Multiple Sclerosis is a disease of the central nervous system (brain and spinal cord) and usually attacks people in the prime of their lives. Your brain relies on messages being communicated from nerve endings all around your body. These nerve endings are responsible for all the actions you carry out on a daily basis – for example movement and speech. All the nerve endings are covered in a sheet of myelin which aids rapid conduction of electric signals between the nerve endings and your brain. With MS your immune system becomes overactive and starts attacking the myelin. Messages can either become scrambled or simply not get through. The result can be any one (or more but not limited to) of the following symptoms: loss of sight, difficulty in walking - for some confinement to a wheelchair, incontinence, speech difficulties, cognitive problems, pain and fatigue.
The Physical Effects
MS can be a terrifying illness. The courage shown by those affected is awe-inspiring but symptoms such as loss of sight, which can often appear suddenly and without warning, are difficult in every way and can affect all aspects of life – both for the individual and their family. These symptoms vary in their severity and duration depending upon whether a person has relapsing & remitting MS or progressive MS but they deny people the chance to do things which others take for granted. These things are often basic, for example MS symptoms include difficulty in walking and for some even permanent confinement to a wheelchair. Other basic functions such as going to the toilet can be affected – perhaps the most difficult symptom to talk about. Commonly speech can be affected – this can prove to be a most isolating symptom making communication difficult, particularly if other motor skills are affected when it can limit the ability even to write. MS can also bring severe cognitive symptoms such as memory loss (e.g. inability to recall events) the inability to problem solve or to find words as well as concentration or attention span problems. Other problems can include constant pain, fatigue, depression or loss of appetite.
The Human Cost
Without help and support having MS can lead to a feeling of loss of dignity, isolation, depression and anxiety attacks. There are also other human costs that come with this illness particularly as symptoms progress and the pressure on carers – who in 60% of cases are spouses or partners – mounts. A recent survey carried out by the MS Society revealed that of the 2700 respondants only 5.5% were still in full time employment. Almost half had taken early retirement due to their MS. Whilst there are benefits provided by the state this will almost certainly lead to a significant drop in income. There may also come a time where the spouse or partner has to give up work to care for the patient. When this happens this can see household income tumble and although there is a carers allowance provided by the state it is insufficient and poverty becomes a very serious threat. All of this puts strain on a marriage and other close relationships.
MS in the West Country
Multiple Sclerosis is the most common cause of disability in young people in the UK – more common, even, than Muscular Dystrophy and Cerebral Palsy. Affecting more women than men, MS hits people in their prime. Onset of the illness is usually between the ages of 20 and 40. It is estimated that there are some 1700 people with MS in the Greater Bristol Area and 100 new cases diagnosed each year. One in 10 of these people will receive the devastating news that they have Primary Progressive MS – the form where disability progresses from the onset. In each and every case MS affects the whole family, not just the individual diagnosed and since its onset is so early in life, people must live with its effects for many years.
Multiple Sclerosis may be difficult to diagnose as there is no single test which can make the diagnosis. The diagnosis is based upon proper clinical assessment of the patient's symptoms (history) and a thorough examination of the nervous system by a neurologist. Usually patients will undergo a series of associated investigations in order to guide the clinician to the diagnosis. These tests include...
Often the brain and/or spinal cord will be imaged. MRI scans are very detailed brain scans which can detect evidence of inflammation within the nervous system.
This is often used to look for further evidence of an inflammatory response within the spinal fluid.
These are tests (neuropsychological) which can measure the speed of nerve impulses between areas of the brain. Slowing of conduction is a feature of Multiple Sclerosis.
There are a number of different types of MS...
Relapsing-Remitting MS(RRMS) is the most common form of the disease
Primary Progressive MS(PPMS) PPMS is characterized by progression of disability
Secondary-Progressive MS(SPMS) SPMS begins with an initial relapsing-remitting disease
Benign MS If you have a small number of relapses followed by a complete recovery