Women are the most likely victims of mysterious MS


March 01, 1994|By Genevieve Matanoski | Genevieve Matanoski,Medical Tribune News Service

Multiple sclerosis is a debilitating and tragic disease that attacks young adults. Women are twice as likely as men to develop MS, the most common cause of non-traumatic disability of young adults in the United States. About 300,000 Americans have this disease, which causes its victims to lose muscular function -- sometimes slowly, sometimes swiftly.

Doctors know very little about what causes MS, and there is no cure. A new therapy called Betaseron has recently been introduced to the market, but supplies are very limited.

Q: What is multiple sclerosis?

A: MS is caused by a loss or disintegration of the myelin sheaths that cover the nerves. When this happens, no signals pass over the nerves. We also may find loss of brain cells that make the myelin. Patients with MS have a number of symptoms, including headache, dizziness, vertigo, vision problems and, eventually, paralysis.

In its early stages, the disease is very difficult to diagnose. Patients may experience intermittent attacks that leave them more disabled after each episode or the disease may cause a progressive loss of function.

Q: Why do the myelin sheaths disintegrate?

A: All evidence suggests that some kind of immune dysfunction causes these changes. Scientists are looking at three theories to account for myelin loss. The first is that somehow the immune system views the myelin as a foreign material and destroys it. The second is that the myelin is mistakenly destroyed when the immune system defends the brain against viral infection. The third is that a viral infection destroys the cells that produce the myelin. Without myelin, the nerves and brain are damaged.

Q: Who is at risk getting MS?

A: The risk of getting MS is 15 to 20 times higher for first-degree relatives of people with the disease. This may be due to inheritance or common exposures.

Part of this risk may be due to the inheritance of genes that allow the immune system to distinguish between one's own tissue and foreign tissue. This may be one aspect or one answer, but it certainly does not apply to all cases.

In terms of when MS strikes, the median age at which people begin to show signs of MS is 32, and the median duration is 14 years. The disease is very rare in those under age 10 and over age 50.

Q: Is the incidence of MS increasing?

A: Some clues to this question can be found in a study that was done in Minnesota, which seems to be a high-risk area for the disease. This fact coupled with the stability of the population in the area have made it an ideal place to follow the changing characteristics of MS.

We can deduce from studies done there that the proportion of the population with the disease has increased over the last 10 years, but this increase cannot be attributed to increasing survival.

As nearly as we can tell, the occurrence of new cases is about six per 100,000. About 15 to 20 percent of patients have a relapse each year. Some patients will stabilize.

At this time there is no cure for MS, although researchers are constantly searching for ways to slow down or stop its progress.

The course of the disease and the most effective treatment appear to differ by patient.

Dr. Genevieve Matanoski is a physician and epidemiologist at the Johns Hopkins School of Hygiene and Public Health. She is a founding director of the school's Institute for Women's Health Research and Policy.

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