Multiple Myeloma

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Multiple Sclerosis
Definition
Multiple sclerosis (MS) is a chronic, disabling disease of the central nervous system. The disease causes inflammation, destruction, and scarring of the sheath that covers nerve fibers (called myelin) in the brain and spinal cord. As a result, electrical signals from the brain are slowed or blocked from reaching the eyes, muscles, and other parts of the body.
Causes
Malfunction of the body's immune system seems to be the cause of MS, but the exact cause of this malfunction is not known.
The following conditions may contribute to MS:
• Viral or other infection
• Genetic factors (heredity)
• Environmental factors
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for MS include:
• Sex: female
• Age: 16-40 years old
• Exposure to certain viruses
• Family members who have MS
• Northern European descent, especially Scandinavian
• Growing up in a colder climate, as opposed to a tropical climate
Symptoms
Symptoms may range from mild to severe and may include:
• Numbness or tingling in the legs, arms, face, or extremities
• Impaired vision in one or both eyes, including:
o Blurred vision
o Double vision
o Loss of vision
• Pain around the affected eye
• Fatigue
• Dizziness
• Muscle stiffness
• Muscle spasms
• Muscle weakness
• Poor coordination or falling
• Trouble walking or maintaining balance
• Paralysis in one or more limbs
• Bladder problems including :
o Urgency
o Hesitancy
o Incomplete emptying
o Incontinence
• Bowel problems, including constipation
• Sexual dysfunction
• Slurred speech
• Difficulty swallowing
• Forgetfulness, memory loss, and confusion
• Trouble concentrating or solving problems
• Depression
Factors that may trigger or worsen symptoms include:
• Heat including:
o Hot weather
o Hot baths or showers
o Fever
• Overexertion
• Infection
There are several types of MS:
Relapsing-remitting MS–Symptoms suddenly reappear every few years, last for a few weeks or months, then go back into remission. Symptoms sometimes worsen with each occurrence.
Primary Progressive MS–Symptoms gradually worsen after symptoms first appear. Relapses and remissions usually do not occur.
Secondary Progressive MS–After years of relapses and remissions, symptoms suddenly begin to progressively worsen.
Progressive Relapsing MS–Symptoms gradually worsen after symptoms first appear. One or more relapses may also occur.
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include:
MRI Scan–a test that uses magnetic and radio waves to check for damage to the myelin sheath of the nerves in the brain and spinal cord
Evoked Responses–a test that records the electrical responses evoked in specific nerves after a repeated sensory stimulus
Lumbar Puncture (Spinal tap)–removal of a small amount of fluid from around the spinal cord to check for white blood cells, antibodies, and proteins
Electroencephalogram (EEG)–a test that records the brain's activity by measuring electrical currents through the brain
Treatment
The goals of MS treatment are to relieve symptoms, prevent relapses, and slow disease progression.
Treatments include:
Medications
Medications may include:
• Corticosteroids–to reduce nerve tissue inflammation and shorten MS flare-ups
• Beta interferon–an antiviral agent used to suppress the immune system
• Glatiramer acetate–to help prevent MS relapses by blocking the immune system from attacking myelin
• Other immunosuppressive drugs such as:
o Mitoxantrone
o Azathioprine (off-label treatment option)
o Methotrexate (off-label treatment option)
o Cyclophosphamide (off-label treatment option)
• Immunoglobulin injections
• Natalizumab–for relapsing MS under a mandatory registration program
• Muscle relaxants–to treat muscle spasms or stiffness
• Other drugs to treat:
o Fatigue
o Depression
o Pain
o Bladder or bowel problems
Physical Therapies and Lifestyle Changes
Therapies and changes may include:
• Regular moderate exercise with your doctor's permission (Swimming is especially beneficial.)
• Physical therapy–to help maintain muscle strength and tone, dexterity and walking ability
• Massage
• Healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
• High fiber diet–to prevent constipation problems
• Stress reduction techniques
Psychological Therapies
Individual or group therapy–to learn better coping strategies for physical symptoms and emotional stress
Prevention
There are no guidelines for preventing MS, because the cause is unknown.
To prevent flare-ups or worsening symptoms if you have MS:
• Take medications as prescribed.
• Avoid hot weather.
• Stay in air-conditioned places during periods of hot weather.
• Get adequate rest.
• Get regular, moderate exercise with your doctor's permission.
• Avoid hot showers or baths.
• Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
• Make sure to get enough fiber in your diet.
• Avoid rapid changes in your weight.
• Consider getting regular massages (to aid stress reduction).