A disorder of the brain and spinal cord caused by progressive damage to the outer covering of nerve cells (myelin). This results in decreased nerve functioning which can lead to a variety of symptoms.

What are the causes, incidence and risk Factors?
The cause of MS is unknown. The disease involves repeated episodes of inflammation of nervous tissue in any area of the central nervous system. These episodes occur when the body's own immune cells attack the nervous system. The location of the inflamed areas varies from person to person and from episode to episode. The inflammation destroys the covering of the nerve cells in that area (myelin sheath), leaving multiple areas of scar tissue (sclerosis) along the covering of the nerve cells. This results in slowing or blocking the transmission of nerve impulses in that area, leading to the symptoms of MS.

Symptoms vary because the location and extent of each attack varies. There is usually a stepwise progression of the disorder, with episodes that last days, weeks, or months alternating with times of reduced or no symptoms (remission). Recurrence (relapse) is common although non-stop progression without periods of remission may also occur.

The exact cause of the inflammation associated with MS is unknown. Geographic studies indicate there may be an environmental factor involved. MS is more likely to occur in northern Europe, the northern United States, Southern Australia, and New Zealand than in other areas. The "intertropical belt" seems to have much lower rates of this condition. There seems to be a genetic link to the disease, with some families more likely to be affected than others and certain genetic makers are more common in people with MS than in the general population.

An increase in the number of immune cells in the body of a person with MS indicates that there may be a type of immune response that triggers the disorder. The most frequent theorabout the cause of multiple sclerosis include a virus-type organism, an abnormality of the genes responsible for control of the immune system, or a combination of both factors.

Multiple Sclerosis (MS) affects approximately 1 out of 1,000 people. Women are affected more commonly than men. This disorder most commonly begins between 20 to 40 years old, but can happen at any age. Risks include a family history of MS and living in a geographical area with a higher incidence rate for MS.

What are the Symptoms?

• Weakness of one or more extremities
• Paralysis of one or more extremities
• Tremor or one or more extremities
• muscle spasticity
• muscle atrophy
• movement, dysfunctional
• numbness
• tingling
• facial pain
• extremity pain
• loss of vision
• double vision
• eye discomfort
• uncontrollable eye movements
• eye symptoms wose with movement of eyes
• decreased coordination
• loss of balance
• decreased ability to controll small or intricate movements
• walking/gait abnormalities
• muscle spasms
• dizziness
• vertigo
• urinary hesitancy
• urinary urgency
• incontinence
• decreased memory
• decreased spontaneity
• decreased judgement
• loss of ability to generalize
• depression
• decreased attention span
• depression
• slurred speech
• difficulty speaking
• fatigue

Additional symptoms that may be associated with the disease:

• constipation
• hearing loss
• positive Babinski's reflex

Note: Symptoms may vary with each attack. They may last days to months, then reduce or disapear, then reoccur periodically. With each reoccurance, the symptoms are as different as new areas are affected. Fever can trigger ot worsen attacks, as can hot baths, sun exposure, and stress.

Are there any Signs and Tests?

Symptoms of MS may mimic other disorders. Diagnosis is made by ruling other conditions out. A history of at least two attacks separated by a period of reduced or no symptoms may indicate one pattern of attack/remission seen in MS. If there are observable decreases in any functions of the central nervous system, the diagnosis of MS may be suspected.

Tests that indicate or confirm multiple sclerosis include:

• head MRI scan that shows scaring or a new lesion
• spinal MRI scan that shows scaring or a new lesion
• lumbar puncture (spinal tap)
• CSF oligoclonal banding
• CSF IgG index

Is there any Treatment available?

There is no known cure for MS at this time. However, there are promising therapies that may decrease exacerbations and delay progression of the disease. Treatment is aimed at controlling symptoms and maintaining function to give maximum quality of life.