Multiple Sclerosis

Multiple sclerosis (MS) is an unpredictable disease of the nervous system in which communication between the brain and other parts of the body is disrupted. Its effects can range from relatively benign in most cases to somewhat disabling to devastating. The symptoms may mysteriously occur and then disappear. In the worst cases a person with MS may be unable to write speak or walk. Approximately 350 000 Americans have MS.

During an MS attack inflammation occurs in areas of the white matter (pale-colored nerve tissue) of the central nervous system in random patches called plaques. This is followed by destruction of myelin the fatty covering that insulates nerve cell fibers in the brain and spinal cord. Myelin allows for the smooth high-speed transmission of electrochemical messages between the brain the spinal cord and the rest of the body. When myelin is damaged neurological transmission of messages may be slowed or blocked completely resulting in diminished or lost function.

Signs and Symptoms

MS is accompanied by the following signs and symptoms.

• Weakness in motor skills and loss of muscle coordination
• Tingling numbness dizziness
• Blurred vision
• Pain
• Heat sensitivity
• Loss of bladder control
• Memory loss problem-solving difficulties
• Mood disturbances

What Causes It?

The cause of MS is unknown. Theories include a childhood virus that primes the immune system for an attack against myelin in early adulthood.

Who's Most At Risk?

People with the following conditions or characteristics are at risk for developing MS.

• First-degree relatives with MS
• Age between 20 and 40
• Living in the northern latitudes for the first 15 years of life
• North European North American or Scandinavian ancestry
• Immune response genes

What to Expect at Your Provider's Office

If you or someone you care for are experiencing symptoms associated with MS you should see your health care provider. Your provider will take a history of clinical symptoms check for neurological problems and refer you for lab tests such as a cerebrospinal fluid exam and agar gel electrophoresis and imaging procedures such as a computed tomography scan (CT scan) and magnetic resonance imaging (MRI).

Treatment Options

Treatment Plan

The primary goal of a treatment plan is to reduce the severity of attacks through the use of certain medications and to extend the individual's physical functioning for as long as possible.

Drug Therapies

Your provider may prescribe the following medications.

• Steroids with anti-inflammatory properties to reduce severity of attacks
• Beta interferon to decrease myelin destruction reduce frequency and severity of attacks and slow progression of disease
• Immunotherapy antigen-targeting cytokines and remyelination are experimental therapies that may alter the course of the disease

Surgical and Other Procedures

Surgery may be used to treat severe and disabling tremors or to reduce severe spasms.

Complementary and Alternative Therapies

A comprehensive treatment plan for MS may include a range of complementary and alternative therapies.

Nutrition

• Eat a diet high in protein and anti-inflammatory oils (nuts seeds and cold-water fish); orange yellow and dark green vegetables; whole grains in small amounts
• Avoid food allergens such as wheat dairy eggs soy citrus tomatoes corn chocolate fish and peanuts—eliminate these foods then reintroduce one at a time watching for reactions. Many individuals with MS are sensitive to foods that contain gluten.
• Eliminate refined foods alcohol caffeine saturated fats (animal products) and additives (MSG and aspartame)

Potentially beneficial nutrient supplements include the following.

• Omega-6 oils (borage evening primrose black currant oils) 1 500 mg two to three times per day. Include zinc (30 mg per day) and selenium (200 mcg per day).
• B-complex vitamins especially B₁₂ (1 000 mcg per day) and B₆ (100 mg per day) and minerals such as calcium (1 000 mg per day) and magnesium (500 mg per day)
• Vitamin C (1 000 mg three times per day) vitamin E (400 IU per day) and coenzyme Q10 (100 mg twice a day)

Herbs

Herbal remedies may offer relief from symptoms. Herbs are generally available as dried extracts (pills capsules or tablets) teas or tinctures (alcohol extraction unless otherwise noted). Dose for teas is 1 heaping tsp per cup of water steeped for 10 minutes (roots need 20 minutes).

Use one to two of the following: hawthorn (Crataegus monogyna) 200 mg two to three times per day ginkgo (Ginkgo biloba) 120 mg two times per day standardized extract especially with cognitive impairment quercetin (100 to 250 mg three times per day) especially with food sensitivities

Combine the following herbs in equal parts to nourish the nervous system and prevent constipation: oatstraw (Avena sativa) skullcap (Scutellaria laterifolia) lavender (Lavendula angustifolia) lemon balm (Melissa officinalis) passionflower (Passiflora incarnata) and horsetail (Equisetum arvense). Drink two to three cups tea daily or take 30 to 60 drops tincture twice a day.

Homeopathy

Combination remedies may be used for fatigue spasm and to help rid the body of impurities.

Acupuncture

Acupuncture may be used to alleviate symptoms.

Massage

Massage is important for maintaining flexibility and reducing spasticity as well as improving the overall sense of well-being.

Prognosis/Possible Complications

About 70 percent of patients experience attacks and remissions and about half of these undergo a chronic progressive worsening after about 10 years. Ten to fifteen percent of patients experience a chronic progressive worsening of the disease from the initial onset. Fifteen to twenty percent of patients follow a benign course. Most MS patients live for 30 years or more many still working and mobile.

Following Up

Patients need lifelong monitoring especially during flare-ups.

Supporting Research

Adams RD Victor M. Principles of Neurology. 6th ed. New York NY: McGraw-Hill; 1997: 902–921.

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers;1995:299-300.

Fauci AS et al. Harrison's Principles of Internal Medicine. 14^th ed. New York NY: McGraw-Hill; 1997: 2409–2419.

Kelley WN et al. Textbook of Internal Medicine. 3^rd ed. Vol 2. Philadelphia PA: Lippincott-Raven; 1997: 2385–2387.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2^nd ed. Durango Colo: Kivaki Press; 1994: 63.

Taylor RB et al. Family Medicine: Principles and Practice. 5th ed. Berlin Germany: Springer; 1998: 589–591.

Rosen P Barkin R et al. Emergency Medicine: Concepts and Clinical Practice. Vol 3. St. Louis MO: Mosby; 1998: 2219–2221.

Conn RB. Current Diagnosis. Philadelphia PA: Saunders; 1991: 988–991.

Branch WT. Office Practice of Medicine. 3rd ed. Philadelphia PA: Saunders;1994: 721 766–767.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.