Rochelle developed multiple sclerosis when she was 27. After eight years she has

Question

Rochelle developed multiple sclerosis when she was 27. After eight years she has lost a good portion of her ability to control her skeletal muscles. She's in the clinic today and is asking you to explain why this has happened. Be sure to review with her the normal physiology of nerve impulses, before you explain the changes that occurred with her multiple sclerosis. Please explain why after 8 years of multiple sclerosis she is losing her ability to control her skeletal muscles? What is the normal physiology of  nerve impulses?

Explanation / Answer

Multiple Sclerosis is a very unpredictable disease. It can strike once and then go dormant for years, or it can come on hard, fast, and strong. MS is a very personal disease; it affects everyone who gets it in a different way. There is a range of symptoms that MS causes, but they differ from person to person.

Does Rochelle have a "relapsing" form of MS? If so, did she get on one of the disease-modifying drugs as soon as she was diagnosed? If not, she may have had a "progressive" form of the disease known as "Primary-Progressive" MS, where there are no significant "relapses" or "remissions" but a slow, steady worsening of symptoms with no discernible highs or lows. PPMS is rare, but it's out there. There are a few new drugs which help PPMS; previously, there were no drugs for those with "Progressive" forms of the disease.

If she had a "Relapsing" form of the disease, and did not take any medication, she may have progressed to a "Progressive" form of the disease called "Secondary-Progressive" MS. Current statistics show that 50% of people with RRMS (Relapsing-Remitting MS) who go untreated will progress to SPMS within 10 years. Some earlier, some later, but half of those untreated will be into their progressive stage within 10 years.

The disease-modifying medications hope to extend the length of time before the progressive phase of the disease begins, but there is too little information at this point to say conclusively whether or not they do. Scientists believe that they will, but without empirical evidence to back it up, it's just speculation. The medications do lengthen the time between relapses, reduce their severity, and reduce the amount of active lesions on the brain, but we don't know yet if they delay the onset of the progressive form of the disease.

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