After 11 Years and Countless Dismissive Doctors, I Was Finally Diagnosed With Early Onset Parkinson's Disease

Parkinson's disease usually strikes older adults, so doctors didn't believe that Christina Korines, 35, had this neurological disorder. Instead, they blamed her tremors and pain on everything from anxiety to ADHD to psychosis.

I remember the day my tremors started. It was 2006, and I was 22 years old. I was in the car with my boyfriend, Nick (who is my now husband). We heard a tap-tap-tap, and we immediately pulled over because we thought something was wrong with the car.

Once we turned off the car, Nick looked down and said, "Something’s going on with your leg." I looked over and realized it was hitting the car door. I was freaked out, but I was sure whatever was making my leg move like that would go away. I thought it had to do with being nervous.

At the time, I was a teacher’s aide working at an elementary school. Shortly after the incident in the car, my tremors reappeared. One of my tasks at work was to cut out letters to form the names of each kid in the class, and I realized I couldn’t control the scissors with my right hand.

At that point, I was worried. I made an appointment with my general practitioner. My doctor told me that it seemed like I had a lot of anxiety and suggested I go to a psychiatrist. I didn’t disagree. When the doctor tells you something, you trust that they are the expert.

The psychiatrist diagnosed me with severe ADHD and put me on a hefty dose of medication. I really wasn’t sure about the diagnosis—I'd always been a great student and never had trouble focusing. But again, I was convinced that the psychiatrist knew what was best, and if he was giving me this prescription, it’s gotta be real.

Yet after a few months on this medication, my tremors, which only affected the right side of my body, got progressively worse. My psychiatrist then told me I should see a neurologist. I was scared, so I held off. It wasn’t until Nick, who at this point was my fiancé, expressed concern about my symptoms that I actually made an appointment.

The neurologist immediately raised the possibility that I had multiple sclerosis (MS) and sent me for an MRI. The MRI came back perfect; there were no signs of MS. At the time, my doctor referred to my young age and joked that I couldn't possibly have Parkinson's disease. "I can’t tell you that you don’t have Parkinson’s, but you’d be in the Guinness Book of World Records if you did." He thought it was really funny. It was a foreshadowing.

After that, I dropped it for a few years. I still had symptoms, but I was tired of being dismissed by doctors and just decided to deal with it on my own. When I was 26, Nick and I got married, and soon after I got pregnant.

Once I gave birth to my daughter, however, my symptoms started worsening again. I was limping and dragging my right foot. Nick was alarmed and suggested we see a doctor who specializes in MS. I had done some research and learned that after you give birth, MS symptoms could get worse.

So, I made an appointment. I had tons of blood work done and an MRI. Everything was perfect, and the doctor confirmed I didn’t have MS…but he had a feeling I could have Parkinson’s disease. He wanted to give me a test that would require me to not breastfeed for 48 hours because the test involved an injection. I had a newborn baby, and I was terrified. I didn’t want to be unable to feed my baby, so I avoided it and didn’t go back.

Instead, I sought out another neurologist who told me I had MS. But once he did the testing, he told me I didn’t have MS. One of the doctors also diagnosed me with generalized anxiety disorder and said I should just do yoga and have lots of sex as treatment.

I remember my exact reaction to that. I replied, "Did my husband call you and tell you these things?" I made it into a joke. In my head, I thought maybe I'm crazy or losing it. So I tried to make light of it. I was defeated. The doctor was very condescending and dismissive. But I thought if a doctor is telling me this, I was like, maybe it's me. Maybe this is all in my head. She laughed at my joke, so that’s how I tried to play it off. But it was so frustrating.

I gave birth to my second daughter four years later. By now, I was starting to have falls. I was still limping so badly, people would ask me if I was in pain. My right arm stopped swinging when I walked. My speech was also affected. I was working as a teacher and the kids in my class couldn’t hear me when I spoke. My sense of smell was also disappearing. One day, Nick came home and said, ‘Chris, the house smells...I think the baby pooped. You don’t smell that?’ I couldn’t smell anything.

I had a breakdown. I was crying. I just kept saying I don’t feel right. My legs don’t feel right. Nick suggested calling a doctor who specialized in Parkinson's. He hadn’t forgotten that one of the doctors early on being mentioned it. I hadn’t either.

I live in New Jersey just outside New York City, so I Googled 'best Parkinson's clinics in NYC." NYU Langone’s Fresco Institute for Parkinson’s & Movement Disorders came up, and in October 2017, I went for my appointment. My doctor came out to meet me in the waiting room, and that gave me a good feeling. As I started walking, he noticed I was limping heavily. He said, "Christina, can you walk in front of me?" I looked at my husband and said, "Nick, that's not good." I could see it in the doctor's face, who was nodding his head as he watched.

