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Multiple Sclerosis: What Is It? How Is It Treated?
November 11, 2019

What is it? 

Multiple sclerosis, or MS, as it is commonly called, is a chronic neurodegenerative disorder caused by immune system dysfunction, which targets the nerves in the brain and spinal cord and affects the sensory and motor functions of the body. This occurs when the immune system damages the myelin coatings of the nerves that send and carry messages to the muscles and organs. 

About one million persons in the United States, and 2.5 million worldwide, are living with MS, which affects every area of a patient’s life. It strikes 2.5 women for every man afflicted, with symptoms often starting between the ages of 20-50. There is no cure yet for this puzzling disease, and its exact cause hasn’t been conclusively identified.  

What causes MS? 

St. Luke’s Fellowship-trained MS specialist Nataliya Ternopolska, MD, says suspected causes of MS include a Vitamin D deficiency, which is, so far, the single identifiable cause, as well as viruses like mononucleosis in the young, environmental toxins, bacterial infections in the digestive tract and genetic mutations in familial predisposed patients. Inhabitants in Europe, Northern United States, Southern Canada and Southeast Australia have a higher incidence of the disease seemingly due to their limited exposure to sunlight and consequent Vitamin D deficiency. 

St. Luke’s MS Services

St. Luke’s MS Center treats more than 1,500 patients per year, says Dr. Ternopolska, who shares a commitment to these people by collaborating with neurologist and MS specialist Joan Sweeney, MD, as well as certified nurse practitioner, Francine Delin, CRNP, and physician assistant Rachel Hanson, PA-C, an MS nurse navigator, Fabiola Mondaca-Soto, RN, and  a clinical social worker. Throughout the course of treating these patients, they often consult with and refer to specialists in urology, psychotherapy, neuropsychology, ophthalmology, neuro rehab, physical therapy, occupational therapy and physiatry for treatment and supportive services. Network programs and resources for MS patients are offered at the Bethlehem, Allentown, East Stroudsburg, Warren, Macungie and Quakertown locations.  

What are its symptoms?

Common symptoms of MS can include focal muscle weakness of the arms and legs, vision loss, balance problems, unexplained fatigue, and thinking and emotional difficulties, including anxiety and problems concentrating. “Neurologic dysfunction may come as attacks and may improve over the time in patients who have Relapsing-Remitting MS,” explains Dr. Ternopolska. Other types of MS and causes of the patient’s progressive decline may include:  Primary-Progressive, in which the patient has a steady series in disability; Secondary-Progressive in which the severity suddenly decreases; and Progressive-Relapsing where the disease generally declines but also brings occasional attacks.  

How is it diagnosed? 

Because the illness can be mistaken for another disorder, it must be confirmed at an MS Center by an MS specialist like Dr. Ternopolska or Dr. Sweeney, after a review of a patient’s symptoms usually in a primary care office. Then medical tests that include an MRI of the brain, an ultrasound of the optic nerve and a spinal tap, are done to make a final diagnosis, says Dr. Ternopolska. “Without these ‘gold standard’ tests, there is a risk for misdiagnosis. Therefore, evaluation must be completed and reviewed by an MS specialist.”

How is it treated?     

Research has greatly advanced the treatment and improved the lives of MS patients in the past 20 years, explains Dr. Ternopolska. “There are 18 FDA-approved medications that suppress the immune system and target different types of the disease. They can be chosen or customized for patients’ lifestyle, gender,  age and other conditions or illnesses.” These drugs can be taken orally, through an IV or by an injection. Some therapies may improve symptoms, while others help delay progression of the disease.  Most patients take large doses of Vitamin D daily.

Two medications are being tested by Johns Hopkins University and University of California at San Francisco in hopes they can restore the nerves’ myelin and conduction ability, Ternopolska says with optimism, and stem cell trials are underway in Canada and New York. “These advances offer hope,” she adds, “though the research is still in its early stages.”  

Is there a cure for MS in the near future? Dr. Ternopolska notes that before this can happen, the exact cause of this debilitating disorder must be found.