Learn About Multiple Sclerosis


Multiple Sclerosis FAQs

Is multiple sclerosis contagious or fatal?

MS is neither contagious nor fatal. People with MS have a life expectancy that is not really any different from the general population. The leading causes of death in the MS community are heart disease, cancer, and stroke. MS tends to affect quality of life, not quantity of life. There are unusual variants of MS than can be very aggressive and potentially shorten life, but these are not the norm.

What are the most common symptoms of MS?

The most common characteristics of MS include fatigue, weakness, spasticity, balance problems, bladder and bowel problems, numbness, vision loss, tremor and vertigo. Not all symptoms affect all MS patients and symptoms and signs may be persistent or may cease from time to time.

Because the signs and symptoms that define the clinical picture of MS are the result of nerve lesions causing disturbances in electrical conduction in one or more areas of the central nervous system, the nature of the symptoms that occur is determined by the location of the lesion.

Why do doctors feel that I am imagining my symptoms?

In the beginning phases of multiple sclerosis, diagnostic tests, such as MRI's, may be negative but the patient may experience subjective sensory symptoms. These symptoms can include numbness, tingling, or fatigue, and will not be seen on diagnostic tests. This leads doctors to believe there is no illness or that anxiety is present. You should also know that a clinical diagnosis of MS may take years. Often a physician observes a person over a period of time before reaching a diagnosis of MS. Neurologists are generally consulted and diagnostic tests such as MRI's, evoked response potential, and others may be used to help with a diagnosis.

If you are not sure you have MS, don't be afraid to ask questions and to find out more about feelings and symptoms. Do not let symptoms continue without further investigation.

Am I going to end up in a wheelchair?

The natural course of MS is highly variable, and it is impossible to predict the nature, severity or timing of progression in a given patient. Some people with MS will have a more progressive disease course than others.

In some cases, the course of MS over the first five years may provide a clue to the progression of the disease over the next 10 years. Recent studies indicate that 90% of patients with minimal disability five years after onset were still ambulatory at 15 years. It is estimated that at 20 years after diagnosis, about 1/3 of people who receive no treatment may require a wheelchair or other assistive device.

With the present immunomodulatory therapies, the goal is to slow the progression of disability. Some people with MS respond quite well and may have no progression over years. For others, the treatment may slow, but not stop the progression. It is important to be proactive and work with your healthcare provider in order to obtain the most appropriate treatment, thus obtaining the highest level of benefit.

What options can help me?

Early treatment makes a difference. The necessity for early treatment in MS is becoming increasingly clearer. The time has passed for the “let’s wait and see how it goes” attitude before treatment is begun. The message is that early treatment seems to delay disability presumably by decreasing the injury to the nervous system by the multiple sclerosis. The drugs used for treating MS are currently: Avonex, Betaseron, Copaxone, Tysabri or Novantrone. Another option is alternative healing modalities. Many people find a combination of the two choices can achieve the best results.

Does diet affect multiple sclerosis?

Although diet is not currently considered a causative factor in MS, anecdotal evidence abounds from individuals with MS who have experienced health benefits by changing their diet. Eating consistently well over a period of time may help reduce fatigue, improve bladder and bowel problems, increase energy, and prevent bone loss. It may also positively impact mental and emotional health, including memory and concentration.

To learn more, request a copy of Nutrition & MS by calling 1-888-MSFOCUS (673-6287).

Does stress affect multiple sclerosis?

By understanding some of the psychological changes that accompany chronic disease, one may take an active role to achieve a more healthy mental state. Psychotherapy or counseling, and body cooling are ways one can relieve stress. Some prefer alternative treatment options, including relaxation techniques (exercise, yoga, massage therapy, meditation, biofeedback, and music) to learn ways to manage unavoidable stress. With MS, the stress that must be managed is the “distress” that may hamper our ability to cope with the events and people in our lives.

Can I get pregnant though I have MS?

For a woman with MS, the decision to have a baby can be more difficult. MS does not hinder a woman’s chance of becoming pregnant and carrying a child to full term. MS is only another factor in one’s decision to have a child, not the only one. Planning the pregnancy and getting all the information you need can make the decision process easier.

Together with your partner, visit your neurologist and discuss current disease activity and possible progression. With a bit of flexibility and a creative, proactive approach on the part of both parents, solutions to various challenges presented by MS are attainable. Attend a local MS support group meeting and talk to others who are successfully parenting with MS.

To learn more, request a copy of Pregnancy for Women with MS by calling 1-888-MSFOCUS (673-6287).