In the exam room he started asking questions and went through my neurology history. I'd had five MRIs at that point. He told me to stop getting MRIs. He looked at my bloodwork, which was good. He pressed me about the symptoms that scared me most: the loss of smell, voice, and the swing in my right arm, and my worsening tremors.

He began testing my motor skills, and midway through asked if he could record the appointment so he could show the other doctors. I remember looking at him and saying, "you think I have Parkinson’s, don’t you?" I knew something was really wrong. Finally he said, "I’m so sorry to tell you that you have young onset Parkinson’s disease."

Young onset Parkinson's disease, also known as early onset Parkinson's disease, affects younger people, I learned. Most people diagnosed with this neurological disorder that affects movement are over 50. But about 2%-10% of people who have it are under 50, and the disease is then called young or early onset Parkinson's, states the Parkinson's Foundation. The cause isn't known, though genetics may be involved.

I didn’t believe it until I looked over at Nick. He turned bright red, and his head flew back into the wall as he started crying. I cried hysterically. I was terrified. But my doctor said, "This isn't going to kill you; it isn't going to shorten your life. You're just going to have a different quality of life. Christina, you’ve had this since you were 22. You’ve gone 11 years fighting this on your own. Let’s try to make your life a little easier."

Though Parkinson's is a progressive disease that causes tremors and stiffness and therefore makes moving more difficult, early onset Parkinson's progresses at a slower rate. That's because young people are healthier in general and also can start treatment—like medication and physical therapy—earlier.

After my diagnosis, I was put on two different medications that were both awful. I gained weight and it affected my sleep. The medicine also gave me compulsive behaviors. I would spend money on things I would have never spent money on. One night I woke up surrounded by chocolate wrappers and credit cards. I just thought, this is not for me. I can’t do this. I decided I had to find a holistic way to live with Parkinson's, with no medication. My doctor didn’t think it was the right decision, but he supported me—he made me promise that if I go back to having falls, I'd go back on the medication.

For months I was medication-free, but I did start back on the medication because my symptoms were worsening. I tried a new medication called Levodopa. At first I was super nauseous and sleepy, but within days I started to feel human again. I had little peaks and sparks of time that made me remember what it feels like to be normal. I now take it 3-4 times a day. On a good day when the medicine works appropriately, my tremors will slow down, yet they never completely disappear.

The meds also allow me to get two solid hours of walking without an obvious limp. I have better balance, I can speak louder, and my sense of smell will come back. All of the things Parkinson’s takes away get a brief reprieve. I feel exactly like Cinderella at midnight when the medicine starts wearing off. It’s like my chariot turns back into a pumpkin.

Parkinson’s comes with an unspoken mental health battle. I have anxiety, and I now take Paxil. On bad days, I speak to a therapist. I’ve also started boxing twice a week. I train like a boxer to keep my hand-eye coordination strong. For 30 minutes, you’d never know I was sick. I try to walk as much as possible, too. On days I can’t walk, my husband carries me into the gym. I’ve also started weight training—the stronger the body, the harder it is for the disease to attack.

Throughout my journey, I’ve become so thankful for the things I still have. Gratitude is very important to me. I look for the moments when I can say, "Man, this is awesome. Today I was able to zip up my kids’ jackets and tie their shoes." My faith in God and our church helps me get through it.

My diagnosis with Parkinson’s has been a long journey. I truly believe that nobody knows your body better than you. If you feel something is wrong, the most important thing to do is listen to your body. I’m not saying all doctors are wrong, but you’re allowed to get a second opinion.

I definitely don’t recommend putting off seeking treatment, but nobody is going to advocate for you as much as you. Keep fighting until you feel comfortable. I’m just so grateful people that I'm surrounded by amazing support.


This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Autoimmune Disease 101

“There’s no sign of this trend slowing down; on the contrary, the prevalence of autoimmune diseases like type 1 diabetes, inflammatory bowel disease, and multiple sclerosis is increasing at an alarming pace. From 2001–2009 alone, the incidence of type 1 diabetes increased by 23 percent!”

To add concern to the growing number of individuals living with the condition, it appears that conventional treatment has little to offer in reducing the severity and discomfort that accompanies autoimmune disease. 

What is Autoimmune Disease?

The human body is designed with a specialized immune system composed of a complex network of special cells and organs.  These cells and organs are designed to defend the body from germs and other foreign invaders.  
At the core of your immune system is the ability to differentiate between “self” and “nonself”, or what is you versus what is foreign matter.  Autoimmune disorders, or disease, occurs when the body’s immune system begins to attack and destroy healthy body tissue by mistake.  

"Autoimmune diseases are born when your body is working hard to defend itself against something potentially dangerous, such as an allergen, a toxin, an infection, or even a food, and it fails to differentiate between the intruder and parts of your own body. Mistaking certain types of tissues for harmful substances, your body turns these antibodies against itself, wreaking havoc on your organs.”

