More On Multiple
Sclerosis
During the last two
weeks we have discussed multiple sclerosis as a neurodegenerative disease, but
we have not discussed in detail that there are four different types of multiple
sclerosis.
Primary Progressive
Multiple Sclerosis:
In this subgroup, the
symptoms of the patient continually progress after diagnosis. Unlike the other
MS subgroups, there are equal proportions of men and women with Primary
Progressive, whereas in the other subgroups women outnumber men 3 to 1.
Additionally, patients are usually diagnosed at an older age (the average age
being 40). Another unique and frustrating characteristic of this group is that
treatments have not been as effective for these patients.
Relapse-Remitting
Multiple Sclerosis:
This is the most common
type with 85% of MS patients displaying Relapse-Remitting MS. As the name
suggests the unique and uniting characteristic of this subgroup is that
patients suffer periodic attacks (relapses) and then go through periods of
remission. The length of relapse, severity of relapse, and the pattern of
nerves affected vary depending on the person. Over time, generally 10-20 years,
people with this subgroup usually progress to Secondary Progressive Multiple
Sclerosis.
Secondary Progressive
Multiple Sclerosis:
Like Primary
Progressive, the symptoms of MS continually progress. In comparison to
Relapse-Remitting MS, there is characteristically less inflammation and an
increase in slow nerve damage in Secondary Progressive MS. Although the
symptoms will begin to progress steadily, that does not necessarily mean that
they will progress more quickly.
Progressive Relapsing
Multiple Sclerosis:
This is the most rare
form of MS, with only 5% of MS patients diagnosed as having Progressive
Relapsing MS. For these patients, relapses occur periodically; however,
symptoms continue and progress between relapses. Due to the progressive onset
of Progressive-Relapsing MS, it may be initially diagnosed as
Primary-Progressive; however, after a relapse occurs doctors often recognize
and change their diagnosis to Progressive-Relapsing MS.
What causes relapses in
MS? Well unfortunately, research hasn’t found the exact physiological triggers.
However, stress, infections, post-pregnancy, and vaccinations have all been
associated with relapses.
Sources:
Types of MS and MS Treatment Options. (n.d.) Multilpe
Sclerosis: Better Questions Lead to Better Answers. Retrieved November 25,
2013 from http://www.multiplesclerosis.com/us/treatment.php
Thank you Raven for this information. I did not realize that there were 4 types. I know at the end there that you stated that there are not any exact physiological triggers to for relapses in MS. So I was interested if there were any common triggers that have been tested.
ReplyDeleteUpon searching, I came across the National MS Society site. The site seemed reliable so I thought I'd peruse through. One of the first things that caught my eye on the site was about exacerbations. For an episode to be classified as an exacerbation or flare up, symptoms would have to last at least 24 hours and separte from a previous "attack" of at least 30 days. This ultimately can last between a few days to several weeks at a time. Some of the most common triggers that they listed were the following: smoking and alcohol, sensitivity to change in temperature, and relation to menopause/menstrual cycles. The current treatments for the more severe flare ups are a short course of high dose corticosteroids or adrenocorticotropic hormone injections (for those that cannot cope with the side effects of the former).
It seems to me that the 4 types of MS actually are levels of MS. Meaning that they lead to one another as the disease gets worse. For instance like you mentioned that Progressive Relapsing is often confused with Primary Progressive MS. I was thinking, couldn't it be that it does start as being Primary Progressive, but then it progresses to Progressive Relapsing. I also found interesting that MS specially Primary Progressive MS is mostly diagnosed on women than it is on men. Which they happened to mention on the National MS Society page, the same site Julianne used, that it might be related to hormones. That's all they had to say about that theory since they still haven't done much research on that area. Good Info Raven.
ReplyDeleteI also found it hard to research why women were more affected by MS than men. However, I did come across one study published in the January 5, 2011 issue of "Neurology", the medical journal of the "American Academy of Neurology". Researchers found that women were 1.4 times as likely than men to have the human leukocyte antigen (HLA) class II gene, the main gene associated with MS. It was also said that women are more likely to transmit this HLA gene variant to other women in their families than men.
ReplyDeletehttp://www.sciencedaily.com/releases/2011/01/110105194832.htm
I am particularly sensitive when MS comes up as a topic because my Uncle was diagnosed with MS three years ago. I was desperate to find something, anything that may treat or lessen relapses even for a little bit. As I was looking for some information, I came across one short TEDxTALK video, which had Terry Wahls, M.D. as a guest speaker. She was diagnosed with Relapse-Remitting Multiple Sclerosis in 2000. In 2007, she hit the point where every day tasks were extremely difficult to do due to progressed symptoms of MS. In the same year, she changed her focus to diet and tried to tackle the disease by using holistic medicine. 6 months later, she became the first one to cure MS, and to be free from the disease. Her story is extraordinary and worth spending time watching it. Below is the link to the video.
ReplyDeletehttp://www.youtube.com/watch?v=KLjgBLwH3Wc
Before I read this I didn’t know that there were four types of MS. It’s unfortunate that there is no cure for this disease. I read this article on Science daily where they researched a possible vaccine for MS. A vaccine used to prevent tuberculosis in other parts of the world may help prevent MS in people who show the beginning sign of the disease. This was recently study published in the Dec. 4, 2013 online issue of Neurology, the medical journal of the American Academy of Neurology. In this study 73 people where recruited who had a first episode of suggested MS. 33 patient received a live vaccine called Bacille Calmetter-Guerin, which is used to TB in other countries, and the other participants received placebo. 58 percent of the vaccinated people did not develop MS compared to the 30 percent who received the placebo. The results of this study seem promising but more research needs to be done to learn more. Even though there were no major side effects there should always be caution for long-term effects. I think we should be hopeful for a possible cure in the future. :)
ReplyDeletehttp://www.sciencedaily.com/releases/2013/12/131204181242.htm