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ultiple sclerosis (MS) is a
relapsing remitting disease. They
chronic and unpredictable
eventually enter a stage of continu-
disease that affects the cen- ous deterioration, although sudden
tral nervous system (brain and spinal
relapses may occur.
cord). Inflammation causes damage
• Progressive relapsing MS is rela-
to the covering or insulation (myelin)
tively uncommon. It is characterized
of the nerve fibers. This damage can
by a steady decline in abilities accom-
eventually slow or block the nerve
panied by sporadic attacks.
signals that control vision,
Treatment options for MS
sensation, motor skills and
fall into three categories:
more, depending on the
Acute therapy, maintenance
location of the affected
therapy and symptomatic
nerves. The cause is
therapy. When a person has
unknown.
an attack of MS, the dis-
The list of possible MS
ease is in an active phase,
symptoms is extremely
suggesting inflammation
widespread, and can
of a region of the brain or
include visual disturbances
spinal cord. We treat the
(blurring, loss of vision,
inflammation with a course
Dr.
double vision, pain), numb-
of intravenous steroids to
Bruce
ness, pain or tingling,
decrease swelling and possi-
Silverman
slurred speech, tremors,
bly limit damage at the site
Columnist
paralysis, fatigue, balance
of disease activity.
or coordination difficulties,
Maintenance therapy
problems with memory
involves using disease-
and concentration. Because all of these modifying drugs, such as interferons,
can be caused by various conditions
that alter the immune system and help
and diseases, definitive diagnosis of
slow the progression of the disease.
MS is difficult and some patients may
The final type of MS therapy is
be misdiagnosed or undiagnosed for
symptomatic, using various drugs
months or even years after symptoms
that target specific symptoms, such as
begin.
fatigue, muscle stiffness, depression,
A diagnosis of multiple sclerosis
muscle spasticity.
is frightening because many people
Treatment of multiple sclerosis
associate it with eventual total disabil- has to be a multidisciplinary effort.
ity. In reality, when accurately diag-
In addition to the neurologist and
nosed and clinically treated, patients
primary care physician, it can involve
with MS can slow the progress of the
psychiatry or psychology, physical
disease and live more meaningful and
medicine and rehabilitation, social
independent lives. Untreated, patients
workers, nurses, and specialists as
may experience significant decline in
needed, such as a gastroenterologist
their ability to function independently. for bowel problems or urologist for
Another frustrating aspect of MS is
bladder issues. And family members
the wide variation in the course of the
are a vital part of the care team.
disease. During an attack, the patient's
Unfortunately, there is currently
deterioration of physical abilities may
no cure for MS, but there is ongoing,
be mild or severe, and it may last from promising research into the disease
a few hours to a few weeks. MS can
that may result in better management
appear in different fashions:
techniques. As with any chronic condi-
• Relapsing remitting MS is character- tion, early diagnosis and treatment can
ized by alternating episodes of physical
have a positive effect on quality of life,
decline and "quiet periods',' or remis-
so ifs important to speak with your
sions, that may last weeks or years. This
health care professional and investigate
is by far the most common form of MS
all of the options available. ❑
and these patients do relatively well.
• Primary progressive MS involves a
continuous gradual decline in abilities, Dr. Bruce Silverman, D.O.,is a board certi-
without periods of remission.
fied neurologist on staff at Providence
• Secondary progressive MS affects
Hospital. His offices are located in
more than half of the people with
Southfield, Novi and Farmington Hills.