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11 Comments Posted on Multiple Sclerosis

Multiple Sclerosis – What do you think causes Multiple Sclerosis? Have you say here!

Prevalence of multiple sclerosis

Over the last few years we have covered the symptoms and treatments of multiple sclerosis in some detail.

Today we would like to turn our attention to the causes of multiple sclerosis and more specifically what you think are the causes of MS?

To that end we have set up a poll looking a some of the possible causes. Please choose which you consider to be the causes. You can select more than one.

Many thanks in advance!


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Maygrelle When I was a kid, our dog had a litter of puppies.  There were four of us kids and four puppies.  Until the pups went to their new homes, each of us kids got to claim and care for a puppy.  After my puppy was sold, she came down with an unidentified illness that caused neurological symptoms.  Her owner wrote to us detailing her symptoms.  She eventually lost the use of her hind legs and was put down.  Twenty years later, my sister and I were diagnosed with MS.  After another 15 years, a 3rd sister is being evaluated for MS.  Of the 3 of us, I, the one who spent the most time with that puppy, have by far the most serious course of the disease.  I can’t help but think that whatever caused that dog to become ill might also be behind multiple sclerosis.  I know that researchers have looked at, and ruled out, canine distemper.  It’s not so far fetched to think that another canine virus might be to blame.
Rebecca2501 I think I have always had it and the symptoms became more apparent after the trauma of the birth of my first child.
Cheryl12750 I feel that I was born with MS. It just took until I was 24 to be diagnosed. That was over 40years ago.
BethWelchOkonczak The predisposition of development of MS is within the HERV-W, a dormant retrovirus that has been embedded in between the 6th and 7th chromosome in human DNA since before we were humans. This retrovirus is activated via catalysts such as Mononucleosis, Strep, Epstein-Barr, Chicken Pox, and other viruses. Once activated, the virus will cause the lymph nodes to create abnormal and deformed proteins, such as fibrinogen which are small enough to leech through the blog brain barrier. These cause a reaction from the immune system and the white blood cells attack the myelin tissue. Additional genetic predispositions can complicate this. Allergies, dietary reactions, poor nutrition, lack of vitamin D, lack of exercise, ingestion of toxins like glyphosate, mercury, aspartame or fluoride, all contribute to the volitility of the MS response and the ability of the body to recover from a relapse.
fedupandconfused Pertussis / whooping cough. Never been the same since 🙁
LourdesRiveraMiranda I sincerely believe that our immune system is healthy, but that it reacts to the agents that activate ms. For example vaccines, contaminated food and water. Then these reactions doctors called them Multiple Sclerosis.
BillyRiser my vit d levels were very low, that i took 50,000iu 2 a week. til it got normal, but i had ms already. also heard it could be from mono, which i have had when i was a kid.
jesse .

thanks!!
TeresaJane Honestly, I believe that we are genetically predisposed to develop MS. Everything I read and my history of symptom relate back to something that makes us more prone to develop the disease. It has to start with a genetic factor. My mother has a lot of the symptom that I have had, although she was never tested for MS (no brain or spinal MRI for lesion, no spinal tap or any other MS related testing). She was diagnosed with DDD, arthritis, carpel tunnel syndrome and many nerve issues. She lives in chronic pain and has had multiple spinal surgeries. Her sister also has severe Rheumatoid arthritis. My father doesn’t seem to have nerve or spinal issues, but my youngest brother has undiagnosed issues. He is just too stubborn to see a Dr. I have a cousin who has been diagnosed with Lupus and possible MS on my father’s side.
I grew up in a city that had heavy lead contamination at the time for a local “plant”. Which is now shut down, of course. There have been several people I grew up with who have developed MS or other rare autoimmune diseases. I had random neurological symptoms for about 11 years before I got “pink eye” while working as a school nurse. A month after that resolved I began losing my vision in the same eye (optic neuritis) and that lead to my diagnosis along with my history of undiagnosed symptom and MRI that also showed many “old” lesions.
Wow… So, to sum it up, I truly believe it is a combination of genetic, environmental and immunological factors. We have to have all of the right components to trigger the disease which hides in our bodies. And from what I have read, that is how science sees it. Although they still can’t find a cure. But how do you cure something that you were born to possibly/probably develop?
Posted on Multiple Sclerosis

Managing Pain and Sleep Issues in MS: Part 1- Pain in Multiple Sclerosis

Image result for Managing Pain and Sleep Issues in MS: Part 1- Pain in Multiple Sclerosis

Pain and sleep disorders often cause confusion and frustration for people with MS, their loved ones, and healthcare providers. Learn from scientists and clinicians about strategies for symptom management, available treatment options, and ongoing research to identify the cause of pain and sleep disorders in MS.

