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About Multiple Sclerosis.    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. Information provided by National Institute of Neurological Disorders and Stroke.

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 Montel Williams MS Foundation 331 West 57th Street PMB 420 New York, NY 10019 info@montelms.org http://www.montelms.org 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 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 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 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 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

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 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 Ataxia Foundation (NAF) 2600 Fernbrook Lane N. Suite 119 Minneapolis, MN 55447-4752 naf@ataxia.org http://www.ataxia.org Tel: 763-553-0020 Fax: 763-553-0167 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 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 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

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