I have significant pain in the vicinity of T2-T7. When the pain first appeared, Mri's revealed new MS lesions in precisely the area (s) where I experienced new pain. Two or three times I could predict where the new 'lesions' were and the imaging confirmed my sense. Another radiologist dismissed the validity of the "lesions" on my spine. My question is: Do atypical MS lesions on the cord cause proximate pain? I have taken pain meds for 6 years, and have had to limit all activities as the result of this pain which remains (definitively)un- diagnosed

Dear Ms. Bertolet,

Thank you for contacting the MS Foundation.

Please contact the MSF Support Team at 888-673-6287, regarding your inquiry.

 

 

Is sleep apnea a symptom or side effect of multiple sclerosis?

Thank you for your inquiry.

Obstructive sleep apnea (OSA) is more common in the MS population as compared to the general population. Some people with MS who have OSA do not fit the typical profile of who we think of as having this sleep condition. Typically, when we think of OSA, we think of a middle-aged male who is likely overweight. In MS, this may not be the case. In the MS community, we do see younger people, women and people of normal body weight with OSA. Sleep disorders are importatnt to watch for in the person with MS as they can contribute to fatigue and put the person at risk for other long-term health problems.

Dr. Ben Thrower

I have been diagnosed with chorioretinitis (lesions in my left eye in the choroid behind the retina) i have lesions in my brain my neurologist says probable MS , my Opthamologist tested my blood for herpes syphyllis toxoplasmosis and lupus also lyme disease all came back negative so could the choioretinitis be ms related? I am from a little city and alot of people who have ms here go to dallas for treatment, I am going to be refered to ut southwestern . but untill i go there was just curious because i donot have optic neuritis just choroiretinitis

MS usually affects the optic nerves and not the retina or choriod. Inflammation of the retina and choroid is normally from another cause. It is highly unlikely that the diagnosis of chorioretinitis is directly caused by MS.

Annette Okai, MD

why would a doctor use chemotherapies on somone with ms that is not real bad

There are several drugs used in MS that could be considered chemotherapies. These include oral medications like methotrexate, Imuran and Cellcept. Intravenous medications include mitoxantrone and cyclophosphamide. Depending upon the medication and the dose, some of these drugs may have a lower side effect risk than others. Without knowing the specifics of a person’s case, it's hard to know a certain medication was recommended. Sometimes a drug like methotrexate may be picked if there is a suspicion of other superimposed health issues, like rheumatoid arthritis.

Dr. Ben Thrower

I was recently diagnosed with MS but I have no physical symptoms. I have several cerebral lesions the largest is located parallel to my ventricles. When can I expect to have symptoms? Is it possible for me to never be symptomatic?

"Thank you for the question. Absolutely it is possible to remain symptom free or at the very least that it not interfere with your daily life -- but the important thing is to seek good follow-up with a neurologist and to start disease modifying agents.

Thank you,

 

Daniel Kantor, MD

Medical Director

Neurologique

 

President

FloridaSociety of Neurology

----------------------------------------------------------------

 

Be a leader, help the network ... join neurologique@gmail.com

 

Multiple Sclerosis Team Approach Rule *** MS Patient Network

 

www.neurologique.org

 

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Should a person currently on Betaseron receive the Zostavax vaccine since it is a live vaccine?

Thank you for your inquiry to the MSF.

The answer is No.

Pts with MS should not receive any vaccinations with a live virus component.

Dr. Mitzi Williams, Neurologist

MS Center of Atlanta

What excise can i do to get rid of my pain. Since i was told that i have MS i have alot of pain back, numbness and my legs burn.

Hello! Here's my response:

"Thanks for the inquiry. Neuropathic pain can be a major problem for MS patients. Targeted exercise can help, especially proper stretching. It would be best to see a professional like a Physical Therapist for help in setting up an exercise and stretching program. The burning pain in your legs will likely not respond totally to exercise. Medication is often necessary. Gabapentin and/or baclofen would be good first choices for help with pain and muscle stiffness.

I hope this helps."

Dr. Greg Zarelli, MD

Where do you recommend getting a light weight walker and a "skinny one." My mother has M.S. and I would like to find one of those for her.

Dear Rebecca,

Your mom can apply to the Assistive Technology Grant program, listed on our webiste under the heading "Programs and Activites" , for possible assistance in obtiang a walker.  Please feel free to contact our support team at 888-673-6287 if you have any questions regarding this process. 

Thank you for your inquiry to the MSF.

Crystal

 

I was diagnosed with Fibromyalgia, but I am discovering that I have more symptoms of MS than I do FMS. And it seems to be progressing which they say FMS doesn't do. Where should I start in getting checked for MS???

