MS is an autoimmune disease in which antibodies attack the white matter in the brain. The white matter is made up of oligodendrocytes that wrap around the axons in the central nervous system (brain and spinal cord) and form a fatty layer called the myelin sheath which helps in signal transduction. When demyelination occurs, the axons of neurons can't effectively conduct action potentials. If you have multiple sclerosis, you’re not alone. MS affects over 400,000 people in the United States and may affect 2.5 million people worldwide. Multiple sclerosis affects 2-3 times as many women as men. No two people get MS in the exact same way as in it differs in timing, location, and severity. In general, people with MS can experience partial or complete loss of any function that is controlled by, or passes through, the brain or spinal cord.
There are 4 different types of MS:
1. Relapsing/Remitting (RRMS):
This is characterized by relapses (also known as exacerbations) during which time new symptoms can appear and old ones resurface or worsen. The relapses are followed by periods of remission, during which time the person fully or partially recovers from the deficits acquired during the relapse. Relapses can last for days, weeks or months and recovery can be slow and gradual or almost instantaneous. The vast majority of people presenting with Multiple Sclerosis are first diagnosed with relapsing/remitting. This is typically when they are in their twenties or thirties, though diagnoses much earlier or later are known. Around twice as many women as men present with this variety.
2. Secondary Progressive (SPMS):
After a number of years many people who have had relapsing/remitting MS will pass into a secondary progressive phase of the disease. This is characterised by a gradual worsening of the disease between relapses. In the early phases of Secondary Progressive, the person may still experience a few relapses but after a while these merge into a general progression. People with secondary progressive may experience good and bad days or weeks, but, apart from some remission following relapsing episodes, no real recovery. After 10 years, 50% of people with relapsing/remitting MS will have developed secondary progressive
3. Progressive Relapsing Multiple Sclerosis (PRMS):
This form of MS follows a progressive course from onset, punctuated by relapses. There is significant recovery immediately following a relapse but between relapses there is a gradual worsening of symptoms.
4.Primary Progressive (PPMS):
This type of MS is characterised by a gradual progression of the disease from its onset with no remissions at all. There may be periods of a leveling off of disease activity and, as with secondary progressive, there may be good and bad days or weeks. PPMS differs from Relapsing/Remitting and Secondary Progressive in that onset is typically in the late thirties or early forties, men are as likely women to develop it and initial disease activity is in the spinal cord and not in the brain. Primary Progressive MS often migrates into the brain, but is less likely to damage brain areas than relapsing/remitting or secondary progressive - for example, people with Primary Progressive are less likely to develop cognitive problems.
There is no known cause for MS, however, factors such as heredity, the immune system, geography and climate, and viruses are being studied.
There is no cure for MS. The current treatment for MS is either injectable or infusion therapy.
Resources:
http://www.mult-sclerosis.org/whatisms.html
http://www.msactivesource.com/msavProject/msas.portal/_baseurl/twoColLayout/SCSRepository/en_US/msas/home/What-Is-Multiple-Sclerosis/index.xml
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7 comments:
The breakdown of the four types of MS was really helpful!
Is one type more common/prevalent than the others?
About 85% of people are initially diagnosed with relapsing-remitting MS. Approximately 10% of people are diagnosed with primary-progressive MS. Many people develop secondary progressive MS after they had been initially diagnosed with relapse-remitting MS. Only about 5% get diagnosed with progressive-relapsing.
http://www.nationalmssociety.org/about-multiple-sclerosis/what-is-ms/index.aspx
I was curious about the age of onset for MS so I did some research and found the average age is between 20-50. However, what was more interesting than MS being a 'young' disease was that about 5% of patients are under the age of 16. Childhood Multiple Sclerosis could have been just as prevalent 20 years ago, but with the advent of new technology, such as magnetic resonance imaging, the number of children being diagnosed is on the increase.
But so little is known about childhood MS that even now there is a delay in diagnosing it and the majority of children presenting symptoms at a young age are not normally diagnosed until early adulthood.
Studies show that the illness appears to be more prevalent in males up to the age of 12 but after puberty it mirrors the gender imbalance in adults, with more girls being diagnosed. This adds strength to the possibility that there maybe a hormone link to MS. There is more information at
http://www.guide4living.com/ multiple-sclerosis/children.htm
During remission in MS, can re-myelination occur? I was also curious if inflammation decreases during remission and if there is a large increase during a relapse?
In response to the question about re-during myelination MS remission, this is what I found:
1. Re-myelination does not occur for awhile due to the fact that MS targets the myelin producing oligodendrocytes in the brain. SOMETIMES, after a long period of time (could be years!), an axon will spontaneously become remyelinated. Also, demyelination can cause scar tissue to replace the myelin which blocks remyelination during remission. When remyelination does occur, it is usually only at the edges of the lesions (no oligodendrocytes are found in the middle). Finally, remyelinated axons tend to not work as well as undamaged ones.
In answer to the inflammation portion...
Inflammation is common during the primary-progressive MS. However, inflammation plays less and less a role when you go on to secondary-progressive. It is thought that inflammation might precede oligodendrocyte death however this is not totally proven yet. It is thought that later on inflammation plays less a role because the inflammatory process has already killed the oligodendrocytes needed to maintain the myelinated axons so demyelination will continue.
http://www.mult-sclerosis.org/howms.html
Here's the link about different bee sting therapy kits used to treat MS. They range from $30-$100 depending if you need a specific kit for MS. There's an injection kit in case you are allergic to the stinger. This was very interesting.
http://www.beevenom.com/kits.htm
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