Autoimmune disorders usually fall within one of two categories: systemic or local.  Here is the difference:

• Systemic autoimmune diseases are linked to the production of non-specific tissue autoantibodies, leading to a spectrum of damage which can affect a wide range of tissues, organs, and cells of the body.
• Localized autoimmune diseases, on the other hand, lead to organ-specific conditions, affecting a single organ or tissue.

It is important to note, however, that the boundary between systematic and non-systematic disorders can become a bit fuzzy as the disease runs its course.  In other words, as the effect and scope of localized autoimmune disorders takes hold of the body, it is not uncommon for the damage to extend beyond the initially targeted areas.

Immune System 101

To better understand how your body has the ability to “attack itself”, leading to the development of an autoimmune disease, it helps to know the basics about immunology.  Let’s briefly look at the various organs, the cells they produce, and the role these specialized cells play in protecting you from illness.
Immunology basics:

• Bone marrow – found within your bones, where immune cells are derived.
• Thymus –  A flat, pinkish-gray gland, found in the upper chest in front of the heart.  This is where your T-cells pass through and mature.
• Lymphatic system – A critical system for the elimination of toxic waste from your tissues.  This system is made up of lymph fluid, lymphatic vessels, bone marrow, lymph nodes, spleen and tonsils.
• T-cells –  These immune system cells function like “warriors” and mature in the thymus.  Once mature t-cells enable each individual T-cell to recognize only one of millions of antigens, at which time they migrate into your lymphatic system and circulate in the blood.
• B-cells – These immune cells are produced in and by your bone marrow and are responsible for the secretion of antibodies.

You’ll notice the term “t-cells” used multiple times in the above list, and as you may have already gathered T-cells are of great importance. These cells are taught to recognize invading cells, or non-self cells, from your own cells.  
Remember, a normal functioning immune system only attacks substances and infections that are thought of as foreign invaders, such as cancer cells.  When the immune system is “confused”, it begins to attack healthy cells found within the body.

Target Organs and Tissues

The triggers for autoimmune disorders are rather variable, and may be brought on by the following conditions:

• Environmental exposure to chemical solvents 
• A drug response
• Contraction of a viral or bacterial infection
• Sunlight or radiation

Just as the triggers for an autoimmune reaction are varied, the debilitating effect vary as well depending on the target organs and tissues affected by disorders.  (1) With more than 80 types of autoimmune disorders, some common tissue types and bodily sites that the immune system can begin to attack include:

• blood vessels
• connective tissue
• endocrine glands (i.e. thyroid or pancreas)
• joints
• muscles
• red blood cells, and
• skin

Keep in mind it is possible to have multiple tissues and organs attacked by the immune system, resulting in the diagnosis and presence of more than one autoimmune condition at the same time. 

Signs and Symptoms of Autoimmune Disease

There is some amount of mystery and confusion behind certain autoimmune conditions, such as multiple sclerosis, rheumatoid arthritis and thyroiditis. Part of what contributes to the unknown lies in the fact that the biological basis, and some of the most common symptoms that accompany such debilitating illnesses, may not be linked to one specific infection.

“Despite its prevalence, the level of basic autoimmune research funding is below 3% of the National Institutes of Health (NIH) total budget, which may explain why we understand so little about the roots of these diseases. Indeed, AARDA reports that the whole arena of autoimmune research is in its infancy…We do know there are factors at the root of autoimmune diseases development, which include both genetic and environmental components.”

While the biological or genetic and environmental factors contributing to the development of an autoimmune disorder may not be well understood, there are some well documented signs and symptoms.
Experiencing any of the symptoms listed below may indicate the presence of an autoimmune disease; however, experiencing more than one of these symptoms could increase the likelihood of an autoimmune disorder:

• Joint pain or muscle pain, accompanied by weakness or tremors
• Unintentional weight loss or weight gain
• Insomnia
• Intolerance to heat or cold
• Rapid heartbeat
• Recurrent rashes or hives or sun-sensitivity 
• Brain fog, difficulty concentrating or focusing
• Abdominal pain, bloody stools, diarrhea
• White patches or ulcers in and around your mouth
• Dry eyes, mouth, or skin
• Numbness or tingling in hands or feet
• Multiple miscarriages or blood clots

Gender Differences

It is estimated that up to 1/3 of the risk factors for developing an autoimmune stem from heredity and genetics; however, gender plays a very large part in the development of autoimmune disease.
Interestingly enough, the female population accounts for about 75% of Americans afflicted by autoimmune conditions. On top of that, autoimmune disease constitutes some of the leading causes of death and disability in women, up to the age of 65.

