Multiple Sclerosis: A Lifetime of Ups and Downs and Pain
Multiple sclerosis is a mysterious auto-immune disease, quirky and unpredictable. The hallmark of MS is the episodic nature of the disorder. Symptoms appear, affecting one part of the body and after some time, weeks or months, disappear. Then different symptoms appear months to years later, affecting another part of the body. You could have numbness of the left hand for several weeks, which resolves. Then three months later, you lose the vision in your right eye. Symptoms vary from patient to patient. One person may have mostly mental deterioration while another may have paraplegia and a third will have visual symptoms or depression.
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The lesions in MS are in the brain and spinal cord. The patient's own immune system starts to destroy the protective myelin sheath that covers the axons, extending out from the neurons. The axons carry messages from the brain throughout the body. MS causes the breakdown of that communication system. The resultant symptomatology depends on which axons are being attacked.
Why the immune system damages the fatty myelin sheath is unknown. MS occurs more often in women, with a ratio slightly over 2:1, which is common in auto-immune disorders. The disease can develop at any age but usually hits around age 30. Genetics plays a part. The incidence is lower in Chinese, Japanese, and black Africans, while Sardinians, Parsis, and Palestinians have high rates. MS is found more commonly in the higher latitudes, however. Geography definitely plays a role.
The presentation can vary considerably, which makes diagnosing the disease difficult.
- Numbness and weakness in an arm or a leg are often among the first symptoms.
- Tremors and loss of coordination can appear.
- Walking becomes difficult as the person develops an unsteady gait.
- Vision problems include loss of vision, either partial or complete, sometimes with associated pain with movement of the eyes. Double vision and blurred vision occur as well.
- Most patients experience fatigue and dizziness.
- Cognitive problems occur, causing difficulty with judgment, attention span, memory, and concentration.
- Psychological disorders appear. Depression is common. Some people develop frank psychosis or dementia.
- Pain occurs in half of MS patients at some point in the disease.
Most people with MS have a relapsing-remitting course that can last for decades. The majority of them eventually enter the secondary progressive phase that does not remit. A minority of patients never remit and are classified as primary progressive MS.
While only about half of MS patients experience physical pain, everyone inflicted with the disease experiences emotional and psychological pain. The disease, slowly in some, faster in others, destroys the body's connections to the brain. In the relapsing-remitting cases, it offers periods of near normalcy, always overlaid by the fear of the return. And each episode steals away a little more of the body's capabilities, eventually leaving the patient an invalid.
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