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Dr. Patti Nemeth, St. Luke's Hospital

Understanding multiple sclerosis is key to control

You may be familiar with multiple sclerosis (MS). After all, an estimated 400,000 people, mostly adults, in the United States live with the disease.

But did you know that more than twice as many women as men have MS?

According to Mayo Clinic neurologist Brian G. Weinshenker, MD, women are more likely than men to have a gene that produces high levels of a protein called interferon gamma, which may predispose them to MS.

The MS disease process involves nerve cells in the central nervous system, which is composed of the brain and spinal cord. Nerve cells have long fibers called axons that transmit information to other nerves. These axons are covered with a protective coating call myelin.

MS damages myelin, leading to a breakdown in communication between nerve cells. This results in symptoms including dizziness, weakness, fatigue, numbness, pain, spasms, blurred vision, coordination problems, bowel and bladder problems, difficulty with memory and attention, sexual dysfunction and depression.

Some women with MS experience many symptoms; others experience few.

About 85 percent of MS patients have relapsing-remitting MS. Periods when the disease gets worse are called relapses, attacks or exacerbations. Periods when symptoms are completely or partially absent are called remission. About 15 percent of MS patients have a more progressive form of the disease that involves permanent disability.

For women with MS, uncertainty about the future and fear of disability are difficult aspects of the disease. But there is good news.

Studies indicate disease-modifying drugs reduce disease activity and relapses, and they help decrease the chance of relapsing-remitting MS progressing to disabling MS.

Also key to a patient's sense of control is a dedicated medical team - including a primary care doctor, a neurologist, a nurse or physician's assistant, a physical therapist and an eye care specialist. Psychologists, occupational and speech therapists and physiatrists are helpful, too.

Above all, MS patients need to understand their bodies and the disease. The National Multiple Sclerosis Society (nmss.org or 800-344-4867) is a good place to start.

Take an active role - and take control.

Dr. Patti Nemeth specializes in neurology at St. Luke's Hospital. Call 314-878-2888 or visit her Physician Referral page.

This article was published in the St. Louis Post-Dispatch on December 17, 2009.