What is MS?

What is Trigeminal Neuralgia?

Genes and MS - What's it all about?

1. MS Risk, Sun & Vitamin D (Posted:8 February 2011)
2. Why Do More Women Than Men Get MS? (Posted: 7 January 2011)

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What is MS?

MS is a disease that damages nerve coverings within the central nervous system. The brain and the central nervous system control all our actions. The central nervous system sends electrical signals along nerves to various parts of the body. Nerve fibres are insulated by a fatty substance called myelin, which aids the flow of messages. MS causes unpredictable spot damage to myelin which breaks down and is replaced by scar tissue. This can interfere with the flow of messages with the result that they may be blocked, weakened or misdirected to the wrong place. Since the messages control all our movements, the effects of MS are very varied. Some have blurred or double vision. Many experience severe fatigue. Some have speech difficulties. Some may have spasms, numbness or partial paralysis of part of the body. Others experience problems with bladder or bowel control or balance. Symptoms can vary from mild to severe. Often people experience long periods of remission when symptoms diminish or even disappear completely.

The cause of MS is not known although research suggests that there may be at least two factors involved - a virus and an immune system effect. The most widely held view is that a virus or more than one virus may trigger a reaction in a person's own defence or immune system which causes it to attack its own myelin as though it was a virus. This is known as an auto-immune reaction and it is believed that people affected by MS may have a genetic susceptibility that renders them vulnerable. Research has attempted to identify viruses and genes that may be involved, but results to date, although showing promising progress, have not yet succeeded. MS is not hereditary but the genetic disposition can be with the result that the risk of contracting the disease among the descendants of a person with MS is greater than the risk among the general population.

There is no cure or preventative treatment to date for MS. However, with good care, it can be managed and many of the symptoms can be alleviated with drugs. A good diet and adequate rest are usually helpful. Physiotherapy and regular exercise can help to relieve muscle tightening and maintain muscle tone. Prompt treatment of any infection is very important. A positive attitude and a determination to maintain maximum mobility and activity appear to be important psychological factors in dealing with the symptoms. More detailed information can be accessed through the useful links page.

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• TRIGEMINAL NEURALGIA

  The trigeminal nerve (also called the fifth cranial nerve) is one of the main nerves of the face. There is one on each side. It comes through the skull from the brain, in front of the ear. It is called trigeminal as it splits into 3 main branches. Each branch divides into many smaller nerves. The nerves from the first branch go to the scalp, forehead and the area around the eye. The nerves from second branch go to the area around the cheek and upper teeth and those from the third branch go to the area around the jaw and lower teeth.

  TN involves sudden, severe, pain from one or more branches of the trigeminal nerve. The second and third branches are the most commonly affected resulting in pain around the cheek or jaw. It usually affects one side of the face and is considered to be about the most severe pain of any medical condition. It is sometimes described as like electric shocks stabbing the face. Each stab can last from a few seconds to a couple of minutes. Events such as eating, talking, brushing teeth, shaving, swallowing or a draught may trigger a pain.
  
  The cause is not known but there is a higher incidence among persons with MS than in the general population. It may be related to the formation of plaques on the trigeminal nerve. Tegretol (carbamazepine) , an anticonvulsant drug used to treat epilepsy is commonly used to treat TN because of its effect in quieting nerve impulses. Other anticonvulsant drugs such as Lamictal (lamotrigine), Neurontin (gabapentin), or Lioresal (baclofen) may also be used. Various surgical techniques may be considered if medication does not work.

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• Genes and MS - What's it all about?

  Recent discovery of a link between two genes and a genetic susceptibility for MS has attracted media attention. The discovery has been hailed as the first for over thirty years. Every discovery of this kind is to be welcomed. The recent discovery is particularly of interest because the two genes involved are outside the HLA group of genes that have been linked to MS for over thirty years.

  The recent studies suggest that variations in these newly linked genes increases the susceptibility to MS by less than one percent whereas variations in genes within the HLA group are believed to account for nearly 50% susceptibility.

  The HLA cluster of genes includes over 200 genes. The detail is very complex and it is believed a considerable number of these genes may play a part in MS. The following is a simplified account of the role of the HLA genes.

  The cells of the body carry protein markers that allow the immune system to identify them . Tissue not marked as belonging to the body is seen as foreign and is normally attacked by the immune system. Viruses and bacteria are identified in this way and a healthy immune system attacks them. The white blood cells are the main component of the immune system. Unless compatible with the body's own tissue, transplanted tissue will also be attacked. Only tissue from an identical twin is fully compatible and drugs are normally used to dampen down the immune system during transplant surgery. After a period, the immune system comes to 'recognise' the new tissue as the body's own.

  Variations in some of the HLA genes result in the immune system not recognising certain cells as the body's own cells and they are attacked. In the case of MS, the protective myelin covering round the nerve cells of the central nervous system are attacked and the resulting damage interferes with the messages between the brain and the muscles. Similar mechanisms are involved in other auto-immune conditions.

  It is to be hoped that the increasing understanding of the human genetic make-up, generally known as the human genome, which contains about 25000 genes, will eventually lead to effective preventative measures against MS and other auto-immune diseases.

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Items posted 2011

MS Risk, Sun & Vitamin D

A diagnosis of MS is frequently preceded by what is referred to as a 'first event' in which MS-like symptoms occur and can last for a period of a few weeks. However not all 'first events' develop into MS. There is now considerable evidence of a connection between exposure to sun as a child, levels of vitamin D and MS. Exposure to sun, which can also carry a serious risk of skin cancer, is one of nature's ways of increasing the level of vitamin D in the blood.

Most of the existing studies concentrated on persons diagnosed with definite MS but a new Australian study that looked at levels of sun exposure, vitamin D, first events and MS has just been published in the journal Neurology. The authors looked at 216 people who had a first event and 395 people with no symptoms of possible MS who were of similar ages, of the same sex and from the same regions of Australia. They questioned participants about exposure to sun, examined skin damage and levels of melanin due to exposure and measured levels of vitamin D in participants' blood.

The authors found persons with more exposure and higher levels of vitamin D were significantly less likely to experience a first event and of those who did have a first event, significant fewer moved on to a diagnoses of MS.

Most of the evidence regarding a link between sun exposure and MS deals with early years exposure and there is no evidence of a benefit of increased exposure to persons already with MS. There is also the very real risk of skin cancer from over exposure.

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Why Do More Women Than Men Get MS?

The study of genes and DNA is extremely complex and specialised but it is playing an increasingly important role in developing an understanding of disease and in discovering new treatments. A research report published online yesterday in Neurology is reviewed on the Medpage Today website.

The researchers believe they have uncovered evidence of an interaction between a group of genes that are known to have an influence on risk of MS and factors outside a person's inherited genes that goes some way to explaining why MS affects roughly twice as many women as men.

The research was funded by the Multiple Sclerosis Society of Canada and the UK Multiple Sclerosis Society and the review on the Medpage Today website of the very technical research can be viewed at Gene Study Suggests Why MS Is Women's Disease

The UK MS Society website posted an explanatory item today (10 Jan 2011) that can be viewed at UK MS Society item .