other ailments; no blood test for multiple sclerosis, and; intermittent occurrence of symptoms at an unpredictable course. Besides, many of its symptoms are ambiguous and difficult to measure, specifically fatigue, erectile dysfunction, depression, and cognitive issues.
Multiple sclerosis is, indeed, an individual disease; hence, it is counterproductive to compare the case of one patient with another. What is important, rather, is to provide full support to the sufferer in whatever way possible. After all, it could be a family member or a loved that needs such support.
Profile: Multiple Sclerosis
Multiple Sclerosis, or MS, is the most common autoimmune disease that affects the central nervous system, which causes are yet to be known even as researchers and scientists carry on their quest for solutions. It is not a contagious disease, and treatments to delay its progression are readily available.
Although multiple sclerosis (MS) can affect other populations, people living outside the 40-degree mark north or south of the equator are more prone to the disease than those living in warmer climates, maybe because of their reduced vitamin D levels and/or less exposure to the sun. The disease usually begins to show signs and symptoms around the age of 20 up to the age of 50, affecting mostly women at twice the rate of men. Although scientists have seen multiple sclerosis cases among young children and the elderly, they claimed that they have not yet encountered symptoms among people below 15 years old or above age 60. Experts have also found that women possess a higher level of protein known as the interferon gamma, which could possibly explain why they are more prone to multiple sclerosis (MS). In addition, the disease has a genetic component. Having a father or mother who contracted MS runs a 3 to 5 percent risk of acquiring the same disease; while having an identical twin raises the risk to 30 percent.
Multiple Sclerosis (MS) Symptoms:
The multiple sclerosis (MS) symptoms are so numerous, but the more salient ones include: numbness and tingling sensation; vision problems or optic neuritis; loss of coordination; fatigue; dizziness; bowel and bladder dysfunction; alteration in sexual ability or erectile dysfunction; depression; emotional changes, and; muscle tremors. There are also other MS symptoms that seldom occur, such as: headaches, difficulty in swallowing, problem with breathing, speech deficiency, seizures, loss of hearing, and itching.
Diagnosing multiple sclerosis (MS)
Diagnosing multiple sclerosis (MS), therefore, is very difficult, and practitioners cite some reasons, like:
- It exhibits numerous symptoms, and every patient reacts differently to each symptom. Some patients may start with only a single symptom followed by a period without progression; while others may demonstrate multiple symptoms all at the same time;
- Many of the symptoms imitate conditions that are characteristics of other ailments;
- There has been no blood test for multiple sclerosis;
- Symptoms occur intermittently and follows an unpredictable course;
- Many symptoms are vague and difficult to gauge, such as fatigue, erectile dysfunction, depression, and cognitive problems, and which general practitioners may attribute to stress; hence, patients may never get to be referred to a specialist.
Nevertheless, experts were able to lay down some accepted criteria for making diagnosis, albeit imperfect, such as:
- Multiple Sclerosis commonly starts between 20 and 50 years old;
- Multiple Sclerosis symptoms and signs that indicate disease of the brain or spinal cord;
- Evidence of two or more lesions in the brain;
- Objective evidence of disease of the brain or spinal cord upon doctor’s examination;
- Two or more episodes that last at least 24 hours, and occur at least one month apart, and;
- No other explanation for the symptoms
Multiple Sclerosis (MS) is an individual disease, and therefore, it is pointless to compare cases of one patient with another.
History of Multiple Sclerosis
Multiple Sclerosis (MS)
Multiple Sclerosis (MS) had already existed even during the Middle Ages when some writings were found containing a record about a patient who succumbed to “excruciating pain, blinding headaches, problems walking and paralysis”, descriptions which, doctors of the present believe, point to what is now called Multiple Sclerosis. The description did not have a name then, but a Dutch saint named Lidwina, who got worse after a fall and experienced remissions and eventually died in 1433, must have been one of the earliest sufferers of the disease. Another probable victim of the similarly unnamed disease was a grandson of King George III, who described his conditions in a diary he kept until his death in 1848.
It was in 1868 when the Multiple Sclerosis condition was identified as a disease. Dr. Jean-Martin Charcot, a professor of neurology at the University of Paris, who has been referred to as “the father of neurology” recorded as he examined a female young patient with this unusual combination of symptoms of the disease: she exhibited tremors he had never seen and other neurological conditions like slurred speech and abnormal eye movements. He tried several applications typical of neurological disorders on her, but failed. Thus, when the patient eventually died, he opened her brain and there discovered brain lesions, the characteristic scars or “plaques” of multiple sclerosis. Because of this findings, Dr. Charcot then called the disease sclerose en plaques.
Multiple Sclerosis was recognized as a specific disease in England by Dr. Moxon in 1873, and in the United States by Dr. Edward Seguin in 1878. Since then, the world came to learn much about multiple sclerosis. It specifically exhibited its salient characteristics, such as: that multiple sclerosis affects more women than men; that it is not a hereditary disease, and; that it is capable of generating many neurological symptoms.
In 1878, Dr. Loius-Antoine Ranvier, French pathologist and anatomist, discovered myelin sheath, although its significance was yet to be known.
