Multiple Sclerosis
Sarah
HCS 245
March 25, 2013
Dr. Tira Hancock MS, RD, CD, NBCT

Multiple Sclerosis Imagine going to the doctor because you have tingling or numbness in you extremities or face, you are constantly tired, and having trouble seeing. You go to your physician and explain all of your ailments to your doctor. They diagnose you with fibromyalgia and vitamin B12 deficiency. After being prescribed medications for those diseases, two weeks later you experience bladder problems and walking difficulties. You return to the doctor with the added ailments. Since you came back with more ailments, they are more inclined to get a full family medical history, neurological exam, MRI, and spinal fluid analysis. The results come back from all of these tests that were ran at you second doctors visit, you are diagnosed with multiple sclerosis (MS). Multiple sclerosis is often misdiagnosed; this is because there is not a single test that tells doctors that a person has MS, and to be diagnosed with MS there needs to be signs in two separate areas of the central nervous system. This paper will describe what multiple sclerosis is, who is affected, environmental factors that contribute to MS, methods of controlling MS, and if social/cultural influences play a part in this disease.
What Is Multiple Sclerosis?
Multiple sclerosis is a painful disease that has scientists stumped. Many are calling multiple sclerosis an autoimmune disease, which means your immune system is fighting off the healthy cells mistakenly. There are others who disagree that are calling the disease immune-mediated. This is because a particular antigen that your immune cells are attacking is still unknown. Multiple sclerosis attacks the central nervous system (CNS) that consists of the brain, spinal cord, and the optic nerves. Your body’s immune system attacks the protective coating around nerve cells called myelin. The damage that is done to the nerve cells affects the messages that are sent between the brain and your body and leads to multiple sclerosis, which causes problems for peoples’ balance, vision, thinking, and strength. The term sclerosis derives from the damaged myelin when it forms scar tissue.
Types Of Multiple Sclerosis
There are four different types of multiple sclerosis disease courses, and each can vary from mild, moderate, or severe. Relapse-remitting multiple sclerosis (RRMS) is the first and most commonly diagnosed at first. During RRMS, inflammation from attacks on the nerve cells causes damage to certain immune cells. Because this can happen anywhere in the body, there is the possibility that multiple people will have the same symptom areas. Approximately 85 percent are diagnosed with RRMS (National Multiple Sclerosis Society, n.d.). With this diagnosis, the immune system relapses the already deteriorating neurological function. Then symptoms cease partially or completely. The next type of diagnosed MS is secondary-progressive MS (SPMS). This type follows RRMS and progresses with or without relapses. Most of those that are diagnosed with RRMS will transition into SPMS. Then there is primary-progressive MS (PPMS) that increasingly worsens the neurologic function from the start. People with PPMS never have relapses and progression rates vary person to person. Finally, there is progressive-relapsing MS (PRMS) which is the least diagnosed. PRMS is initially diagnosed as PPMS because of the worsening neurological function from the start, but relapses can occur. Also, with PRMS each person’s symptoms are different and progress differently.
Who Is Affected?
Scientists have been working hard to find an exact underlying cause for multiple sclerosis. MS is not a contagious disease, so one is not going to get it by being in another room with someone who has MS. Since it is not a transmittable disease, epidemiologists have linked gender, genetics, age, geography, and ethnic background as factors in the findings of multiple sclerosis around the world. Most are diagnosed within the ages of 20 and 50, but may be diagnosed in younger and older as well. Commonly, MS happens to those that are geographically located away from the equator. This is because there is usually less sunlight and Vitamin D deficiency. Along with the geographical location, people of the African-American, Asian, and north European ancestry are more likely diagnosed with MS. Women are more likely to become diagnosed with MS. Scientist have not come to an exact reason as to why more women are prone to MS then men. Epidemiologists have come to two conclusions; women who have MS are likely to have a gene that produces more protein called interferon gamma, which irritates MS and encourages tissue damage (WebMD, 2004), and they think hormones are a factor for women. Multiple Sclerosis can be caused by genetic factors as well. In the United States there is a one in 750 chance for someone to be diagnosed with MS (National Multiple Sclerosis Society, n.d.). The chances of being diagnosed with MS can change if someone in your first-degree family (i.e. non twins or siblings) has MS. First-degree diagnosis has a one in 40 chance with the risk that if multiple family members that have it, the odds are increased. Identical twins that have a member with MS have a one in four chance of being diagnosed with MS.