Though the relationship between sex and the prevalence of autoimmune disease is not well understood, researchers have been able to document that women have higher levels of antibodies, mounting larger inflammatory responses than men when their immune systems are triggered.
As hormones fluctuate, autoimmune diseases responds in accordance to such shifts. When a women becomes pregnant, has her menstrual cycle, goes through menopause, or takes birth control, the severity of the condition may change.  Despite the large percentage of the female population at risk of developing an autoimmune disorder, autoimmunity is not often discussed as a potential health issue.

Commonly Diagnosed Diseases

Thyroid disease, lupus, multiple sclerosis, and rheumatoid arthritis top the list as some of the most commonly diagnoses autoimmune diseases in the United States.  Let’s take a closer look at these commonly diagnosed conditions so you have a better understanding of how autoimmune disorders can impact your health.
Thyroid Disease: Graves' diseases and Hashimoto's disease are the two types of autoimmune diseases that target the thyroid.  Graves’ disease leads to an overactive thyroid (hyperthyroidism), whereas Hashimoto’s disease causes an underactive thyroid (hypothyroidism).  Most individuals are diagnosed with thyroid disease between the age of 20 and 30 years old, and women have higher rates of thyroid disease compared to men.
 The thyroid gland is the main metabolic regulator of the body, thus any sort of gland dysfunction affects your metabolism. In the presence of Graves’ disease, as the thyroid gland is attacked by the body’s antibodies, inflammation and swelling result. This in turn leads to hyperthyroidism, or an overactive metabolic state, whereby the body  basically goes into overdrive.  As the metabolic rate increases, one may also experience an increase in heart rate and blood pressure.
Hashimoto’s thyroiditis is caused by antibodies reacting against proteins on the thyroid; however, this disease is characterized by a gradual destruction of the gland itself.  As the gland is destroyed, the body is no longer able to produce critical thyroid hormones required by the body, and metabolic rate will decrease, most often leading to unintentional weight gain.

Systemic Lupus Erythematosus (SLE):  SLE (i.e. “lupus), is a chronic, autoimmune disorder that affects many organs and tissues, most often skin, blood, joints, kidneys, lungs, and the heart.  Antibodies produced in response to the disorder lead to the formation of immune cell complexes, which build up over time various tissues leading to pain, inflammation, or destruction of the areas of the body that are under attack.
For many, lupus is considered a mild condition and will only affect a few organs. For others, however, it can trigger serious and potentially life-threatening, conditions.  Lupus can occur at any age, and the disease is 10-15 times more common in women than men.
Studies have shown that some lupus patients have low levels of DHEA (i.e. dehydroepiandrosterone), and further studies are continuing to investigate the contribution of this hormone to the onset of the disease.

Multiples Sclerosis (MS): Multiple sclerosis is a chronic inflammatory autoimmune disease, that specifically targets the central nervous system, thus impacting normal function of the brain and spinal cord.
In MS, the body produces excess antibodies that go on to specifically attack the myelin, which is a protective sheath that covers nerves.  As a result of the attack, neurological, cognitive, and psychological problems set in.   One may experience weakness or paralysis of limbs, numbness, vision problems, speech difficulties, problems with walking or changes to motor skills, and sexual dysfunction.
MS is actually the most commonly diagnosed neurological disease in young adults and, most often detected in between  the age 20 and 40. MS, like many other conditions, is much more prevalent (almost twice as much) in women compared to men.

Rheumatoid Arthritis (RA):  Rheumatoid Arthritis is a widespread, disabling autoimmune disease, affecting the joints and muscles of the body.  The most  frequently impacted joints are those that are free-moving, including small joints of the hands, knees, ankles, hips, elbows, wrists and shoulders.
RA results after the body launches an autoimmune attack on the synovial membranes, the tissue that lines and cushions your joints.  In response to the attack, one may experience inflammation and pain. As the condition continues to progress, the pain and swelling increase, and over time this may result in destruction and deformity of the bones.
RA typically surfaces between the age of 25 and 50, though the symptoms may be mistaken as a normal part of aging.  The condition afflicts females two to four times more than males.  Unfortunately, RA is  rather progressive, despite treatment protcols.   Many times the objective of treatment is quite simply to control inflammation, prevent or slow joint damage, hopefully leading the condition into remission.

Traditional Autoimmune Treatments

To date, there is no cure for the majority of diagnosed autoimmune disorders, thus individuals are faced with a lifetime of debilitating symptoms, which may include loss of organ or tissue function, and extensive medical costs.
 The goal of treatment is most often targeted at the reduction chronic symptoms, decreasing the intensity of the immune system activity, and being able to maintain the immune system’s “normal” ability to fight foreign invaders.
Treatments vary widely and depend on the specific disease and the symptoms.
Take for example an individual living with Type I Diabetes, where the target is to replenish insulin levels, usually through injections or supplement the body with a hormone or vitamin that the body is lacking.  This is much different than the treatment of an autoimmune disorder that either directly or indirectly affects the blood or the circulatory system (i.e. autoimmune hemolytic anemia, lupus, or antiphospholipidal antibody syndrome.)  Treatment of these conditions may require blood transfusions.
In the case of an autoimmune disorder that affects the bones, joints, or muscle (i.e. multiple sclerosis or rheumatoid arthritis), treatment may be geared towards the maintenance of mobility or the incorporation of a medication to suppress pain and reduce inflammation.
It is also not uncommon for medicine to be prescribed as way to control or reduce the immune system’s response. Popular medications include corticosteroids and immunosuppressant drugs (i.e. azathioprine, chlorambucil, cyclophosphamide, cyclosporine, mycophenolate, and methotrexate). 