Dear Renee,

The MSF has information listed on our website to tell you more about how an MS diagnosis is determined. You can view this link, http://www.msfocus.org/diagnose-multiple-sclerosis.aspx or look on our website home page under the heading “Learn About MS.” Some people who suspect that they have MS may discuss their concerns with their physician or the may inquire further with a neurologist or MS specialist.

Thank you for contacting the MS Foundation.

Program Services Support Team

Other than Neurontin, what can I take for nerve pain? Would Estrogen therapy help?

Although multiple sclerosis was previously thought of as a “painless” disease, it is now recognized that pain is a common symptom in MS, affecting over 50% of patients at some point in their disease. Unfortunately, pain is a rather generic term that can refer to numerous underlying issues; in addition, people have different “tolerances,” above which stimuli are deemed as painful. Certainly, the factors for the later are an area of intense research. Pain may refer to a local destructive process (i.e. skin breakdown from sacral decubitus ulcer, fracture, or trauma) or may represent a disruption in the mechanism for sensory input, including altered sensory signals (dysthesias) or the sensation that normal stimuli are painful (allodynia). An individual’s experience of pain is likely altered by co-existing conditions and previous experiences with pain (or health care response to pain). Obviously, not all painful sensations in an MS patient are a direct result of multiple sclerosis; therefore, the first step in pain management is to appropriately delineate the nature / etiology of the specific pain (or pains) in question. As with most MS symptoms, treatment of pain in MS is accomplished best by utilizing a team approach including pharmacological and non-pharmacological modalities.

 

Many people suffer from musculoskeletal pain, often due to abnormal “wear and tear” of muscles or joints. Often, this is described as an aching pain, usually precipitated (or exacerbated) by certain movements, and often responsive to non-steroidal anti-inflammatory medications (like ibuprofen), heat, ice, and rest.  Physical therapy is often helpful with this type of pain, providing exercises to strengthen muscle and increase flexibility, to normalize function and improve posture. Therapists also use other modalities, including ultrasound or electric stimulation, to relieve pain. Musculoskeletal pain is quite common in patient with multiple sclerosis and may be due to alterations in function due to acquired neurological deficits. For example, one patient with a foot drop due to leg weakness may develop hip or back pain from “hiking the hip upwards” to clear the foot when walking; others may get pain in the good leg because of “overuse” in an attempt to compensate for the affected limb.  Patients with LE weakness from spastic paraparesis may hyperextend their knee (genu recurvatum), which can lead to abnormal wear and tear (and pain in the affected joint); on the other hand, if the weakness is severe, a joint may develop a decreased range of motion or even freeze (develop a contracture) due to decreased movement.  

 

Spasticity is a very common finding in patients with multiple sclerosis. Although often described as “muscle stiffness,” it is defined as “velocity-dependant resistance to muscle stretch”. Although spasticity is sometimes painful (causing muscle stiffness and spasms), it can often be beneficial, allowing patients to compensate for underlying weakness, in that a spastic leg is often stiffly extended, and a spastic arm is often in flexion. Obviously, too much tone can not only be painful, but it can also interfere with function and increase fatigue (due to the excessive muscle contraction). Unfortunately, other types of pain (or infection) can exacerbate spasticity, at times leading to a “vicious cycle” of increased pain and increased spasticity. Treatment of spasticity is also multi-disciplinary, often involving physical therapy (active and passive stretch) and medications like baclofen (Lioresil) and tizanidine (Zanaflex).

 

  1. It is thought that this nerve pain is caused by an aberrant signal jumping from one damaged nerve to another (so-called ephaptic transmission), which is likely why this type of pain often responds to seizure medications (anti-convulsants), which probably reduce the aforementioned “short circuits.” Gabapentin (Neurontin) or pregabalin (Lyrica) is often used to treat this type of pain; other epilepsy medications like lamotrigine (Lamictal) or carbamazepine (Tegretol) can also be used. Tricyclic antidepressants like amitriptyline (Elavil) and nortriptyline (Pamelor) can also be effective.

 

Depression is very common in patients with MS (much more so than in the general population), and often “depression hurts,” especially in patients who have significant other issues with pain. I suspect that there is a vicious cycle with pain and depression with worsening pain leading to worsening depression, and vice versa, and I have had patients experience improvement with both mood and pain with agents like duloxetine (Cymbalta) and venlafaxine (Effexor).

 

The topic of hormones in MS deserves an article by itself. Given that women are over 3 times more likely to get MS than men suggests that female hormones play a role in MS; it has also been observed that pregnancy is a relatively protective time from an MS point of view, but the disease is often quite active in the post-partum period. These observations have lead to some ongoing clinical trials in MS. Certainly, the Women’s Health Initiative raised significant questions about the safety of hormone replacement, and there is very little data to support hormones for pain relief.