Environmental Factors
There are a few environmental factors that can trigger multiple sclerosis. As mentioned earlier, geographic location plays a part in the onset of multiple sclerosis. Also, migration patterns are a factor. Those that live in an area with a high rate of MS and move before the age of 15, they have a lessened chance of developing MS if they move to a place that has a lower rate of MS. If they move to the place that has the same, or greater rate, or MS from where they moved, they have the same or increased chance of being diagnosed with MS. Multiple Sclerosis is more prevalent in the Pacific Northwest than anywhere else in the world- about 12,000 cases (Seattle Magazine, 2011). Smoking is another factor for MS. Smoking, like many other diseases, actively progresses the disease and you may develop MS. Finally, there are some infectious factors that are being investigated for developing MS. We are exposed to multiple diseases as we grow that cause inflammation. Some of the diseases being tested are measles, human herpes virus-6, and Chlamydia pneumonia.
Treatment Options
Multiple sclerosis is not a curable disease. It is a disease that can be managed. There are ten medications that are approved by the Food and Drug Administration to help treat the relapses of MS by reducing the activity of the disease and progression. Currently, there is not a medication that helps with primary-progressive MS. Corticosteroids are often prescribed for inflammation, but there is no scientific evidence that they are beneficial for long-term. Since MS can affect any part of the body, there are medications that can help treat the problem areas that are affected. It is also highly encouraged that people diagnosed with MS enter rehabilitation to help with functionality and maintain functionality so they can live normal, or mostly normal lives. They are able to continue working and day-to-day activities if they keep the symptoms under control and attend rehabilitation treatments. It is also important to maintain annual wellness visits to catch any other possible diseases.
Complementary and Alternative Medicine (CAM)
There are other options for controlling the symptoms of multiple sclerosis called complementary and alternative medicine (CAM). Complementary medicine is just as it seems, it is added forms of treatment to help aid the conventional medicine. If it is just used without the form of conventional medicine then it is considered alternative. Some of CAM’s are acupuncture, Vitamin D, exercise, meditation, and T’ai Chi. Those who choose the CAM’s are not guaranteed any benefits for treatment but turn to these forms because a lot of the FDA approved medications that have been tested are often not beneficial. Those diagnosed would rather use the other forms of treatment rather than putting medications into their systems. The same goes for many cultures.
Conclusion
To conclude, multiple sclerosis is a painful disease that scientists are working diligently to come up with a cure since there is not a known cure at this time. Multiple sclerosis is a disease that attacks your immune system and the myelin that surround your nerves which prevents the impulses from reaching parts of the body. This disease affects those geographically away from the equator and mainly of the northern European decent and those that have MS in the family. There is not a way to control the spread of the disease but there are medications or other forms of treatment to help maintain the symptoms of MS. Different cultures have different ways of dealing with any disease, some choose to medicate or some choose not to mediate and let the disease run its course or use alternatives. The best way to maintain a good life while living with MS is to eat a balanced diet, exercise, keep up with your treatments, and attend rehabilitation. There is no way to prevent the disease; you just have to learn to maintain it.

References
Medline Plus. (2014, March 20). Multiple Sclerosis. Retrieved from http://www.nlm.nih.gov/medlineplus/multiplesclerosis.html
National Multiple Sclerosis Society. (n.d.). Types of MS. Retrieved from http://www.nationalmssociety.org/What-is-MS/Types-of-MS
National Multiple Sclerosis Society. (n.d.). Who Gets MS? Retrieved from http://www.nationalmssociety.org/What-is-MS/Who-Gets-MS
Seattle Magazine. (2011, June). Washington is a Hotbed for Three Dangerous Diseases. Retrieved from http://www.seattlemag.com/article/lifestyle/health/washington-hotbed-three-dangerous-diseases
WebMD. (2004). Why More Women Get Multiple Sclerosis. Retrieved from http://www.webmd.com/women/news/20050127/why-more-women-get-multiple-sclerosis