Questions and Answers about MS

Question: I’ve heard that there are more MS exacerbations in the spring and fall. Does this mean I can expect a flare up as soon as the season begins to change? Also, would the occurance of MS in cycles give credence to the cause of MS being a virus or bacteria rather than an autoimmune disease?

Answer: At least two publications have suggested that MS attacks are more likely to occur in certain months. Other scientists disagree. It is generally agreed, however that there is an increased incidence of MS attacks following upper respiratory infections. This may account for the apparent cyclic attacks. Most MS investigators believe that such infections activate the immune system, which increases the chance of an attack. This does not necessarily prove that a virus causes MS. Most epidemiologists have suggested that MS is initiated at an early age and is due to an environmental agent (possibly a virus) which interacts with the immune system of certain susceptible individuals.

Question: Should my wife and I consider having a baby? What are the dangers, if any, to her MS if she becomes pregnant?

Answer: This question must be answered by each individual couple, and there is more than one consideration involved.

First, women who are pregnant actually have fewer attacks of MS. However, like all statistics this observation may apply to groups of individuals, so that it is still possible to have an attack.

Second, there is a slightly greater likelihood of having an attack during the six months following delivery of a child. The net result, however, is that when pregnancy and delivery are considered together, there is no difference in the disability of patients who have had children and those who have not. Some investigators even give the statistical advantage to mothers.

Third, there is no significant disadvantage to the child. Birth and delivery are not made difficult for most people with MS. There is a slight increased risk over a child from a non-MS patient that the baby will some time develop MS, but the odds are still very, very small.

Question: What if I am disabled and cannot care for my child?

Answer: This is a serious consideration and must be answered differently for each family situation. Having a child is an energy drain. The odds are that you would not be too disabled to care for a child. Also, many families have family backup, spouses, or other relatives who can care for a child.

In general, we advise people with MS to live as normal a life as possible.

For many couples this means they should go ahead and have a family. However, each MS family should consult their own doctor and counsellor about this issue, and discuss it seriously with their spouse. There is a publication available from the local MS Society entitled “Should I have a baby?” which may be helpful.

Question: Do you know of any treatment or treatments, for hypersensitivity with MS?

Answer: The word “hypersensitivity” can mean at least two things in the medical field. First, it can mean “allergy” such as a penicillin or ragweed allergy. The word can also mean an uncomfortable or painful sensation in the body, especially when the body part touches other objects. Allergies are treated in multiple sclerosis patients in the same ways as in people without MS. Dysesthesias, the second type of “hypersensitivity” are due to abnormalitites of the nervous system and may respond to treatment with medications such as tricyclic antidepressants (although the symptoms are not due to depression) or carbamazepine.

Question: Are there ways to help decreased vision in MS?

Answer: Problems with vision occur quite frequently in MS. The defects arise either from damage to the pathways of the central nervous system that affect sight directly, or to the nerve pathways that affect eye movements as controlled by the muscles attached to the eyes. Inflammation of the optic nerves that enter the eye is called optic neuritis. This entity is often the first symptom of MS in young people and can affect one or both eyes. Corticosteroids are often used during acute or progressive attacks and can shorten the duration of symptoms. In the chronic stages, symptomatic therapy includes bright lights, often attached to magnifiers. If blindness, which is very rare, occurs, talking books can be a very useful means of entertainment and information. If damage occurs to the nerve tracts that coordinate movements of the eyes, double vision, dizziness, blurred vision, or a constant scene of movement (oscillopsia) can occur.

Again, corticosteroids are used for the acute episode. Patching one eye helps double vision and some types of blurred vision. Prisms in the glasses are used for the chronic phase. Occasionally the drug Baclofen may alleviate oscillopsia. One important point often overlooked is that all poor vision suffered by MS people is not due to MS. Presbyopia (which often causes a person to hold reading material at arms length) occurs at age 40 or later and can be helped by glasses (refraction). Nearsightedness can also worsen with age. An ophthalmologist acquainted with neurological problems (neuro-ophthalmologist) (located at major medical centers) may be required to determine the nature and best method of treatment for visual disorders in MS.

Question: Can an antidepressant cause or precipitate an exacerbation of MS?

Answer: The only known precipitating factors for exacerbations of MS are upper respiratory infections and delivery of a baby. However, as has been stated many times, pregnancy and delivery do not affect the net long term outlook of MS. Fever or bacterial infections can cause “pseudo-exacerbations” due to physiological changes, but do not reflect new damage to the central nervous system. Following resolution of a “pseudo-exacerbation”, a person returns to their previous level of function. Drugs do not cause exacerbations of MS, but they may have side effects which cause or aggravate symptoms similar to those which occur in MS.

MORE INFORMATION: If you didn’t find the information you were looking for, we suggest you go to the National MS Society website. They provide a large amount of reputable information.