Multiple Sclerosis Information at the National Institute of Neurological Disorders and Stroke
Multiple Sclerosis is a disease which results from interuptions in nerve communications between the central nervous system and other parts of the body. These interupptions are likely due to an autoimmune process attacking the myelin sheath, which is the insulating outer layer of nerve fibers. MS can cause a broad range of symptoms, depending on which nerves are under attack. It can range from a mild illness with intermittant attacks of weakness, fatigue, or abnormal sensations, to a chronic disabling illness with paralysis and loss of many body functions. There is no known cure, and treatments vary depending on the symptoms. Beta interferons, which are proteins which affect the immune system, are commonly used in some types of MS to prolong periods of remission. Several other approved treatments have become available in recent years. Research on the use of beta interferons and other treatments for MS are ongoing. Read more at the National Institute of Neurological Disorders and Stroke and National Institutes of Health
Information on MS at the UCSF Multiple Sclerosis Research Center
Multiple sclerosis (MS) is a chronic, often disabling disease of the central nervous system (CNS). Converging lines of evidence suggest that the disease is caused by a disturbance in immune function. This disturbance permits cells of the immune system to attack myelin, the insulating sheath that surrounds the nerve fibers (axons) located in the CNS (i.e., the brain and spinal cord). When myelin is damaged, electrical impulses cannot travel quickly along nerve fiber pathways in the brain and spinal cord. Disruption of electrical conductivity results in fatigue and disturbances of vision, strength, coordination, balance, sensations, and bladder and bowel function. More at the UCSF Multiple Sclerosis Research Center.
Multiple sclerosis: Essentials at Consumer Reports
What is it? What are the symptoms? How is it diagnosed? How common is it? What will happen? Questions to ask.
Key points about treatments at Consumer Reports.
Intriguing Leads on the Horizon
Recent preliminary studies have suggested that a phenomenon called Chronic Cerebrospinal Venous Insufficiency (CCSVI), a reported abnormality in blood drainage from the brain and spinal cord, may contribute to nervous system damage in MS. This hypothesis has been put forth by Dr. Paolo Zamboni from the University of Ferrara in Italy. Read more at the National MS Society website.
Video: If I Had Multiple Sclerosis
In this short video, Dr. Thomas John (Jock) Murray, MD, FRCP(C), OC, Dalhousie University gives an overview of multiple sclerosis by answering the questions most newly diagnosed patients would ask. Watch at the National Library of Medicine.
Podcast: Multiple Sclerosis - An Overview
Dr. William ‘Bill’ Tyor, a neurologist and the director of the Multiple Sclerosis Center at MUSC, discusses multiple sclerosis (MS), giving an overview of how and when symptoms present. He elaborates upon symptomology by describing the common remission/relapse type of the disease as compared to primary progressive and benign types of MS. Dr. Tyor also explains diagnostic measures and the general appearance of brain scans for people with MS, noting that some other diseases and infections may mimic MS. Listen at the Medical University of South Carolina Podcast Library.
Video: Multiple Sclerosis Update
Multiple Sclerosis is a chronic neurological disease that usually develops when people are young adults. This interview covers the symptoms, diagnosis and latest treatments for MS, as well as some recent advances and research initiatives that offer hope to people who have MS. Watch at the University of Maryland Medical Center.
Disease modifying therapies in multiple sclerosis.
This set of guidelines presents recommendations on the most effective use of multiple sclerosis treatments, including interferon beta, glucocorticoids, glatiramer acetate, cyclophosphamide, methotrexate, azothiaprine, intravenous immunoglobulins, and others. The guidelines were written after reviewing all published data regarding the effectiveness of each treatment. Recommendations were weighted in consideration of two factors: How well done were the studies which produced the data for each MS treatment? Did the studies tend to agree with each other, or did their results provide conflicting information? These guidelines sort it all out so that you and your doctor can be aware of the best treatments available for your particular situation... Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines through the National Guideline Clearinghouse.
Assessment: the use of natalizumab (Tysabri) for the treatment of multiple sclerosis (an evidence-based review).
Natalizumab may now be an additional treatment options for certain MS patients, but it has several reported risks which limit its use. This guideline makes recommendations on the use of natalizumab based on a thorough review of the available scientific data, including reports of some serious adverse effects... Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology from the National Guideline Clearinghouse.
Immunization and multiple sclerosis: a summary of published evidence and recommendations
Some physicians have recommended avoiding vaccines during MS relapses. But what if you cut yourself and need a tetanus booster during a relapse? And what about your annual influenza vaccine? In this guideline, the experts review the evidence and sort it all out...From the National Guideline Clearinghouse.
The utility of MRI in suspected MS: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society
The use of MRI in making an early diagnosis of MS has been evolving into a more precise tool. After the first episode of symptoms which suggest MS, if other neurologic conditions have been ruled out, MRI findings may enable your doctor to more reliably predict an MS diagnosis. This can be valuable knowledge in cases where early treatment may make a difference in future disability level. This guideline sorts through the scientific evidence as to exactly what types of MRI findings predict the future onset of MS...From the National Guideline Clearinghouse.
Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis
Conclusion: CDMS is strongly associated with CCSVI, a scenario that has not previously been described, characterised by abnormal venous haemodynamics determined by extracranial multiple venous strictures of unknown origin. Read free article at PubMed.
Abstract: Treatment of early multiple sclerosis: the value of treatment initiation after a first clinical episode
Does treating MS early, during the "clinically isolated symptom" stage, make a difference in terms of postponing the development of future symptoms? The authors of this paper review three large clinical trials of early treatment with interferon beta. See abstract at PubMed.
Abstract: Fumaric Acid and its esters: an emerging treatment for multiple sclerosis
Chemical compounds called fumaric acid esters (FAE) have been used in the treatment of psoriasis, which, like MS, appears to be a disease of altered immune system regulation. German researchers, in a small , phase 2 clinical trial, found decreased MRI abnormalities in MS patients treated with a type of FAE called Bg12. Because of this promising result, several larger clinical trials of FAE are now in the works.
Abstract: Explaining multiple sclerosis prevalence by ultraviolet exposure: a geospatial analysis
It has long been noted that northern latitudes have a higher prevalence of MS cases, and it has been assumed that this is due to lack of exposure to ultraviolet (UV) light and possibly associated low vitamin D levels. This study use geospatial technology to estimate the relative risk of MS in different areas of North America, based on each region's UV index. The risk of of MS in the regions with lowest UV index was up to 5 times higher than the risk in the regions of highest UV index.
Abstract: Asymptomatic reactivation of JC virus in patients treated with natalizumab
Soon after the FDA approved natalizumab for use in MS, several cases of progressive mutifocal leukoencephalitis (PML) were reported in users. PML, a brain inflammation caused by the JC virus which is usually fatal, was suspected to have occurred because natalizumab decreased the body's ability to destroy the JC virus or to keep it in check. This study measured certain markers of JC virus (substances which would indicate the presence of the JC virus) in 19 patients undergoing natalizumab treatment. Surprisingly, they found that a significant percentage of these patients--not just a few-- had reactivation of a previously dormant JC virus which appeared to be related to immune suppression by the natalizumab. These reactivations were all asymptomatic. This study is important because it makes doctors aware that a significant number of those treated with natalizumab will have a previously dormant JC virus come out of dormancy during treatment.
Abstract: Blocking angiotensin-converting enzyme induces potent regulatory T cells and modulates TH1- and TH17-mediated autoimmunity.
Could a commonly used class of blood pressure medications called ACE inhibitors eventually be a treatment for MS? It appears that the cascade of hormones and chemicals that regulate blood pressure in humans may also be involved in autoimmune conditions such as MS, providing researchers a target for interrupting the progression of multiple sclerosis. This study was done on mice with an experimentally induced condition similar to MS in humans, and had some positive results.
Abstract: Combination therapy of lovastatin and rolipram provides neuroprotection and promotes neurorepair in inflammatory demyelination model of multiple sclerosis
Use of the cholesterol-lowering statin drugs such as lovastatin and simvastatin in combination with other MS treatments has received much attention, but remains controversial. This animal study uses combination of lovastatin and a drug called rolipram to assess its effect on nerve protection in animals with an MS-like neurological disease, and gets positive results.
Abstract: Negative impact of statins on oligodendrocytes and myelin formation in vitro and in vivo.
This study reveals a cautionary finding regarding the use of statins as a possible treatment for MS. The animals in this study which were given the statins had lowered ability to repair the damaged myelin in their central nervous systems.
Looking for a Top-Rated
Consumers' Guide to Top Doctors finds the Doctors Rated Best by other Doctors
To find out who the top doctors are around the country, nonprofit Consumers' CHECKBOOK surveyed roughly 340,000 physicians to tell us which specialists they would want to care for a loved one. The Top Doctors database contains the names of over 23,000 doctors who were mentioned most often. Find top-rated doctors in the fifty largest metropolitan areas, in over thirty-five specialties, and more.
Source: Wikimedia Commons
Symptoms of MS
World MS Day
Consumers' Guide to Top Doctors finds the Doctors Rated Best by other Doctors in over 30 specialties.
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Consumers' Guide to Hospitals
Which Hospital Should You Choose (or Avoid)?
What makes the Consumers' Guide to Hospitals so special?
We've got 30 million answers to that question. That's how many hospital records Consumers' CHECKBOOK sifted through to calculate risk-adjusted death rates and adverse-outcome rates, and that's just part of the data used to rate the hospitals. The organization also sent out more than 280,000 questionnaires to physicians in 53 major metropolitan areas in the United States, asking them to rate their local hospitals; checked ratings of the hospitals by surveyed consumers; checked which hospitals were providing recommended tests and procedures for patients with specified medical problems; and more."
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