Posted on Multiple Sclerosis

Multiple Sclerosis – what are the treatments available for MS?

10 Facts about Multiple Sclerosis

10 Facts about Multiple Sclerosis

There’s currently no cure for multiple sclerosis (MS), but it’s possible to treat the symptoms with medications and other treatments.

Treatment for MS depends on the specific symptoms and difficulties the person has. It may include:

treating relapses of MS symptoms (with steroid medication)

treating specific MS symptoms

treatment to reduce the number of relapses (disease-modifying therapies)

You’ll be supported by a team of different healthcare professionals working together. This may include a neurologist (specialist in treating conditions of the nervous system), a physiotherapist, a speech and language therapist, and a number of other professionals.

Your team will also include a specialist MS nurse, who will usually serve as your main point of contact.

Further information

Department of Health: National Service Framework for long-term conditions (PDF, 127Mb)

NICE: multiple sclerosis in adults

Treatment for MS relapses

Contact your specialist MS nurse or GP if you think you’re having a relapse.

A flare-up of symptoms can sometimes be caused by something other than a relapse, such as an infection, so your nurse or GP needs to check for other possible causes.

Treatment for a relapse usually involves either:

  • a five-day course of steroid tablets taken at home

    injections of steroid medication given in hospital for three to five days

 

Steroids can help speed up your recovery from a relapse, but they don’t prevent further relapses or stop MS getting worse over time.

They are only given for a short period of time to avoid possible steroid side effects, such as osteoporosis (weak bones), weight gain and diabetes, although some people will still experience problems.

Not using steroids more than three times a year (if possible) will also help to reduce the risk of side effects.

Further information

MS Trust: steroids

MS Society: treatments

Treatment for specific MS symptoms

MS can cause a range of symptoms that can be treated individually. Treatments for some of the main symptoms are discussed in the following sections.

Fatigue

Many people with MS experience fatigue.

For fatigue caused by MS, you may be prescribed amantadine, although this medication may only have a limited effect. You should also be given general advice on ways to manage fatigue, such as exercise, keeping healthy sleep patterns, energy-saving techniques and avoiding medications that can worsen fatigue (including some painkillers).

Specialist fatigue management courses or therapy, such as cognitive behavioural therapy (CBT), can also help some people with MS cope with their fatigue.

Visual problems

MS-related visual problems will often improve on their own, usually within a few weeks, so you may not need any treatment. If your symptoms are particularly severe, you may be prescribed steroids to help speed up recovery.

If you have problems with involuntary eye movements, medication such as gabapentin can sometimes help. Some people with double vision need help from ophthalmologists (eye specialists).

Muscle spasms and stiffness

Muscle spasms and stiffness (spasticity) can be improved with physiotherapy. Techniques such as stretching exercises can help if your movement is restricted.

If your muscle spasms are more severe, you may be prescribed a medicine that can relax your muscles. This will usually be either baclofen or gabapentin, although there are alternative medicines, such as tizanidine, diazepam, clonazepam and dantrolene.

These medicines all have side effects, such as dizziness, weakness, nausea and diarrhoea, so discuss which of these would be best for you with your specialist MS nurse or GP.

Mobility problems

Mobility problems are often the result of muscle spasms and spasticity (see above), but they can also be caused by muscle weakness, or problems with balance or dizziness.

If you have problems with mobility, you might benefit from:

an exercise programme supervised by a physiotherapist

special exercises called vestibular rehabilitation, if you have problems with balance

medication for dizziness or tremors

mobility aids, such as a walking stick, or occasionally a wheelchair

home adaptations such as stair lifts or railings

An occupational therapist can carry out an assessment of your home and suggest adaptations that may be of help.