Keeping Your Immune System Healthy

Keeping the immune system healthy and functioning appropriately involves taking care of your health on many different levels.  Most books on the topics, as well as many health experts, promote the simple concept of “living well”.
Whole body wellness involves basic, common sense practices like following a healthy diet, getting enough rest or  sleep, exercising consistently, drinking alcohol only in moderation, and avoiding stress.
To take your wellness to the next level, there are some additional steps you can take to keep your immune system healthy such as:

• Avoiding all possible exposure to environmental toxins such as mercury, poisons and heavy metals.
• Avoidance of taking unnecessary drugs.
• Choosing your foods wisely with an understanding that your diet plays a large part in healthy functioning immune system.
• Regular sexual activity has been found to be beneficial through its contribution to a healthy hormone balance.

 Dietary Intervention
Now that you have a better understanding of autoimmune disease and how it can impact your health, you may be asking yourself, “Do I need to follow a Paleo gluten-free diet to help boost my immune system?  What about alternative supplements or more holistic treatments?”
If you are asking yourself these questions, join the club!  Of the estimated 23 million people in the United States suffering from autoimmune disease, most are asking themselves these same questions daily, hoping for a safe solution without medical and drug-related intervention.
If you suffer from an autoimmune condition, or you know of a loved one or friend who may be struggling with the condition, you may already be aware of the Autoimmune Paleo diet (AIP).  Many individuals are transitioning to a refined paleo eating plan in an effort to improve life-disrupting symptoms including pain and fatigue.
While medical experts have offered mixed feedback as to how effective the Paleo diet is in treating autoimmune disease, individuals who have a vested interest in following the dietary plan consistently support the AIP, claiming that it has improved their quality of life.
While the AIP may be initiated as a way to manage an autoimmune issue, chances are those suffering from autoimmune disease also have a poorly functioning digestive tract.  If the gut is not in good shape, byproducts of all of the things passing through the intestines are leaking through the gut barrier and into the blood stream, stimulating the immune system to respond with greater intensity.
The AIP is designed to help decrease inflammation and immune system stimulation at the same time.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                    PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/       

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Multiple sclerosis: Skin cells may help to repair nerve damage

A personalized treatment for multiple sclerosis may be one step closer, thanks to a new study that reveals how a person's own skin cells could be used to repair the nerve damage that the disease causes.

Led by scientists in the United Kingdom, the study took skin cells from adult mice with multiple sclerosis (MS) and then reprogramed them into neural stem cells (NSCs).

These "induced neural stem cells" (iNSCs) were transplanted into the rodents' cerebrospinal fluid.

There, they reduced inflammation and repaired damage to the central nervous system (CNS).

Lead study author and his team believe that their strategy could offer a promising treatment for MS and other neurological diseases.

MS is a progressive neurological disease that is estimated to affect more than 2.3 million people across the globe.

While the precise causes of MS remain unclear, "an abnormal immune system response" is thought to be involved. Such a response leads to inflammation in the CNS, which causes the destruction of myelin, or the fatty substance that protects nerve fibers.

As a result, the nerve fibers become damaged. This disrupts neuronal signaling and triggers the neurological symptoms of MS, including tingling in the face or extremities and problems with movement, balance, and coordination.

Using stem cells to treat MS
Previous research has investigated the use of NSCs for the treatment of MS. NSCs are stem cells that have the ability to transform into different types of cell in the CNS — including neurons and glial cells.

However, there are some barriers to this strategy. As researchers note, NSCs are derived from embryos, and it would be hard to obtain them in high enough quantities to sustain clinical treatment.
It is also possible that the immune system would see embryo-derived NSCs as foreign invaders and try to destroy them.

As such, researchers have turned their attention toward iNSCs, or NSCs that can be developed by reprogramming adult skin cells. Importantly, since these cells would be derived from the patients themselves, the risk of an immune system attack would be significantly reduced.

To test whether iNSCs could be a feasible treatment option for MS, the researchers tested them on adult mice that had been genetically engineered to develop the condition.