In 1916, when doctors thought that multiple sclerosis was caused by a toxin or virus that entered into the brain through the bloodstream, Dr. James Dawson of the University of Edinburgh did a microscopic study on the brains of dead MS patients and was able to describe distinctly the inflammation around the blood vessels and the damage to myelin. n
In 1919, an abnormality in spinal fluid was discovered, but then again, its significance remained unknown.
Amid the disorder of World War II, the scientific community continued to search for cure of multiple sclerosis, that in 1943, the actual composition of myelin was determined.
In 1947, when doctors postulated on the findings that multiple sclerosis was due to blood flow problems, and as they were trying to stimulate circulation for treatment, a researcher at Columbia University discovered that MS patients had bizarre protein by-products in their cerebrospinal fluid. This eventually ushered to the present’s MS testing.
It was in 1960s when multiple sclerosis was declared an autoimmune disease which, in the following decade, ushered to a discovery of steroids to treat Multiple Sclerosis (MS) attacks. It was also during this period that scientists developed the first disease-defying agent.
Although, science has already accomplished much, since the Middle Ages, to find solutions to the problems of multiple sclerosis, studies still continue to discover a cure that would totally eradicated the disease. Let us just hope that with new technologies we may see victory soon.
Multiple Sclerosis and Pregnancy
It is common knowledge that Multiple Sclerosis (MS) is a debilitating disease which affects the victim’s spinal cord, brain and also optic nerves which attributes to muscular weakness, the loss of coordination’s, and also visual disturbances and speeches to the sufferer. Because of this fact, women who have Multiple Sclerosis (MS) disease may get confused and develop some sort of apprehension about getting pregnant. Perhaps, they may have thought about the impact multiple sclerosis (MS) brings on their foetus or babies later. They could not be blamed for harbouring such fear because having a baby is a very important event in a woman’s life. Besides, it had been a common belief before 1950 when women with multiple sclerosis were advised not to get pregnant because it might worsen their condition.
Therefore, it is important to give light to this issue.
First of all, women with Multiple Sclerosis (MS) should be at peace at the fact that there has been no evidence recorded so far about multiple sclerosis impairing fertility, or causing spontaneous abortions, stillbirths and baby abnormalities. Secondly, the belief that had been circulating before 1950 has already been reversed after hundreds of studies revealed that there is no proof to the idea that pregnancy worsens multiple sclerosis conditions. Many studies conducted over the decades have proven that multiple sclerosis does not adversely affect pregnancy, labour, nor in child birth. In fact, doctors have observed that symptoms or relapses of the disease seem to stabilize during the course of pregnancy until childbirth.
It is only after the baby is born, however, when the situation reverses as Multiple Sclerosis (MS) exacerbation occurs. Most of the women are likely to deal with a 20 to 40 percent risk of relapses during the first six months after childbirth. But these relapses are not responsible for, nor serve as contributing factors to, the long-term MS disability. At any rate, it is recommended that women with Multiple Sclerosis (MS) need to map out plans regarding who will take care of the baby, or bring them to the hospital during the post-partum relapse periods.
The temporary improvement or stability during pregnancy is thought to have been due to the hormonal changes during pregnancy. Specifically, prolactin, a hormone of lactation produced by the pituitary glands, which abounds in the course of pregnancy is said to be responsible for such improvement. Scientists believe that prolactin helps the body in the reconstruction of myelin, or the white fatty material that serves as a protective sheath around the nerve fibres in the brain and spinal cord, that has been damaged during regressions. You may be interested in checking out what are some of the MS symptoms.
Women who have been taking medications for Multiple Sclerosis (MS) need to be aware that some of these drugs might be harmful to the foetus or may cause birth defects when taken during pregnancy and breast feeding. That is why they have to consult with their respective physicians when considering pregnancy. Particular drugs that have been identified to be harmful, include: prednisone, corticotrophin, azathioprine, cyclophosphamide, diazepam, phenytoin, carbamazepine, and baclofen.
Another good news is that pregnant women with Multiple Sclerosis (MS) now have a decreasing chance of caesarean deliveries, no more likely to experience pre-eclampsia and other high blood pressure conditions, premature rupture of membranes, and having babies with poor prenatal growth rate. In other words, they can now enjoy pregnancy like other women who do not have the Multiple Sclerosis (MS) disease.
Types of Multiple Sclerosis (MS)
What are the types of Multiple Sclerosis
Multiple Sclerosis is a life-long and individual disease, which cause is yet to be known. However, studies have shown and classified its types as Relapsing Remitting Multiple Sclerosis, Secondary Progressive MS, Primary Progressive Multiple Sclerosis, and Progressive Relapsing MS.
Relapsing Remitting Multiple Sclerosis (RRMS). This is the most common types of MS with which patients are initially diagnosed. Here, the patient usually suffers an attack, or series of attacks called exacerbations followed by complete or partial remissions. Relapses are very unpredictable because its occurrences are intermittent and can be mild or severe; and recovery can also either be instantaneous or gradual. It is in the relapse stage that new symptoms may re-appear and then old ones will resurface or possibly worsen, and the disease becomes very active and residual damage may occur to the nerves. After a relapse comes, remission period, during of which the time patient may either seem to show 100 percent recovery, or only partial recovery. A little over 80 percent of MS sufferers begin with the Relapsing Remitting MS type.
