Multiple Sclerosis
Information Page |
NINDS is part of the
National Institutes of
Health
Table of Contents (click to jump to sections)
What is Multiple Sclerosis?
Is there any treatment?
What is the prognosis?
What research is being done?
Organizations
Related NINDS Publications and Information
Publicaciones en Español
Additional resources from MEDLINEplus
What is 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.
One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks
in people with relapsing forms of MS and was approved for marketing by the U.S. Food and Drug Administration (FDA) in 2004.
However, in 2005 the drug’s manufacturer voluntarily suspended marketing of the drug after several reports of significant
adverse events. In 2006, the FDA again approved sale of the drug for MS but under strict treatment guidelines involving infusion
centers where patients can be monitored by specially trained physicians.
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.
What research is being done? The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health
(NIH) conduct research in laboratories at the NIH and also support additional research through grants to major medical institutions
across the country. Scientists continue their extensive efforts to create new and better therapies for MS. One of the most
promising MS research areas involves naturally occurring antiviral proteins known as interferons. 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. In addition, there are a number of treatments under investigation that may curtail attacks
or improve function. Over a dozen clinical trials testing potential therapies are underway, and additional new treatments
are being devised and tested in animal models.
In 2001, the National Academies/Institute of Medicine, a Federal technical and scientific advisory agency, prepared a strategic
review of MS research. To read or download the National Academies/Institute of Medicine report, go to: "Multiple Sclerosis: Current Status and Strategies for the Future."
Select this link to view a list of studies currently seeking patients.
Multiple Sclerosis Association of America 706 Haddonfield Road Cherry Hill, NJ 08002 webmaster@msaa.com www.msassociation.org Tel: 856-488-4500 800-532-7667 Fax: 856-661-9797 |
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 |
Accelerated Cure Project for Multiple Sclerosis 300 Fifth Avenue Waltham, MA 02451 info-ninds08@acceleratedcure.com http://www.acceleratedcure.org Tel: 781-487-0008 Fax: 781-487-0009 |
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 |
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 |
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 |
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 |
National Ataxia Foundation (NAF) 2600 Fernbrook Lane North Suite 119 Minneapolis, MN 55447-4752 naf@ataxia.org http://www.ataxia.org Tel: 763-553-0020 Fax: 763-553-0167 |
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 |
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 |
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 |
Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
Last updated August 13, 2008