An unpredictable disease of the central nervous system, multiple sclerosis (MS) can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted. Many investigators believe MS to be an autoimmune disease -- one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, it is the nerve-insulating myelin that comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus.
Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance. These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis. Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or "pins and needles" sensations. Some may also experience pain. Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss. Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked. Depression is another common feature of MS.
Is there any treatment?
There is as yet no cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. An immunosuppressant treatment, Novantrone (mitoxantrone ), is approved by the FDA for the treatment of advanced or chronic MS.
While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients. Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile. Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue. If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help. Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used.
What is the prognosis?
A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to readily identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously wax and wane. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk. MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment.
What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Scientists continue their extensive efforts to create new and better therapies for MS. One of the most promising MS research areas involves naturally occurring antiviral proteins known as interferons. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. In addition, there are a number of treatments under investigation that may curtail attacks or improve function. Over a dozen clinical trials testing potential therapies are underway, and additional new treatments are being devised and tested in animal models.
In 2001, the National Academies/Institute of Medicine, a Federal technical and scientific advisory agency, prepared a strategic review of MS research. To read or download the National Academies/Institute of Medicine report, go to: "Multiple Sclerosis: Current Status and Strategies for the Future."
Clinical Trials Select this link to view a list of studies currently seeking patients.
Organizations
Clearinghouse on Disability Information
Special Education & Rehabilitative Services Communications & Customer Service Team
550 12th Street, SW, Rm. 5133
Washington, DC 20202-2550
http://www.ed.gov/about/offices/list/osers
Tel: 202-245-7307 202-205-5637 (TTD)
Fax: 292024507636
International Essential Tremor Foundation
P.O. Box 14005
Lenexa, KS 66285-4005
http://www.essentialtremor.org
Tel: 913-341-3880 888-387-3667
Fax: 913-341-1296
Multiple Sclerosis Association of America
706 Haddonfield Road
Cherry Hill, NJ 08002
msaa@msaa.com
http://www.msaa.com
Tel: 856-488-4500 800-532-7667
Fax: 856-661-9797
Multiple Sclerosis Foundation
6350 North Andrews Avenue
Ft. Lauderdale, FL 33309-2130
support@msfocus.org
http://www.msfocus.org
Tel: 954-776-6805 888-MSFOCUS (673-6287)
Fax: 954-351-0630
National Rehabilitation Information Center (NARIC)
4200 Forbes Boulevard
Suite 202
Lanham, MD 20706-4829
naricinfo@heitechservices.com
http://www.naric.com
Tel: 301-459-5900/301-459-5984 (TTY) 800-346-2742
Fax: 301-562-2401
National Ataxia Foundation (NAF)
2600 Fernbrook Lane North
Suite 119
Minneapolis, MN 55447-4752
naf@ataxia.org
http://www.ataxia.org
Tel: 763-553-0020
Fax: 763-553-0167
National Multiple Sclerosis Society
733 Third Avenue
6th Floor
New York, NY 10017-3288
nat@nmss.org
http://www.nationalmssociety.org
Tel: 212-986-3240 800-344-4867 (FIGHTMS)
Fax: 212-986-7981
American Autoimmune Related Diseases Association
22100 Gratiot Avenue
Eastpointe
East Detroit, MI 48201-2227
aarda@aarda.org
http://www.aarda.org
Tel: 586-776-3900 800-598-4668
Fax: 586-776-3903
National Organization for Rare Disorders (NORD)
P.O. Box 1968
(55 Kenosia Avenue)
Danbury, CT 06813-1968
orphan@rarediseases.org
http://www.rarediseases.org
Tel: 203-744-0100 Voice Mail 800-999-NORD (6673)
Fax: 203-798-2291
Well Spouse Association
63 West Main Street
Suite H
Freehold, NJ 07728
info@wellspouse.org
http://www.wellspouse.org
Tel: 800-838-0879 732-577-8899
Fax: 732-577-8644
Paralyzed Veterans of America (PVA)
801 18th Street, NW
Washington, DC 20006-3517
info@pva.org
http://www.pva.org
Tel: 202-USA-1300 (872-1300) 800-424-8200
Fax: 202-785-4452
Accelerated Cure Project for Multiple Sclerosis
300 Fifth Avenue
Waltham, MA 02451
info@acceleratedcure.org
http://www.acceleratedcure.org
Tel: 781-487-0008
Fax: 781-487-0009
Related NINDS Publications and Information
Multiple Sclerosis: Hope Through Research
Multiple Sclerosis (MS) information sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS).
Neurological Diagnostic Tests and Procedures
Fact sheet on neurological diagnosis and testing, prepared by the National Institute of Neurological Disorders and Stroke (NINDS).
Small Trial Shows Daclizumab Add-On Therapy Improves Multiple Sclerosis Outcome
May 2004 press release on a clinical trial showing improved patient outcome after use of the drug daclizumab.
Old Drug, New Use: New Research Shows Common Cholesterol-Lowering Drug Reduces Multiple Sclerosis Symptoms in Mice
January 2003 news summary on studies suggesting that statin drugs may be useful for multiple sclerosis.
Brain Produces New Cells in Multiple Sclerosis
February 2002 news summary on brain repair in multiple sclerosis.
Biomarkers in Multiple Sclerosis - Workshop Summary
Biomarkers in Multiple Sclerosis - Workshop Summary
Genetics and Multiple Sclerosis: Future Prospects Workshop
Genetics and Multiple Sclerosis: Future Prospects Workshop
Multiple Sclerosis and Chemokines: Prospects for Therapeutic and Prophylactic Intervention
Health Disparities Working Group Meeting: Cognitive and Emotional Health Multiple Sclerosis and Chemokines: Prospects for Therapeutic and Prophylactic Intervention
NINDS Seeks Patients with Multiple Sclerosis
Lay-language descriptions of new program announcements and clinical trials seeking patient volunteers.
NINDS Accepts Organ Donations for Multiple Sclerosis Research
Lay-language descriptions of new program announcements and clinical trials seeking patient volunteers.
Publicaciones en Español
Esclerosis Múltiple: Esperanza en la Investigacion
A Spanish-language public information booklet on multiple sclerosis/Informacion de la Enfermadad de Esclerosis
Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
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NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.
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All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
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Last updated December 01, 2006
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