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1. What will happen to me if I am diagnosed with MS?

   Since this disease affects people so differently, it is impossible to predict. It is important to remember that most MS patients do not end up in a wheelchair, and life expectancy is normal or near normal. About 85 percent of people initially diagnosed with MS have relapsing-remitting MS, characterized by temporary attacks followed by periods of remission. About half those diagnosed with relapsing-remitting MS develop secondary progressive MS, in which there is a worsening of symptoms with or without occasional flare-ups and minor remissions. However, health care professionals expect that the disease-modifying drugs introduced in the 1990s will lower the percentage of patients who experience severe symptoms or develop progressive disease.

2. What are the symptoms?

   MS affects each person differently. Symptoms are a direct result of demyelination—the destruction of myelin, the substance made of fat and protein that helps speed messages through the central nervous system. When myelin is destroyed, the messages from the brain to the rest of the body are either slowed or destroyed. This results in impaired function and symptoms associated with MS, which can include difficulty walking, unusual fatigue, vision loss, strange tactile sensations like numbness or weakness, tremors, a lack of coordination, slurred speech, sudden paralysis and bladder dysfunction.

   Complications that are a result of the primary symptoms are often called secondary symptoms—urinary tract infections due to bladder dysfunction, for example. Other secondary symptoms include poor postural alignment and trunk control, decreased bone density (increasing risk of fracture) and shallow, inefficient breathing. Paralysis can lead to the secondary symptom of pressure sores. While secondary symptoms can be treated, the goal is to prevent them by treating the primary symptoms.

   There is a third classification of symptoms—the social and psychological effects. People with MS often become depressed. Psychologists, psychiatrists and social workers can help treat these symptoms.

   It is important to remember that many MS symptoms can be effectively managed and complications avoided with regular care by a neurologist and other health professionals.

3. Is there any treatment for MS?

   There is no cure for MS, but there are medications that may reduce disease activity in relapsing MS. These include Avonex, Betaseron and Rebif, all of which are injectable. Betaseron is also used in secondary-progressive MS with relapses. In addition, the drug Copaxone is used for the relapsing-remitting form of MS, and Tysabri is used for the treatment of relapsing forms of the disease in people who have not responded well to other therapies. In progressive MS, Novantrone can be used to reduce disability and the frequency of relapses in patients with secondary-progressive, progressive-relapsing or worsening relapsing-remitting MS. However, the lifetime dose of Novantrone is limited due to cardiac toxicity.

   Many aspects of MS can be effectively managed. For example, exacerbations can often be treated successfully with steroids. These drugs reduce inflammation at the site of new demyelination, allowing you to return to normal functioning more quickly than if they were not used. However, steroids have not been proven to have any long-term effect on the course of the disease and do have severe side effects. Also, physical and occupational therapy (rehabilitation) may help improve impaired functions. Counseling may have a positive effect on the psychological toll the disease takes on a person and her family.