Multiple Sclerosis: The Facts You Need (Your Personal Health)

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9781552093672: Multiple Sclerosis: The Facts You Need (Your Personal Health)

Multiple sclerosis -- MS -- strikes about one in a thousand North Americans, usually in early adulthood, when they are building careers and starting families. Because the disease involves the central nervous system, its effects are wide-ranging and difficult to predict.

Multiple Sclerosis: The Facts You Need -- part of the Your Personal Health Series -- is a fact filled, comprehensive guide to living with MS, supported by diagrams, case histories, a drug table and an extensive list of helpful books and organizations. Topics include:

  • what MS is, and who gets it;
  • how MS is diagnosed as "possible," "probable" or "definite";
  • why the disease affects different people in different ways;
  • how "relapsing-remitting" MS differs from "progressive" MS;
  • how people with MS and their families, can adapt their homes, careers and lifestyles to cope with the disease;
  • which treatments work, which don't and what help is on the horizon.

Combining authoritative medical advice and practical hands-on tips, Multiple Sclerosis: The Facts You Need is an invaluable guide for anyone affected, directly or indirectly by this complex disease.

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About the Author:

Dr. Paul O'Connor has been treating people with MS for over 15 years. He is director of the MS Clinic at the University of Toronto, and chief of the Division of Neurology at St. Michael's Hospital.

Excerpt. © Reprinted by permission. All rights reserved.:

Introduction

Typically, in modern medicine, we know a fair bit about who suffers from a condition, less about how to treat it effectively and least of all about what actually causes it. Certainly this applies to multiple sclerosis (MS), a disease of the nervous system that is the most common disabling neurological disorder of people between the ages of 20 and 40.

Jane is a 24-year-old store clerk. One day she notices poor vision in her right eye. It lasts for about six weeks and then clears. A year later she notes a numbness in her left arm and left leg. She also feels fatigued. She sees her family physician, who refers her to a neurologist. After diagnostic testing he tells her she has MS.

Bob is a 32-year-old stockbroker. He used to enjoy jogging, but in the past few years he has noticed a progressive stiffness and weakening in his legs which does not improve. He has also had urinary problems and sexual difficulties. He too sees a neurologist and, after a series of tests, learns that he has multiple sclerosis.

The Discovery of MS

The first description of what was probably MS dates back to August 4, 1421, when Jan Van Bieren, Count of Holland, described the "strange disease of the virgin Lidwina," who in 1395, at the age of 15, developed severe facial pain and leg weakness after falling on the ice while skating. Within a few years her problems had increased: her legs were so weak that she could not walk, she had leg numbness and she was intermittently blind in one eye. She died in 1433 at the age of 53.

The first descriptions of the physical changes that MS produces in the brain and spinal cord came almost simultaneously, in 1835, from Jean Cruveilhier, professor of pathologic anatomy in the Sorbonne's Faculty of Medicine in Paris, and Robert Carswell, a Scotsman who worked at the Hospital de la Pitie in Paris for three years.

However, the first scientific description of the signs and symptoms of MS came from Jean-Martin Charcot (1825-1893). Charcot outlined a condition called la sclérose en plaques -- in effect, multiple sclerosis -- which he had first become familiar with while watching its gradual development in a maid employed in his house. From 1862 to 1870, Charcot worked at La Salpêtrière, a Paris asylum for beggars, the aged, the infirm and the insane. There, he examined thousands of patients. His findings led him to correlate the signs and symptoms of MS with the disease-related anatomical changes seen at autopsy.

Following Charcot's description, the disease was increasingly recognized. When the German pathologist Muller wrote a book on the subject in 1904, he cited more than 1,100 published papers relating to the subject.

Charcot's scientific exploration of MS paralleled the creation of neurology, the specialty branch of medicine that deals with diseases of the nervous system. In those early days, the only way to determine what was going on in a person was through neurological examination-that is, by having the person demonstrate how well certain functions of the nervous system (vision, balance, reflexes and so on) were working. Today we have a variety of special tests to help us diagnose the disease.

Types of MS

Charcot understood that MS is a variable disease with different forms. Today, physicians categorize MS as one of two main types. If recurrent attacks of neurological symptoms are followed by periods of improvement the disease is called relapsing-remitting MS. This is what Jane has. If, on the other hand, the symptoms worsen over time without any periods of improvement, the disease is called progressive MS. This is what Bob has.

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