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Contents
Procedure description: Multiple Sclerosis Treatment
Patient preparation: Multiple Sclerosis Treatment
Recovery: Multiple Sclerosis Treatment
Note: Multiple Sclerosis Treatment
Conditions: Multiple Sclerosis Treatment
Common Synonyms: Multiple Sclerosis Treatment
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| Procedure description: Multiple Sclerosis Treatment |
Multiple sclerosis is a disease which affects the nerves in the brain and spinal cord, causing problems with muscle control, vision, balance and sensation.
Multiple Sclerosis is thought to be an autoimmune disease, meaning that your body's immune system, which normally attacks things like bacteria and viruses, attacks your own healthy body tissue, and causes damage to myelin sheath.
Result of myelin sheath damage is known as demyelination.
Loss of myelin sheath causes that the nerve can't send signals properly.
Multiple Sclerosis affects different people in different ways, and symptoms can vary from day to day. The most common symptoms include:
1)vision problems, including eye pain, dim or blurred vision and double vision
2)problems with walking, balance and coordination
3)stiffness and spasm
4)numbness or "pins and needles"
5)tremor (shakiness)
6)speech difficulties, including slurred speech
7)poor memory, feeling emotional and difficulty in thinking logically
8)painful muscle spasms
9)fatigue
10)muscle weakness
11)difficulty swallowing
12)bladder and bowel problems such as inability to hold urine (incontinence) and constipation
13)sexual difficulties (erectile dysfunction in men)
This is a daunting list, but remember it's unlikely that you will have all of these symptoms
TYPES OF MULTIPLE SCLEROSIS
There are three basic types of MS, characterised by different patterns of symptoms.
RELAPSING-REMITTING TYPE OF MULTIPLE SCLEROSIS
Aproximatelly 80% of Multiple Sclerosis is presented as a relapsing and remitting type.
This means there are periods of relapse, when symptoms flare up, often quite suddenly, and then periods of remission, when symptoms improve.
SECONDARY PROGRESSIVE TYPE OF MULTIPLE SCLEROSIS
After a period of having relapsing-remitting Multiple Sclerosis, secondary progressive Multiple Sclerosis can develop.
It is characterized by gradually shorter periods of remission and worse symptoms during relapses. About half of people who have relapsing-remitting MS go on to the secondary progressive stage in the first 10 years.
PRIMARY PROGRESSIVE TYPE OF MULTIPLE SCLEROSIS
For about 3 people in 20, there are no periods of remission and the disease gets gradually worse from the start. This causes increasing disability, and can reduce life expectancy.
The course of the Multiple Sclerosis can be very unpredictable. In some cases, there are gaps of 10 years between flare-ups. In others they are frequent. In men who develop the disease for the first time in middle age, deterioration may be rapide.
There are no completely successful treatments for Multiple Sclerosis. But by managing your condition, you can aim to reduce the frequency and severity of your attacks, and improve your symptoms.
Just as important as medical treatments to control your symptoms is having timely access to practical support as soon as any new symptoms develop.
This includes neurological rehabilitation schemes that help you to continue with independent living.
DISEASE MODIFYING DRUGS
Disease-modifying drugs can affect the course of your disease, and help to reduce the frequency or severity of attacks.
STEROIDS
Your GP may prescribe you a course of steroids, usually methylprednisolone (eg Depo-Medrone), to help make your relapses shorter and less severe.
Steroids are usually given first intravenously (by a drip) and then by mouth.
There are few side-effects from taking short courses of steroids, but long-term treatment can cause:raised blood pressure, diabetes, osteoporosis ,change in appearance (reddened face, acne, obesity)
Generally, you should not take more than three courses of steroids in a year, and you should not take steroids for more than three weeks at a time.
Other drugs may modify the course of your disease.
Interferon beta-1a (Avonex or Rebif) and interferon beta-1b (Betaferon) are used for some people who have the relapsing and remitting form of the disease.
They are not effective for everybody, and some people experience side-effects such as irritation at the injection sight, flu-like symptoms, diarrhoea and insomnia.