Neuropathic pain

Neuropathic pain is caused by damage to your nerves and is usually sharp and stabbing. It can also occur in the form of extreme skin sensitivity, or a burning sensation.

This type of pain can be treated using the medicines gabapentin or carbamazepine, or with a medication called amitriptyline. This is an older type of antidepressant, but these days it’s mainly used for pain control.

Musculoskeletal pain

Living with MS can cause stresses and strains to the muscles and joints in your body.

A physiotherapist may be able to help with this pain by suggesting exercise techniques or better seating positions.

If your pain is more severe, you may be prescribed painkillers. Alternatively, you may have a device that stimulates your nerves, called as a transcutaneous electrical nerve stimulation (TENS) machine.

Problems with thinking, learning and memory

If you experience problems with thinking and memory, any treatment you receive will be fully explained and recorded, so that it’s clear to you.

You should be referred to a clinical psychologist, who will assess your problems and suggest ways to manage them.

Emotional problems

If you experience emotional outbursts, such as laughing or crying for no apparent reason, you should be assessed by a specialist such as a clinical psychologist. They may suggest treatment with an antidepressant.

People with MS who have depression can also be treated with antidepressants or therapy, such as CBT.

If you often feel anxious or worried, you may be prescribed antidepressants or benzodiazepines, which are a type of tranquilliser that have a calming effect.

Sexual problems

Men with MS who find it hard to obtain or maintain an erection (erectile dysfunction) may be prescribed medication to temporarily increase the blood flow to the penis, such as sildenafil (Viagra). This is provided by the NHS if you have MS.

Relationship counselling or seeing a sex therapist may also help both men and women with MS who are having problems with reduced interest in sex or difficulty reaching orgasm.

Bladder problems

Various medications are available if you have an overactive bladder or need to pee frequently during the night.

If you find it difficult to empty your bladder, advice from a continence nurse or physiotherapist can help. Handheld external stimulators can also help some people to start peeing or to empty the bladder.

Occasionally, a catheter can be used to empty the bladder when needed. In rare cases, people with MS may need a long-term catheter to keep the bladder emptying safely.

You may be referred to a continence adviser or urologist, who can offer specialist treatment and advice, such as botulinim toxin injections, bladder exercises or electrical treatment for your bladder muscles. Read more about treating urinary incontinence.

Bowel problems

It may be possible to treat mild to moderate constipation by changing your diet or taking laxatives.

More severe constipation may need to be treated with suppositories, which are inserted into your bottom, or an enema. An enema involves having a liquid medication rinsed through your bottom and large bowel, which softens and flushes out your stools.

Bowel incontinence can sometimes be treated with anti-diarrhoea medication or by doing pelvic floor exercises to strengthen your rectal muscles.

Speech and swallowing difficulties

A speech and language therapist can help you find ways to overcome problems with speech and swallowing.

For example, they can offer advice about foods that are easy to swallow and they can recommend exercises to strengthen the muscles used in speech and swallowing.

If swallowing problems become very severe, some people need to be fed using a tube, which is fitted into the stomach through the skin.

Further information

MS Trust: treating MS symptoms

MS Society: signs and symptoms

Disease-modifying therapies

Although MS can’t currently be cured, there are medicines that can help to reduce the number and severity of relapses in some people. These are called “disease-modifying therapies”.

These aim to reduce the amount of damage and scarring to the myelin sheath (layer surrounding your nerves), associated with MS relapses.

These treatments may also help to slow worsening disability in MS, although definitive research into their long-term benefits is limited.

Disease-modifying therapies are not suitable for everyone with MS. They’re only prescribed to those with relapsing remitting MS or secondary progressive MS who meet certain criteria, such as the number of relapses they’ve had.

People without relapses are very unlikely to benefit from the treatments and could still experience side effects from them.

Further information

MS Society: disease-modifying therapies

MS Trust: disease-modifying drugs

MS Decisions

Beta interferon

The types of beta interferon licensed for use in the UK are interferon beta-1a (Avonex, Rebif and Plegridy) and interferon beta-1b (Betaferon and Extavia). These are all given by injection.

You may be offered treatment with one of these medicines if either:

you’ve got relapsing remitting MS and you’ve had a recent relapse and/or MRI scans show that your MS is active

you have secondary progressive MS and still have significant relapses

All beta interferons often cause mild side effects, particularly flu-like symptoms (headaches, chills and mild fever), for 24-48 hours after they’re injected, and temporary pain or redness at the injection site.