 Dr. David Jones, MD

I had a MRI that showed white matter in my brain. I have one area that looks like my small finger and other areas not that big. I have some memory problems and have problems with words and thoughts but not all the time. I have become clumsy and my vision has become awful. I saw a Dr. who said, he could do more test but he doesn't know if I will get anymore white matter or not. This may be it. I would need to decide what to do regarding more testing. Should I let it go and just wait to see if I get worse. It appears this is the one disease that early detection is of no use. Of course, the day I saw him I was doing ok on exam. After I left it took me 5 minutes to get something out of my mouth but he didn't see that.My daughter said, too bad the Dr. didn't hear that.....

Early treatment of MS is generally more effective than waiting until later in the disease. If there is some suspicion that you may have MS, I would suggets going ahead with more testing rather than taking a "wait and see" approach.

Dr. Ben Thrower, MD

I have a major pain whenever I move. My PT said she's never had an ms patient that had this particular pain. It's the bone behind my left ear and it's quite painful. I've tried acupuncture, a dentist, steroid injections, cymbalta,and no pain meds ever helps. Sometimes I think its a spasm but other times I'm not sure. It's getting worse. What can I do? Thanks for any reply. Pam

You may be describing occipital neuralgia. This condition is more common in people with MS, but can be seen in those without MS as well. The greater occipital nerve exits the base of the skull and supplies sensation to the scalp. Pain can travel anywhere along that course of the nerve but may center behind the ear or at the base of the skull. Possible treatments include a local nerve block, carbamazepine (Tegretol) or oxcarbazepine (Trileptal). An older anti-inflammatory drug called indomethacin is sometimes effective as well.

Dr. Ben Thrower, MD

I have over 24 lesions on my brain. What are the chances of me getting a new lesion that will actually cause me to be bedridden? Is it the same as someone with only one lesion or does it go up, because I have so many?

The total number of lesions you have on MRI does not predict the future risk of a severe relapse. There are many variables to consider. If you are on one of the FDA-approved therapies, your risk of an attack is lower. If you have a relapse, there is some chance of a permanent new symptom, but it would be unlikely that a relapse would leave you permanently unable to get out of bed.

Ben Thrower, MD

I've heard of a woman with m.s. becoming pregnant and all symptoms of m.s. disappeared while she was pregnant. Can you explain? Also, is any research being done on things such as this?

Pregnancy is typically associated with a relative quieting of MS, especially in the second and third trimesters. This is an area of significant research with an estrogen called estriol appearing to play a large role. There are ongoing research projects looking at the use of estriol in treating MS. The 6 months after the baby is associated with a slightly higher risk of a relapse. Overall, the effect of pregnancy and delivery on a woman's MS may be slightly protective.

Dr. Ben Thrower, MD

I have been on betaseron for nearly two yrs, I had a recent MRI Brain that shows a new 4 mm lesion in the left thalamic area of my brain, does this mean the meds stopped working? Thanks.

“No medicine is perfect and people continue to have new MRI white spots despite therapy. It sounds like the Betaseron has been working for awhile and the decision of whether to switch is a lot more complicated than whether there is a new lesion or not -- this is why it is so important for you to talk to your neurologist about how you are doing.”

Thank you,

Daniel Kantor, MD

Medical Director

Neurologique

President

FloridaSociety of Neurology

----------------------------------

Be a leader, help the network ... join neurologique@gmail.com

Multiple Sclerosis Team Approach Rule *** MS Patient Network

www.neurologique.org

Twitter, facebook, blogs and more.

I have been on betaseron for nearly two yrs, I had a recent MRI Brain that shows a new 4 mm lesion in the left thalamic area of my brain, does this mean the meds stopped working? Thanks.

“No medicine is perfect and people continue to have new MRI white spots despite therapy. It sounds like the Betaseron has been working for awhile and the decision of whether to switch is a lot more complicated than whether there is a new lesion or not -- this is why it is so important for you to talk to your neurologist about how you are doing.”

Thank you,

Daniel Kantor, MD

Medical Director

Neurologique

President

Florida Society of Neurology

----------------------------------

Be a leader, help the network ... join neurologique@gmail.com

Multiple Sclerosis Team Approach Rule *** MS Patient Network

www.neurologique.org

Twitter, facebook, blogs and more.