Glatiramer acetate (Copaxone) injections can reduce the frequency of attacks of Multiple Sclerosis.
It can be prescribed for some people with relapsing-remitting Multiple Sclerosis or secondary progressive Multiple Sclerosis.
As a result of concerns about the cost effectiveness of these expensive medicines, only patients with certain types of Multiple Sclerosis(relapsing-remitting and secondary progressive) are entitled to receive these medicines on the NHS. Also, only a neurologist at a specialist Multiple Sclerosis centre can prescribe the drugs.
SYMPTOM CONTROLLING DRUGS
Different types of drugs can be used to treat your symptoms of Multiple Sclerosis.
These include muscle relaxants for muscle spasms and stiffness (spasticity).
Treatments are also available for other symptoms such as incontinence, constipation and sexual dysfunction (impotence).
Some people with Multiple Sclerosis claim that cannabis is helpful in relieving their symptoms, especially spasticity. Evidence from clinical trials has shown some benefit from both cannabis and cannabis extracts for reducing symptoms of Multiple Sclerosis.
However, at present cannabis remains illegal and can only be produced, possessed and supplied for research purposes.
MULTIPLE SCLEROSIS AND SURGICAL TREATMENT
Surgery is occasionally used in patients with bladder and bowel problems. Surgery on the brain may be performed to reduce tremor. |
| Patient preparation: Multiple Sclerosis Treatment |
There is no simple test to diagnose Multiple Sclerosis. Doctors usually diagnose the disease after studying the symptoms, and excluding other possible causes.
Usually two episodes of neurological symptoms are needed to confirm the diagnosis. Other tests that your neurologist may say you need include those listed below
An MRI (magnetic resonance imaging) scan of the brain and spinal cord uses magnetic waves to create pictures. This may show a particular pattern of damage due to MS. The scan is also useful in ruling out other causes of your symptoms, such as abnormal pressure on the spinal cord.7
A lumbar puncture (spinal tap), where a sample of cerebrospinal fluid is taken by inserting a needle between two vertebrae of the spine. In MS, the fluid may contain white blood cells, high levels of protein and certain antibodies.7
Evoked potential testing, which measures electrical activity in the brain in response to stimulation. Wires are placed on the scalp and the arms or legs are stimulated with a mild electric current. Sight and hearing can also be tested in this way.7
Neuropsychological tests, which examine how the areas involved in thinking (rather than moving) are working. Psychologists will give you tasks to check various abilities such as memory, arithmetic, attention, judgement and reasoning.7
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| Recovery: Multiple Sclerosis Treatment |
Exercise
A physiotherapist can advise you on the right amount of exercise to do, which aims to keep your joints supple and your muscles toned.
Diet
A dietician can give you advice on a well balanced diet, which should include fresh fruits and vegetables.
Dietary advice is particularly important if chewing and swallowing are a problem.
Foods high in polyunsaturated fats (particularly linoleic acid) have been shown to be beneficial in some studies.11 These can be found in seeds such as sunflower and linseed and some vegetable oils. Alternatively you could take capsules.1
Practical adjustments
You may need special equipment, to reduce your working hours or even change your job as a result of MS.
You can get advice about work roles and funding for equipment from disability employment advisers, who are normally based at local Job Centres. The local authority may supply equipment to your home, such as ramps and lifts.
You may also need specific medical aids and appliances, such as catheters if you have bladder problems. You should be able to get these through a district nurse or nurse continence adviser.
Wherever possible you should try to use whatever aids are available to help you get out and about. This is beneficial both psychologically and physically.
Social support is often as important as medical treatments. Charitable organisations such as the Multiple Sclerosis Society (see Further information, below) have local branches that can give advice and support to both you and your family. |
| Note: Multiple Sclerosis Treatment |
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| Conditions: Multiple Sclerosis Treatment |
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| Common Synonyms: Multiple Sclerosis Treatment |
| Multiple Sclerosis Management, MS treatment, Multiple Sclerosis Medications, Multiple Sclerosis Surgery, Multiple Sclerosis Surgical Treatment |
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