Dear Dr Garner,
Our family is very upset, as my sister who is 43 years old was just diagnosed with Multiple Sclerosis. Could you tell me anything you can about the disease and if there is hope for treatment soon. She is currently taking injections each day, which are painful.
I thank you and God Bless you for all you do.
Devastated in Ditmas Park

Dear Devastated-
I can imagine how sad and anxious your family and sister must feel.
Many cases of Multiple Sclerosis are mild and most people can live a relatively normal life.
In some cases the disease may be more aggressive. Unfortunately, as in your sister’s case, it is young adults in the prime of life. who are most often affected.
While the cause is not well known, most believe that it is related to abnormalities in the body’s immune system. The disease may be an auto-immune process in which the body begins to attack itself in error. The same type of process occurs in people with arthritis, but in that disease the joints are destroyed. In MS, the lining of the nerves of the brain and spinal cord are attacked. This can cause symptoms which vary greatly from person to person. The symptoms include abnormal fatigue, blurred or double vision, loss of balance, slurred speech, shaking of the hands, bladder and bowel problems, difficulty walking, memory loss, mood swings and in severe cases, partial or complete paralysis.
The typical pattern of symptoms is to subside and reoccur. In some cases, the time to reoccur is great, and in others there may be a pattern of symptoms that recur rather frequently and become progressively disabling.
As I said at the beginning, many cases may be mild and not even reoccur after the first episode.
Most people experience their first symptoms of MS between the ages of 20 and 40. Women are more frequently affected than men.
The first symptoms usually involve vision problems, including blurred or double vision, color blindness and rarely, loss of vision in one eye.
Much of the treatment so far has involved medications that aim to stop the attack that the body makes against the brain and spinal cord
. Interferon is one class of medications used. This involves injections and may be what your sister is currently using for treatment.
This past week a report was issued in the New England Journal of medicine, which I hope you will ask your doctor about.
The report discussed a new way to treat MS, using pills, instead of injections. There were two medications that were tried in the research trials, which aimed to stop the killer T Cells that the body made in error to attack the nerve linings in the brain and spinal cord.
One pill caused the T cells to die before they could do harm. The other pill inactivated the T cells. The results were dramatic, in decreasing reoccurrence. In addition, most patients liked the fact that it was in pill form and did not require frequent injections.
While it was very effective in stopping relapses, both had several side effects that are worrisome. While inactivating the T cells that the body made in error, it also weakened the immune systems in patients taking the pills. As a result, there were more serious infections, cancer and even deaths in the group taking the new pills.
This poses a dilemma for doctors and patients- do the risks outweigh the benefits?
The pills, if approved by the FDA would probably be available by the end of 2011.
It is hoped that other medications, using the same principal could be developed that have fewer side effects.
Another exciting treatment option being investigated is known by the initials CCSVI.
There is a theory that MS might be caused by a blockage of blood flow in the brain, resulting in increased pressure in the veins of the brain and spinal cord, which results in damage that could cause MS.
The reports regarding this new treatment are few in number and require much more study and testing before it can be regarded as a standard treatment in a report from Italy, a doctor there has been reporting dramatic results, using an operation to unblock the blood flow in the veins of the brain. He reports those two years after surgery, that 72% of patients had no symptoms. I know that some of the larger medical centers in our area have been evaluating this procedure and I present it here, not as a miracle cure, but for information you can discuss with your doctor.
I urge you to assure that your sister sees a doctor who has extensive experience in treating MS. This will allow her to have the proper care, as well as to be aware of the latest breakthroughs and risks associated with each type of treatment.
The good thing to remember is that while the disease is unpredictable, most patients are mildly affected and lead normal lifestyles.
I wish you luck, and please feel free to call on me should you have any questions regarding referrals for doctors who specialize in treatment of MS.

*Reprinted with the permission of The Tablet