Multiple Sclerosis

Is MS Hereditary?

Genetic factors are recognized as playing a role in MS. This is not to say that they cause MS. Although MS is typically a disease of people of European ancestry, it also occurs in African Americans, who share genes common in both African and European populations. The observation that MS is about one half as […]

Is There A Connection Between Virus Infection And Autoimmune Disease?

A comment about the relationship of virus infection to autoimmune disease in general is warranted. Infectious mononucleosis occurs only when adolescents or young adults are infected with the EBV. The symptoms of infectious mononucleosis (and other autoimmune phenomena) occur as a result of the immune reaction to the viral infection. Dr. Gertrude Henle, who discovered […]

What Causes an MS Plaque?

The typical MS plaque seen in patients who have died early in their illness or who have had brain biopsies is composed of a mixture of lymphocytes with many more macrophages, without antibody. The macro-phages in the plaque contain myelin within their cell bodies in various stages of digestion. Some axons are damaged, but they […]

Do Antibodies Cause MS?

For a long time, antibody was considered to be a likely cause of myelin damage in MS, but the theory fell into disrepute. More recently, there appears to be stronger evidence that an antibody to a newly recognized myelin protein (anti-MOG antibody) may be playing a role in some patients. Additional evidence comes from analysis […]

What is Autoimmunity?

Autoimmunity is an immune reaction against “self.” Autoimmune disease implies that tissue damage is a result of an autoimmune (autoallergic) reaction. This may be the result of antibody production or as a result of lymphocytes (CD4+) causing damage directly or in concert with macrophages. There is a third type of immunologic reaction, an antibody-mediated tissue […]

What Is The Role Of The Immune System In MS?

A great deal of evidence has been accumulated over the last several decades that abnormal immune reactions against myelin proteins can be detected in patients with MS. Although antibodies to myelin are common in patients with MS, they are also common in patients with other disorders as well. The occurrence of inflammatory disease of the […]

Is Chlamydia A Cause Of MS?

Chlamydia pneumoniae and, more recently, Acineto-bacter are other organisms that have been implicated by other research. The chlamydia (C. pneumoniae) that is being studied is not the organism that commonly causes sexually transmitted disease. Although research continues, these agents have not been shown to play any specific role in MS.

What Is The Importance Of HSV-6 In MS?

Currently, a great deal of interest is in the newly recognized family of viruses known as HSV-6. This virus family is distantly related to HSV-1 (the cold sore virus) but is very closely related to the EBV and yet another family of viruses called HSV-7. Both HSV-6 and another closely related virus HSV-7 share two […]

I Have Antibody To The Epstein-Barr Virus. Why Do I Have This Antibody If I Have MS?

My doctor told me that I have antibody to the Epstein-Barr virus. Why do I have this antibody if I have MS? All of us encounter the EBV at some point in our lives. The very young and the old may not have any symptoms accompanying their infection, but adolescents and young adults characteristically experience […]

What Does Herpes (Virus) Have To Do With MS?

The herpes families of viruses are DNA viruses that once inside our bodies persist for the rest of our lives. Although herpes simplex type I (HSV-1) and type II (HSV-2) can live in neurons and seem to be protected by them, there is no evidence that they or another family of herpes viruses (cytomegaloviruses) have […]

Do Viruses Cause MS?

The onset of an acute demyelinating disease (postinfectious encephalomyelitis) occurs after a number of different infections such as measles and mumps as well as smallpox vaccination. About one quarter of these cases diagnosed as postinfectious encephalomyelitis end up with a diagnosis of MS. This naturally raised the theory that viruses might be the cause of […]

What Causes MS?

There is no simple single answer to the questions “what causes MS?” or “why do some people get MS?” Over the last century and a half, three important inter-related contributing factors have been recognized: environmental (usually thought to be infectious), immune, and hereditary (genetic) factors. Obviously, it would be impossible to do more than superficially […]

Will I Regain My Bladder Control?