The team took cells from the skin of the mice and reprogramed them into NSCs, effectively making iNSCs. Next, the team transplanted these iNSCs into the cerebrospinal fluid of the mice.
Study yields promising findings

The researchers found that this led to a reduction in levels of succinate, which is a metabolite that the team found is increased in MS. This increase prompts microglia — a type of glial cell found in the CNS — to trigger inflammation and cause nerve damage.

By reducing succinate levels, the iNSCs reprogrammed the microglia — which, in turn, reduced inflammation and brain and spinal cord damage in the mice.

Of course, human clinical trials are needed before iNSCs can be considered as a suitable treatment for MS, but this latest study certainly shows promise.

"Our mouse study suggests that using a patient's reprogrammed cells could provide a route to personalized treatment of chronic inflammatory diseases, including progressive forms of MS."   said the lead author.

"This is particularly promising," Dr.  adds, "as these cells should be more readily obtainable than conventional neural stem cells and would not carry the risk of an adverse immune response."

this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   
https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement     
 

Multiple sclerosis: What you need to know

Multiple sclerosis is a chronic disease that affects the central nervous system, especially the brain, spinal cord, and optic nerves. This can lead to a wide range of symptoms throughout the body.

It is not possible to predict how multiple sclerosis (MS) will progress in any individual.

Some people have mild symptoms, such as blurred vision and numbness and tingling in the limbs. In severe cases, a person may experience paralysis, vision loss, and mobility problems. However, this is rare.

It is difficult to know precisely how many people have MS. According to the National Institute for Neurological Disorders and Stroke (NINDS), 250,000–350,000 people in the United States are living with MS.

The National Multiple Sclerosis Society estimate the number could be closer to 1 million.

However, new treatments are proving effective at slowing the disease.
What is MS?
Scientists do not know exactly what causes MS, but they believe it is an autoimmune disorder that affects the central nervous system (CNS). When a person has an autoimmune disease, the immune system attacks healthy tissue, just as it might attack a virus or bacteria.

In the case of MS, the immune system attacks the myelin sheath that surrounds and protects the nerve fibers, causing inflammation. Myelin also helps the nerves conduct electrical signals quickly and efficiently.

Multiple sclerosis means "scar tissue in multiple areas."

When the myelin sheath disappears or sustains damage in multiple areas, it leaves a scar, or sclerosis. Doctors also call these areas plaques or lesions. They mainly affect:

    the brain stem
    the cerebellum, which coordinates movement and controls balance
    the spinal cord
    the optic nerves
    white matter in some regions of the brain

As more lesions develop, nerve fibers can break or become damaged. As a result, the electrical impulses from the brain do not flow smoothly to the target nerve. This means that the body cannot carry out certain functions.
Types of MS

There are four types of MS:

Clinically isolated syndrome (CIS): This is a single, first episode, with symptoms lasting at least 24 hours. If another episode occurs at a later date, a doctor will diagnose relapse-remitting MS.

Relapse-remitting MS (RRMS): This is the most common form, affecting around 85% of people with MS. RRMS involves episodes of new or increasing symptoms, followed by periods of remission, during which symptoms go away partially or totally.

Primary progressive MS (PPMS): Symptoms worsen progressively, without early relapses or remissions. Some people may experience times of stability and periods when symptoms worsen and then get better. Around 15% of people with MS have PPMS.

Secondary progressive MS (SPMS): At first, people will experience episodes of relapse and remission, but then the disease will start to progress steadily.

Find out more here about the different types of MS and what they mean.
Symptoms
Because MS affects the CNS, which controls all the actions in the body, symptoms can affect any part of the body.

The most common symptoms of MS are:

Muscle weakness: People may develop weak muscles due to lack of use or stimulation due to nerve damage.

Numbness and tingling: A pins and needles-type sensation is one of the earliest symptoms of MS that can affect the face, body, or arms and legs.

Lhermitte's sign: A person may experience a sensation like an electric shock when they move their neck, known as Lhermitte's sign.

Bladder problems: A person may have difficulty emptying their bladder or need to urinate frequently or suddenly (urge incontinence). Loss of bladder control is an early sign of MS.

Bowel problems: Constipation can cause fecal impaction, which can lead to bowel incontinence.

Fatigue: This can undermine a person's ability to function at work or at home. Fatigue is one of the most common symptoms of MS.

Dizziness and vertigo: These are common problems, along with balance and coordination issues.

Sexual dysfunction: Both males and females may lose interest in sex.

Spasticity and muscle spasms: This is an early sign of MS. Damaged nerve fibers in the spinal cord and brain can cause painful muscle spasms, particularly in the legs.

Tremor: Some people with MS may experience involuntary quivering movements.

Vision problems: Some people may experience double or blurred vision, a partial or total loss of vision, or red-green color distortion. This usually affects one eye at a time. Inflammation of the optic nerve can result in pain when the eye moves. Vision problems are an early sign of MS.