Glatiramer acetate

One brand of glatiramer acetate, called Copaxone, is licensed for use in the UK. It’s injected under the skin either every day or at a higher dose three times a week.

You may be offered treatment with glatiramer acetate if you’ve got relapsing remitting MS and you’ve had a recent relapse, and/or MRI scans show that your MS is active.

Common side effects of glatiramer acetate include problems with redness or hardening of the skin at the injection sites, and occasionally palpitations or flushing after the injection.

Teriflunomide

Teriflunomide, branded as Aubagio, is a tablet taken once a day.

You may be offered treatment with teriflunomide if you have relapsing remitting MS and you’ve had a recent relapse, and/or MRI scans show that your MS is active.

Common side effects of teriflunomide include headaches, feeling sick, diarrhoea and hair thinning or hair loss. You’ll also need blood tests frequently in the early months of treatment to check for problems with liver function.

Natalizumab

Natalizumab, branded as Tysabri, is injected into a vein (known as an infusion) once every 28 days.

You may be offered treatment with natalizumab if you have severe relapsing remitting MS that’s getting worse quite quickly – for example, if you’ve had two or more severe relapses within a year and MRI scans show that your MS is getting worse.

Side effects of natalizumab are rare, but can include an increased risk of an itch or rash (hives), headaches, dizziness, joint pain, and feeling or being sick at the time of the infusions.

The main concern of treatment with natalizumab is a risk of a brain infection called progressive multifocal leukoencephalopathy (PML). This is uncommon, but can become a significant problem with long-term treatment in some people.

Fingolimod

Fingolimod, branded as Gilenya, is taken as a capsule once a day.

You may be offered treatment with fingolimod if you have relapsing remitting MS and you experience the same or an increased number of relapses, despite treatment with other medications such as beta interferons.

The medication doesn’t usually cause significant side effects, but some people experience an increased risk of infections, headaches, diarrhoea, liver problems and visual problems.

Alemtuzumab

Alemtuzumab, branded as Lemtrada, is initially given into a vein once a day for five consecutive days. This is followed by a second course of treatment a year later, which lasts for three consecutive days.

You may be offered treatment with alemtuzumab if you’ve got relapsing remitting MS and you’ve had a relapse in the past year, and/or MRI scans show that your MS is active.

Common side effects of alemtuzumab include an increased risk of infections, headaches, rashes and fever. Regular blood and urine tests will be carried out to monitor treatment.

Dimethyl fumarate

Dimethyl fumarate, branded as Tecfidera, is a tablet taken twice a day.

You may be offered treatment with dimethyl fumarate if you’ve got relapsing remitting MS and you’ve had a recent relapse and/or MRI scans show that your MS is active.

Common side effects of dimethyl fumarate include hot flushes, diarrhoea, nausea, abdominal (tummy) pain and headaches. Stomach upsets usually settle after a month or so. The flushes can continue, but aren’t normally a major issue.

Cladribine

Cladribine, branded as Mavenclad, is a tablet taken as a course of treatment over two years. You take a tablet once a day for four or five days in the first month that you start treatment and then again a month later for another four or five days. This cycle is then repeated a year later.

You may be offered treatment with cladribine if you have very active relapsing remitting MS. This means you have severe MS that’s getting worse quite quickly – for example you’ve had at least two relapses in the past year and MRI scans show that your MS is getting worse.

You may also be offered cladribine if you’ve had a relapse in the past year and MRI scans show that your MS is active even if you’ve been taking a different disease-modifying therapy.

Common side effects of cladribine include a reduced white blood cell count, cold sores and shingles, rash and hair loss. Regular blood tests will be carried out to monitor treatment.

Further information

NICE: beta interferon and glatiramer acetate for the treatment of multiple sclerosis

NICE: teriflunomide for relapsing-remitting multiple sclerosis

NICE: natalizumab for the treatment of adults with highly active relapsing-remitting multiple sclerosis

NICE: fingolimod for the treatment of highly active relapsing-remitting multiple sclerosis

NICE: alemtuzumab for treating relapsing-remitting multiple sclerosis

NICE: dimethyl fumarate for treating relapsing-remitting multiple sclerosis

NICE: cladribine tablets for treating relapsing-remitting multiple sclerosis

Clinical trials

Much progress has been made in MS treatment thanks to clinical trials, where new treatments and treatment combinations are compared with standard ones.

