A: Multiple Sclerosis is a disease of the central nervous system. Its cause is unknown. The disease cannot be prevented, or cured. However, it is not fatal, and much progress is being made in treating symptoms and identifying underlying mechanisms that trigger this disease. Multiple sclerosis is defined as an autoimmune disease because it uses the body's own immune system to attack its own tissues. In the case of MS, these tissues are the myelin covering the nerve fibers in the brain.

A: Most people experience their first symptoms of MS between the ages of 20 and 40, symptoms rarely begin before age 15 or after age 60. Whites are more than twice as likely to develop MS than other races. In general, women are affected at almost twice the rate of men.

A: No one knows exactly how many people have MS. It is believed that, currently, there are approximately between 250,000 and 350,000 people in the United States with MS diagnosed by a physician.

A: The initial symptoms of Multiple Sclerosis typically include:

• Difficulty in walking
• Abnormal sensations including numbness and "pins and needles"
• Eye pain and loss of vision.
• Tremor
• Lack of coordination
• Slurred speech or other speech effects
• Sudden onset of paralysis (may seem similar to a stroke)
• A reduction in the ability to think, reason, and remember.

After the initial symptoms of Multiple Sclerosis, other symptoms often arise. Since Multiple Sclerosis involves demyelination (the destruction of the fatty myelin sheath that surrounds nerve fibers and insulates them like the insulation around wires.) The loss of myelin results in disruption of the nerve impulses to the body. Symptoms include:

Primary Symptoms: (Arise as the direct result of the disease)

• Numbness
• Tremors
• Weakness
• Loss of balance and coordination
• Loss of vision
• Dizziness and vertigo
• Difficulty swallowing
• Pain (including eye pain and headache)
• Paralysis
• Seizures
• Bladder and bowel disfunction
• Hearing problems
• Itching
• Sexual disfunction

Secondary Symptoms: (Complications that arise as a result of the primary symptoms)

• Urinary tract infections resulting from bladder disfunction
• Muscle weakness and imbalances from lack of muscle use and inactivity
• Bedsores

Tertiary Symptoms: (The social, occupational, psychological and spiritual complications of the disease)

• Loss of livelihood because are the disability (inability to walk or inability to operate a car)
• Relationship problems due to the strain of chronic illness and due to sexual disfunction
• Depression

Q: Are there different types of Multiple Sclerosis?

A: Yes. Researchers have identified four major 'groupings" of the disease:

1. Benign (20%)

   The characteristics are:

   • One or two attacks with complete recovery
   • No progression over time
   • No permanent disability

   It is not possible to identify this form of Multiple Sclerosis until after the fact because the symptoms are a lack of progression. At the onset of this type of Multiple Sclerosis, it would have been identified as relapsing-remitting.

2. Relapsing-remitting (25%)

   The characteristics are:

   • Unpredictable attacks (i.e., relapses), followed by
   • Partial or total recovery (i.e., remission)

   The attacks (more formally called exacerbations) can last days or months. The recovery periods may be months or years. Ten to fifteen years without an attack are required for the disease to be considered in complete remission.

3. Secondary progressive (40%)

   The characteristics are:

   • Initially relapsing-remitting
   • Followed by progressive disability later in the disease

4. Primary progressive (15%)

   The characteristics are:

   • A lack of distinct attacks
   • Slow onset
   • Steadily worsening symptoms
   • The accumulation of disability may eventually level off or may continue to worsen.

Q: What Tests Are Used to Diagnosis Multiple Sclerosis?

• A lumbar puncture, or spinal tap
• Specialized tests for standard reflexes
• An evoked potential (EP) test
• Magnetic Resonance Imaging (MRI)