Gait and mobility changes: MS can change the way people walk, because of muscle weakness and problems with balance, dizziness, and fatigue.

Emotional changes and depression: Demyelination and nerve-fiber damage in the brain can trigger emotional changes.

Learning and memory problems: These can make it difficult to concentrate, plan, learn, prioritize, and multitask.

Pain: Pain is a common symptom in MS. Neuropathic pain is directly due to MS. Other types of pain occur because of weakness or stiffness of muscles.

Less common symptoms include:

    headache
    hearing loss
    itching
    respiratory or breathing problems
    seizures
    speech disorders
    swallowing problems

There is also a higher risk of:

    urinary tract infections
    reduced activity and loss of mobility

These can impact a person's work and social life.

In the later stages, people may experience changes in perception and thinking and sensitivity to heat.

MS affects individuals differently. For some, it starts with a subtle sensation, and their symptoms do not progress for months or years. Sometimes, symptoms worsen rapidly, within weeks or months.

A few people will only have mild symptoms, and others will experience significant changes that lead to disability. However, most people will experience times when symptoms worsen and then get better.

Lhermitte's sign is a common symptom of MS that happens when a person moves their head. Find out more here.
Causes and risk factors

Scientists do not really know what causes MS, but risk factors include:

Age: Most people receive a diagnosis between the ages of 20 and 40 years.

Sex: Most forms of MS are twice as likely to affect women than men.

Genetic factors: Susceptibility may pass down in the genes, but scientists believe an environmental trigger is also necessary for MS to develop, even in people with specific genetic features.

Smoking: People who smoke appear to be more likely to develop MS. They tend to have more lesions and brain shrinkage than non-smokers.

Infections: Exposure to viruses, such as Epstein-Barr virus (EBV), or mononucleosis, may increase a person's risk of developing MS, but research has not shown a definite link. Other viruses that may play a role include human herpes virus type 6 (HHV6) and mycoplasma pneumonia.

Vitamin D deficiency: MS is more common among people who have less exposure to bright sunlight, which is necessary for the body to create vitamin D. Some experts think that low levels of vitamin D may affect the way the immune system works.

Vitamin B12 deficiency: The body uses vitamin B when it produces myelin. A lack of this vitamin may increase the risk of neurological diseases, such as MS.

Previous theories have included exposure to canine distemper, physical trauma, or aspartame, an artificial sweetener, but there is no evidence to support these

There is probably no single trigger for MS, but multiple factors may contribute.

How does MS affect women? Click here to find out more.
Diagnosis

The doctor will carry out a physical and neurological examination, ask about symptoms, and consider the person's medical history.

No single test can confirm a diagnosis, so a doctor will use several strategies when deciding whether a person meets the criteria for a diagnosis.

These include:

    MRI scans of the brain and spinal cord, which may reveal lesions
    spinal fluid analysis, which may identify antibodies that suggest a previous infection
    an evoked potential test, which measures electrical activity in response to stimuli

Other conditions have symptoms that are similar to those of MS, so a doctor may suggest other tests to assess for other possible causes.

If the doctor diagnoses MS, they will need to identify what type it is and whether it is active or not. The person may need more tests in the future to assess for further changes.

Learn more here about the tests for diagnosing MS.
Treatment
There is no cure for MS, but treatment is available that can:

    slow the progression and reduce the number and severity of relapses
    relieve symptoms

Some people also use complementary and alternative therapies, but research does not always confirm the usefulness of these.
Medications to slow progression

Several disease-modifying therapies (DMTs) have approval from the Food and Drug Administration (FDA) for the relapsing forms of MS. These work by changing the way the immune system functions.

A doctor may give some of these by mouth, some by injection, and some as an infusion. How often the person needs to take them and whether or not they can do this at home will depend on the drug.

The following DMTs currently have approval:

Injectable medications

    interferon beta 1-a (Avonex and Rebif)
    interferon beta-1b (Betaseron and Extavia)
    glatiramer acetate: (Copaxone and Glatopa)
    peginterferon beta-1a) (Plegridy)

Oral medications

    teriflunomide (Aubagio)
    fingolimod (Gilenya)
    dimethyl fumarate (Tecfidera)
    mavenclad (cladribine)
    mayzent (siponimod)

Infused medications

    alemtuzumab (Lemtrada)
    mitoxantrone (Novantrone)
    ocrelizumab (Ocrevus)
    natalizumab (Tysabri)

Current guidelines recommend using these drugs from the early stages, as there is a good chance that they can slow the progression of MS, especially if the person takes them when symptoms are not yet severe.

Some drugs are more useful at specific stages. For example, a doctor may prescribe mitoxantrone at a later, more severe stage of MS.

A doctor will monitor how well a drug is working, as there may be adverse effects, and the same drugs do not suit everyone. New drug options coming onto the market are proving to be safer and more effective than some existing ones.