Sufro de muchos sintomas, espasticidad, fatiga, depresion, vertigo,ansiedaed, y los llamados sintomas invisibles, por ejemplo, electricidad, el abrazo de la esclerosis, pero en especifico quisiera saber a que se debe el calentamiento excesivo de las palmas de los pies y manos, especialmente por las noches. Tengo aire acondicionado, incluso duermo con alguna manta, pero siempre destapado los pies y manos. He tratado el gabapentin y otros medicamentos, pero nada me ayuda. Alguien padece ese sintoma, o hay alguna explicacion. Incluso mi esposo toca mis manos y las siente calientes, incluso me tomo la temperatura y esta bien. Espero me puedan contestar, ya que lo redacte en Español. Gracias

Gracias por su consulta a la Fundación MS.

La siguiente es una respuesta proporcionada por uno de los profesionales médicos voluntarios de la Fundación:


"El malestar al igual que usted describe pueden responder a la gabapentina, Cymbalta, Savella, carbamazepina además de muchos otros medicamentos. No es un medicamento antiguo llamado 4-aminopiridina que a veces funciona para los síntomas relacionados con el sobrecalentamiento. Este medicamento no está aprobado por la FDA, pero puede verse agravada por un farmacéutico ".

El Dr. lanzador

-----
MS Personal de Apoyo

iwas given positive diag of ms 2 days ago. i also have type 2 diab. wicj we are having a terrible time getting under control. how do i manage both of these

MS and type 2 diabetes are really two different health issues. While type 1 diabetes is an autoimmune condition like MS, type 2 diabetes is not. You may need to avoid steroids for MS relapses as they can significantly elevate your blood sugars. Given how common type 2 diabetes is, it's not unusual to see individuals with both conditions.

Ben Thrower, M.D.

It is my understanding that if a person has thyroid disease they are a good candidate for MS. I believe I have a lot of the symptoms suchas: muscke spasm of leg, muscle weakness of leg, difficulty urinating, dizziness, problems with balance, depression, forgetful, unable to concetrate, feeling stupid.

People with MS often have thyroid disease but having thyroid problems alone doesn't mean that someone has MS -- but having neurological symptoms does mean that you should talk to your PCP about seeing a neurologist -- they can help figure out the cause of your symptoms.

 

--

Thank you,

 

Daniel Kantor, MD

Medical Director

Neurologique

 

President

FloridaSociety of Neurology

 

** Come to the FSN Annual Meeting: Sept 28 - 30, 2012. Register Today! **

----------------------------------------------------------------

 

Be a leader, help the network ... join neurologique@gmail.com

 

Multiple Sclerosis Team Approach Rule *** MS Patient Network

 

 

www.neurologique.org

 

Twitter, Facebook, Blogs, YouTube and more.

I have RRMS. A week or so ago I woke up with pain in behind my right eye. It even hurt to blink. I had blurred vision as well. This lasted for three days. Does this mean I had an exacerbation?

Yes, you should definitely call your neurologist and let them know that you may have had optic neuritis. Although if it really only lasted 3 days then it is quite short and there may be no need for an intervention, but your doctor would want to know about it as it may have an effect on future treatments. 

 

Thank you,

 

Daniel Kantor, MD

Medical Director

Neurologique

 

President

FloridaSociety of Neurology

 

** Come to the FSN Annual Meeting: Sept 28 - 30, 2012. Register Today! **

----------------------------------------------------------------

 

Be a leader, help the network ... join neurologique@gmail.com

 

Multiple Sclerosis Team Approach Rule *** MS Patient Network

 

 www.neurologique.org

 

Twitter, Facebook, Blogs, YouTube and more.

Are headaches/migraines a common MS symptom?

Headaches are common period. 40 million Americans have migraines and even more have any type of headaches. So, sometimes headache is just a common symptom for anyone -- with or without MS, but other times it may be associated with MS or may even be an MS symptom. Stay tuned for an article that I am writing for MSFocus magazine.

 

Thank you,

 

Daniel Kantor, MD

Medical Director

Neurologique

 

President

Florida Society of Neurology

 

** Come to the FSN Annual Meeting: Sept 28 - 30, 2012. Register Today! **

----------------------------------------------------------------

 

Be a leader, help the network ... join neurologique@gmail.com

 

Multiple Sclerosis Team Approach Rule *** MS Patient Network

 

www.neurologique.org

 

Twitter, Facebook, Blogs, YouTube and more.

I have more questions

The Multiple Sclerosis Foundation is pleased to answer any question you have about multiple sclerosis. If you have a question that was not addressed, please call our National Toll-free Helpline at 1-888-MSFOCUS (673-6287); or you can contact us by email: support@msfocus.org.

(Last reviewed 7/2009)


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