Multiple Sclerosis in the News

Before we come to the end of the month, it's important to discuss Multiple Sclerosis, since March is Multiple Sclerosis Awareness Month. MS is a disease that affects more than 2.3 million people worldwide, with an estimated 400,000 people affected in the United States.

Did you know that several people in the public eye are living life with MS?

Actress Selma Blair, who recently made her diagnosis public and proudly walked the Academy Awards red carpet with a cane, her sense of style fully intact, had been experiencing symptoms long before diagnosis. She recalled in an Instagram post puzzling ‘flares’ like being unable to find her mouth with her hand at an outdoor dinner.

Award-winning American author Joan Didion was diagnosed in 1972, when treatment options were dramatically fewer. She wrote about her diagnosis in her book The White Album, saying, “I had, at this time, a sharp apprehension not of what it was like to be old but of what it was like to open the door to the stranger and find that the stranger did indeed have the knife. In a few lines of dialogue in a neurologist’s office in Beverly Hills, the improbable had become the probable, the norm: things which happened only to other people could in fact happen to me.”

Jack Osbourne, reality TV star and son of Ozzy Osbourne, revealed his diagnosis publicly in 2012. He has become something of an ambassador for the disease, even going so far as to work with Teva Neuroscience on an information campaign called “You Don’t Know Jack About MS.”  He is candid about his experience with the disease. “I definitely appreciate things more, and I’m learning that it’s okay to not go full throttle all the time. But I’m not going to build my life around my disease. I still go on hikes and ride my motorcycle because I love being active,” he says.

Other well-known people who have MS include Ann Romney, Jamie-Lynn Sigler, Neil Cavuto, Teri Garr and Montel Williams.

What is Multiple Sclerosis?

The National Multiple Sclerosis Society defines MS as “an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and the brain and body.”

In MS, damage to the myelin coating around the nerve fibers (called demyelination) in the central nervous system and to the nerve fibers themselves interferes with the transmission of nerve signals between the brain, spinal cord and the rest of the body. Disrupted nerve signals cause the symptoms of MS, which vary from one person to another and over time for any given individual, depending on where and when the damage occurs.

Neurological Events

The first neurological event a patient experiences usually lasts for at least 24 hours and is called the Clinically Isolated Syndrome (CIS). It is caused by inflammation or the demyelination of the nerve cells in the central nervous system. Out of the blue, your hands and feet may go numb, or tingle, and your muscles feel weak. If this happens one time, it’s diagnosed as CIS. If it happens more than once, it may be MS. If it happens to a person already diagnosed with MS, it’s considered an MS flare-up or relapse.

“It’s important to realize that everyone is different and everyone will have a different experience with the disease,” says Dr. Chelsea Berkley, a neurologist with INTEGRIS Baptist Medical Center in Oklahoma City. “It’s also important to let people know that treatment options are excellent. As recently as the 1990s, we only had a few medications at our disposal, and diagnoses were made much later than they are today. We’ve got 15 medications available to us now, with excellent efficacy.”

Types of MS

Despite relatively unique presentation in each individual, four basic types of the disease have been identified. These are not exact, and they will vary.

Relapsing-Remitting MS (RRMS). About 85 percent of the people with MS have this form. It is the most common. RRMS is distinguished by periods of relative calm followed by intermittent periods wherein new symptoms appear, old symptoms flare-up and become exacerbated.

Secondary-Progressive MS (SPMS). Most people who are diagnosed with RRMS initially will transition to SPMS eventually. SPMS is marked by steadily worsening of symptoms without the remissions or stable periods of RRMS.

Primary-Progressive MS (PPMS). This relatively uncommon type of MS only affects about 10 percent of people diagnosed with MS. In PPMS, symptoms slowly worsen from the very beginning, with no remissions or relapses.

Progressive-Relapsing MS (PRMS). Only five percent of people with MS are diagnosed with this rare form. PRMS progresses or worsens steadily from the beginning, and is punctuated by acute relapses, but no remissions.

Risk Factors and Symptoms

Certain factors can put you at greater risk for developing MS. These include:

• Age - Although people of any age may develop MS, it is most common among people between 16 and 55.
• Gender - Two to three times as many women are diagnosed with RRMS as men.
• Race - People who are white, specifically those of Northern European ancestry, are at the greatest risk of developing MS. Conversely, people of Native American, African or Asian descent are at the lowest risk.
• Family history - You are at a greater risk of being diagnosed with MS if one of your parents or siblings has had MS.
• Infections - Certain viruses, including Epstein-Barr which causes mononucleosis, have been linked to MS.

Common symptoms of MS can include:

• Depression
• Fatigue
• Difficulty walking
• Neck sensations that feel like electric shocks during certain movements, particularly bending the neck forward
• Vision problems including loss of vision, frequently accompanied by pain; prolonged double vision or blurry vision
• Weakness in single or multiple limbs, usually occurring on one side of the body at a time, or in the legs and trunk
• Tingling
• Bladder problems
• Bowel problems
• Vertigo and dizziness
• Emotional changes
• Pain
• Sexual problems
• Cognitive changes

Less common symptoms of MS can include:

• Speech problems such as slurred speech
• Tremor
• Breathing problems
• Trouble swallowing
• Seizures
• Itching
• Hearing loss
• Headache

“Some people may experience symptoms that come and go, like a hand that goes a little numb for a week and then it goes away," says Dr. Berkley. But she stresses that symptoms vary greatly and it’s important to advocate for your health.

"Some people are told that their symptoms are anxiety, or migraines, but what I say is that if you experience a symptom that lasts 24 hours or more, then bring it up to your doctor. If it turns out that it is something like anxiety, well, that’s worth treating as well," she says.