All clinical trials in the UK are carefully overseen to ensure they are worthwhile and safely conducted. Participants in clinical trials sometimes do better overall than those in routine care.

Speak to your care team if you’re interested in taking part in a clinical trial.

Further information

Clinical trials for multiple sclerosis

Clinical trials and medical research

MS Society: get involved in research

Complementary and alternative therapies for MS

Some people with MS find that complementary therapies help them feel better. Many complementary treatments and therapies claim to ease symptoms, although scientific evidence is often not clear about how effective they are.

Many people think that complementary treatments have no harmful effects. However, people can occasionally experience problems, and it’s not a good idea to use them as an alternative to medicines prescribed by your doctor. If you’re considering using an alternative treatment alongside your prescribed medicines, it’s important to let your doctor know your plans.

Further information

MS Society: complementary and alternative medicines

MS Trust: complementary and alternative medicine

Posted on Multiple Sclerosis

NEW GUIDELINE: START TAKING MS DRUGS EARLY ON

NEW GUIDELINE: START TAKING MS DRUGS EARLY ON

NEW GUIDELINE: START TAKING MS DRUGS EARLY ON

For most people, it’s better to start taking drugs for multiple sclerosis (MS) early on rather than letting the disease run its course, according to a new guideline for treating MS from the American Academy of Neurology. The guideline is published in the April 23, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology, and presented at the 70th AAN Annual Meeting in Los Angeles, April 21 to April 27, 2018. The guideline is endorsed by the Multiple Sclerosis Association of America and the National Multiple Sclerosis Society.

“The treatment landscape for people with MS has changed dramatically over the last decade,” said lead author Alexander D. Rae-Grant, MD, of Cleveland Clinic in Cleveland, Ohio, and a Fellow of the American Academy of Neurology. “We now have a number of disease-modifying therapies to choose from that may help treat MS by changing how the disease affects people over time by slowing the disease process.”

Multiple sclerosis affects about 400,000 Americans and is a leading cause of disability among young adults. It is a chronic inflammatory condition that affects the central nervous system, causing substantial disability and increasing the risk of mortality. People living with MS experience symptoms such as vision problems, muscle weakness, bladder or bowel dysfunction, tremors, trouble with coordination, and cognitive and emotional problems.

Unlike some treatments, which only help manage symptoms, disease-modifying therapies are drugs that can alter or change the course of MS for patients. While they are not a cure, they can reduce the number of relapses a person has and slow the process of MS.

For the guideline, experts from the American Academy of Neurology carefully reviewed available scientific studies on the use of MS drugs.

They found that starting to use an MS drug as early as possible may be better than letting MS run its course. This is because the disease is known to get worse over time. According to the guideline, several MS drugs have either strong or moderate evidence supporting their use for slowing certain disease processes.

While MS drugs may help slow and stabilize the disease process, some people with MS may experience a return of disease activity while using an MS drug. According to the guideline, if that happens, they may need to switch to another MS drug shown to have less risk of returning disease activity.

The guideline experts also note that some people whose MS is stable may think about stopping their MS drug use since they have no signs of the disease. According to the guideline, very few studies have been done on the benefits or risks of stopping MS drugs.

Currently, there is no blood test that can determine whether a person’s MS drug is working and there is no universally accepted method to determine which MS drug to use in which order or in which individuals.
Some MS drugs have risks for the reproductive health of both men and women, and the guideline offers recommendations regarding pregnancy and disease-modifying therapies for women with MS, including that their doctors monitor any plans for pregnancy.

According to the guideline authors, it is important to be aware of the potential risks of these medicines, and they recommend that people weigh the benefits and risks with their physician before deciding to start, switch or stop using an MS drug.

Learn more about multiple sclerosis at www.BrainandLife.org, the American Academy of Neurology’s patient and caregiver website and online home of Brain & LifeTM, a free magazine that focuses on the intersection of neurologic disease and brain health.

The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 34,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.