Secondary Progressive Multiple Sclerosis (SPMS). After having experienced RRMS, about 90 percent of the sufferers progress into this stage where remissions are characterized by gradual deterioration in the nerve function with or without relapses. If ever relapses occur the MS worsens until the central nervous system is completely affected. Beside from some remissions following relapsing episode, no actual recovery is expected from this type. However, many sufferers of SPMS can still live fairly normal lives because progression is not sudden.
Primary Progressive Multiple Sclerosis (PPMS). This type of MS may be difficult to diagnose since it is not preceded by any attack. PPMS is characterized by steady progression and worsening of the specific disease with no distinct periods of remission at all. However there could be temporary periods when the disease tends to level off and give minor relief to the patient, but the course of the disease continually declines. Affecting mostly men in their late thirties and or around early forties, the disease primarily attacks spinal cord which then causes walking difficulties in about 85 percent of sufferers. From the spinal cord, the disease then moves toward the brain, although patients are unlikely to have cognitive problems associated with damage to the brain.
Progressive Relapsing Multiple Sclerosis (PRMS). Roughly 5 percent of MS sufferers have this rarer form of multiple sclerosis, which is characterized by acute attacks with little recovery during few relapses. Immediately after a relapse, a significant recovery occurs, but in between relapses there is a gradual worsening of symptoms. The relapses, however, do not represent recovery of the central nervous system, but it simply serves as a break prior to more significant attacks. Unlike the Primary Progressive Multiple Sclerosis, this type of MS does not level off.
Aside from the above mentioned four types of Multiple Sclerosis, there are also the so-called sub-types or other terms used to explain MS, such as:
Benign Multple Sclerosis. The term benign can be misleading as it implies that the impact of the disease is slight. Benign MS is actually a small group within the group of the Relapsing Remitting MS whose sufferers may have had the disease for so many years and during that period doesn’t pick up serious or enduring disability. Patients who have this type show little or no progression after the initial attack and may seem to remain fully functional, but they can experience cognitive dysfunction, short-term memory problems and may also show clinical evidence of brain or spinal atrophy. Benign MS can be as disabling as any other. Statistics revealed that of the 20 percent of patients initially diagnosed with Benign MS, only 5 percent actually fall into this category.
Malignant Multiple Sclerosis, which is medically known as Marburg’s Variant and Acute Multiple Sclerosis, is an extremely rare yet aggressive form of MS characterized by very rapid and relentless decline to significant disability in a short period or even death.
Chronic Progressive Multiple Sclerosis is a term no longer recognized but was used by physicians to lumped together Primary Progressive and Secondary Progressive or Progressive Relapsing MS.
Devic’s Disease, which is known also as Neuromyelitis Optica, is normally relate to a condition of multiple sclerosis. It is also characterized by an strike to the Optic Neuritis on both eyes which then followed by a acute inflammation the spinal cord.
Balo’s concentric sclerosisis another extremely rare disease more common in China and the Philippines than elsewhere. It appears like multiple sclerosis, although medically, it is difficult to distinguish between the two.
The types of Multiple Sclerosis (MS) mentioned above will affect people if different way and you might need to learn what are the ms symptoms.
Oral MS Medication
Canberra – The Health Ministry slashes down price of Gilenya, a multiple sclerosis oral treatment, effective Thursday. This was taken from The West newspaper in Australia.
Health Minister Nicola Roxon made the announcement amid speculations from MS lobby groups that its inclusion to the Pharmaceutical Benefits Scheme (PBS) could be deferred by the Federal Government, whose policy is to cut budget on new drugs. After the price reduction, Gilenya tablet will now cost $34 a script for a month-long course under PBS. The MS drug costs about $30,000 a year, and was more expensive than the other treatments for multiple sclerosis.
The move to reduce Gilenya’s price is hailed by multiple sclerosis patients who have had to bear the agony of constant injections as often as daily in the hospitals.
“A tablet is a hell of a lot easier than having a needle every second night,”
Fremantle architect Asher Galvin, 32, who was diagnosed with remitting relapsing multiple sclerosis three years ago said. Galvin has taken the drug for two months in a trial paid for by the drug’s maker, Novartis.
“Overall, my energy levels have increased and I don’t feel as drowsy in the morning,” Galvin added.
Gilenya has produced the first oral multiple sclerosis medication on PBS in which after several trials demonstrated that the pill, when taken on daily basis, will and can gradually reduce the progress of the multiple sclerosis disease and able to cut its relapse rates.
Earlier, British authorities, deterred by Gilenya’s high price, decided against making it available in the market because they did not believe it was a cost-effective medicine.
Meanwhile, Erbitux, the drug used to treat metastatic colorectal cancer, will soon be added to the PBS after late-stage bowel cancer patient groups lobbied for it. The unsubsidized cost of the drug is about $30,000 a year.
