According to the National MS Society, about one million people over the age of 18 in the United States live with a diagnosis of multiple sclerosis (MS). World-wide, the estimate is about 2.3 million people.
MS is a chronic and unpredictable disease in which the body’s immune system attacks healthy tissue in the central nervous system (CNS). The disease causes inflammation and deterioration of the myelin, which is the sheath around nerve fibers, including those in the optic nerves and spinal cord.
The Centers for Disease Control and Prevention (CDC) is creating a National Neurological Conditions Surveillance System (NNCSS) in order to better track neurological conditions such as MS. In the meantime, this is what students can learn about the disease.
Four Types of MS
The progression of MS after diagnosis is unpredictable. However, four basic disease courses have been defined:
- Clinically Isolated Syndrome (CIS): This describes the first episode of neurologic symptoms caused by inflammation and damage to or deterioration of myelin, or demyelination. CIS does not necessarily mean a diagnosis of MS; it could be an isolated incident.
- Relapsing-remitting MS (RRMS): RRMS is the most common disease course seen in MS patients. It is characterized by “clearly defined attacks of new or increasing neurologic symptoms.” (As an aside, if students are familiar with the TV drama The West Wing, this is the type of MS President Josiah Bartlett had.) After the attacks, patients make a partial to full recovery of function, and the disease does not progress in between attacks.
- Secondary progressive MS (SPMS): In SPMS, a relapsing-remitting MS resolves into a disease course that is more consistently progressive.
- Primary progressive MS (PPMS): This type of MS follows a steady progression of disability from the onset of symptoms. There are no to few relapses or remissions.
Diagnosis and Treatment of MS
MS is difficult to diagnose because neurological symptoms can have many possible causes. At this time, no set of symptoms, no physical findings, and no laboratory tests exist that definitively determine if a person has MS.
To determine if a patient has MS, a healthcare professional combines taking a detailed medical history and performs a variety of tests to determine underlying environmental or medical causes of neurological symptoms. Magnetic resonance imaging (MRI) of the brain and spinal cord, which can reveal lesions that are the hallmark of MS, is an important test to perform.
Treatment for MS consists of medication therapy and rehabilitation strategies to modify disease course and manage symptoms. For more information to teach in the classroom, see the Comprehensive Care page at the National MS Society site.