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MULTIPLE SCLEROSIS Normal neuron WHAT IS MS? MS is an inflammatory disease of the central nervous system (CNS) in which the myelin sheath deteriorates, resulting in the destruction of nerve fibers. The origin is unknown, but we do know: • There are multiple autoimmune, environmental, and genetic factors that can trigger MS. • A person with a history of serious viral or bacterial infection is more prone to be affected. • Usual onset is between 20 and 40 years of age. • It occurs twice as often in young women than in young men, but after 30, both genders are equally affected. The normally smooth electrical conduction from the brain (wall socket) to the body (lamp) "flickers" with MS because the smooth flow of nerve signals (electricity) has been interrupted. • Every year, 25,000 new cases are diagnosed in the United States. Once diagnosed, MS patients typically follow a clinical course of flares and remissions. Although complete asymptomatic remission does occur, it is rare. Debilitation directly relates to the form of MS, genetic history, environmental factors, and how aggressively and consistently the disease is treated. The average life expectancy after diagnosis is 25–30 years, and complications can include minor to severe decrease in quality of life, contractures, mild to complete debilitation, secondary infections, clinical depression, and altered self-image. There is no cure. WHAT'S HAPPENING IN THE BODY? The pathophysiology of MS is fairly straightforward. Normally, nerve signals travel at lightning speed within the CNS via fibers from the brain to the spinal cord and back again. These delicate nerve fibers are surrounded and protected by a fatty, slick coating called the myelin sheath. Innumerable signals—for Demyelination in MS gross and fine muscle movement, smell, vision, and so on—allow graceful and efficient function. Demyelination is damage to the myelin sheath from disease or injury, after which signals do not travel smoothly. As the body attempts to repair the damaged sheath, scar tissue builds and hardens (sclerosis) in multiple spots along the myelin sheath—thus the term multiple sclerosis. Hardened, scarred patches of myelin sheath cause halting or stuttering signals from and to the brain, leading to symptoms like eye pain, muscle weakness, and spasticity. Here's an easy way to understand demyelination. Decades ago, household electrical cords were covered in a black, fuzzy, yarn-like material. The flow of electricity from a wall socket to a lamp was sometimes inconsistent 58 massage & bodywork november/december 2012