The loss of bladder function occurs in a proportion of patients. With acute attacks when control of voiding is lost, recovery follows promptly. However, from several older studies of patients with long-term follow-up, it is apparent than eventually about two thirds of the patients may be left with some impairment of bladder function. Expert care […]

Will I Get Paralyzed And End Up In A Wheelchair?

How long will I be able to walk? Will I get paralyzed and end up in a wheelchair? The ability to walk is affected in an increasing proportion of untreated MS patients over time. However, the rate of progression varies from patient to patient. Frequent attacks with incomplete recovery are indicators of a poorer outlook. […]

Is Memory Affected With MS?

Memory can be affected by MS. Confusion can accompany attacks and can be associated with memory difficulty, but this is not defined as true memory impairment. It is associated with generally impaired cognition. Anxiety and/or Depression also can rob a person of their ability to maintain attention. When the anxiety or depression abates, memory is […]

Why Do Some People Get Worse So Quickly? Will I?

There are probably many reasons why some people worsen more quickly than others. Stress is implicated in many other diseases, and without question, it plays an important role in MS. It is clear that some patients are genetically predisposed to rapid progression of illness. Persons who have the DR-2 (DR-1 1501) gene have more severe […]

How Long Will It Be Before I Will Be Disabled?

Recently, there has been speculation that disability in MS patients will be predictably present after several years of illness. Some have claimed that there is no difference between various patient groups and that dis-ability eventuates in the majority of patients. Apart from this rhetoric, it is clear that the rate of progression in the early […]

Do All People With MS Become Disabled?

Some neurologists, many in academic circles, have a perception that MS is predictably associated with dis-ability. Before the advent of new testing procedures, particularly MRI of the brain and spinal cord, many patients were not diagnosed during life. Without proven treatments, there was little incentive to do so in those without disability. The training of […]

How Will I Know Whether I Will Get Progressive Disease?

The absence of attacks with new neurologic symptoms, or recurrence of older problems, does not necessarily mean that a person has progressive MS. Patients can be stable for long periods of time. To recognize progression in MS, neurologic difficulties must be progressing. A neurologist can only determine this if the patient has progressed or changed […]

Who Gets Progressive Disease Without Attacks?

At first, my response was to assume that the person who asked this question was simply asking about the definition of this type of illness. However, he was actually asking about differences in populations and their risk of this type of illness. Here again, ethnic differences become apparent. In France, Charcot first described the spinal […]

What Is Spinal MS?

Spinal MS was a term used for primary progressive MS but has not generally been used for the last 30 years or so. It was a good descriptor for this illness because the predominant symptoms were those of slowly progressive weakness and sensory problems, predominantly affecting the legs. In the past, it was especially difficult […]

What Is Chronic Progressive MS?

Both secondary progressive and relapsing progressive MS were referred to as chronic progressive in the past. The term chronic progressive is no longer used. Primary progressive patients were also sometimes referred to as chronic progressive. Importantly, if an MS patient has never had an attack followed by a remission, they are diagnosed as having primary […]

If I Have Relapsing-Remitting MS, Can I Get Progressive?

Patients with relapsing-remitting illness have attacks of one or more symptoms with varying frequency and with variable degrees of recovery but do not progress between attacks. Relapsing-remitting MS patients have attacks without interval progression, which is the essential feature of this type of MS. If there is progression between attacks, this is  secondary progressive MS. […]

What Kinds of MS Exist?

To most physicians dealing with MS and many patients, this illness seems to be a family of closely related disorders. To begin with, a doctor’s clinical diagnosis of MS is based on the recognition of symptoms that recur (relapse). The relapsing nature of the disease is unique to MS. Recognition of symptoms that are typically […]

What Are The Actual New “McDonald Diagnostic Criteria” That Neurologists Use To Make A Diagnosis Of MS?

The McDonald committee outlined the criteria in an article titled Recommended Diagnostic Criteria, which is in the Annals of Neurology. These criteria have been adopted in the United States and internationally.

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