Adverse effects of immunosuppressant drugs include a higher risk of infections. Some medications may also harm the liver.

If a person notices adverse effects or if their symptoms get worse, they should seek medical advice.
Medications for relieving symptoms during a flare

Other drugs are useful when a person experiences a worsening of symptoms, during a flare. They will not need these drugs all the time.

Corticosteroids: These reduce inflammation and suppress the immune system. They can treat an acute flare-up of symptoms in certain types of MS. Examples include Solu-Medrol (methylprednisolone) and Deltasone (prednisone). Steroids can have adverse effects if a person uses them too often, and they are not likely to provide any long-term benefit.

Behavioral changes: If vision problems occur, a doctor may recommend resting the eyes from time to time or limiting screen time. A person with MS may need to learn to rest when fatigue sets in and to pace themselves so they can complete activities.

Problems with mobility and balance: Physical therapy and walking devices, such as a cane, may help. The drug dalfampridine (Ampyra) may also prove useful.

Tremor: A person may use assistive devices or attach weights to the limbs to reduce shaking. Medications may also help with tremors.

Fatigue: Getting enough rest and avoiding heat can help. Physical and occupational therapy can help teach people more comfortable ways to do things. Assistive devices, such as a mobility scooter, can help conserve energy. Medication or counseling may help boost energy by improving sleep.

Pain: A doctor may prescribe anticonvulsant or antispasmodic drugs or alcohol injections to relieve trigeminal neuralgia, a sharp pain that affects the face. Pain relief medication, such as gabapentin, may help with body pain. There are also medications to relieve muscle pain and cramping in MS.

Bladder and bowel problems: Some medications and dietary changes can help resolve these.

Depression: A doctor may prescribe a selective serotonin reuptake inhibitor (SSRI), as these are less likely to cause fatigue than other antidepressant drugs.

Cognitive changes: Donepezil, a drug for Alzheimer's, may help some people.

Learn more here about how to manage an exacerbation of MS.
Complementary and alternative therapies

The following may help with different aspects of MS:

    heat and massage treatment for pain
    acupuncture for pain and gait
    stress management to boost mood
    exercise to maintain strength and flexibility, reduce stiffness, and boost mood
    a healthful diet with plenty of fresh fruits, vegetables, and fiber
    quitting or avoiding smoking

Various supplements are available for purchase online, including vitamin D and Omega-3 supplements.

Some people use these, although scientists have not proven that they will help. A person should not use supplements without first consulting their doctor.

What is a healthful diet for a person with MS? Find out here.
Medical marijuana

Studies have suggested that cannabis may help relieve pain, muscle stiffness, and insomnia. However, there is not enough evidence to confirm this.

People should also note that:

    There is a difference between using street cannabis and medical cannabis.
    Not all forms of cannabis are legal in all states.

A person should ask their doctor for advice before using cannabis, as some forms can have adverse effects. Smoking cannabis is unlikely to be beneficial, and it may make symptoms worse.

Some people have suggested that biotin may help. Find out more here.
Rehabilitation and physical therapy
Rehabilitation can help improve or maintain a person's ability to perform effectively at home and work.

Programs generally include:

Physical therapy: This aims to provide the skills to maintain and restore maximum movement and functional ability.

Occupational therapy: The therapeutic use of work, self-care, and play may help maintain mental and physical function.

Speech and swallowing therapy: A speech and language therapist will carry out specialized training for those who need it.

Cognitive rehabilitation: This helps people manage specific problems in thinking and perception.

Vocational rehabilitation: This helps a person whose life has changed with MS to make career plans, learn job skills, get and keep a job.
Plasma exchange

Plasma exchange involves withdrawing blood from the individual, removing the plasma, replacing it with new plasma, and transfusing it back into the person.

This process removes the antibodies in the blood that are attacking parts of the person's body, but whether it can help people with MS is unclear. Studies have produced mixed results.

Plasma exchange is usually only suitable for severe MS attacks.
Stem cell therapy

Scientists are looking into the use of stem cell therapy to regenerate various body cells and restore function to those who have lost it due to a health condition.

Researchers hope that one day, stem cell therapy techniques may be able to reverse the damage done by MS and restore functionality in the nervous system.
Outlook

MS is a potentially severe health condition that affects the nervous system. Progression of MS is different for each person, so it is hard to predict what will happen, but most people will not experience severe disability.

In recent years, scientists have made rapid progress in developing drugs and treatments for MS. Newer drugs are safer and more effective, and they offer significant hope for slowing disease progression.

As researchers learn more about genetic features and changes that occur with MS, there is also hope that they will be able to predict more easily which kind of MS a person will have and establish the most effective treatment from the earliest stage.

A person who receives appropriate treatment and follows a healthful lifestyle can expect to live the same number of years as a person without MS.

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