Penn Medicine Neuroscience Center: Multiple Sclerosis Center
 
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What is MS?

What is MS?

Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system (the brain and spinal cord).

Although it can appear at any age, MS most commonly begins between the ages of 20 and 40 and affects more women than men, at an approximate ratio of two to one. The exact cause of MS is not known, but it is believed to result from damage to the myelin sheath, the material that surrounds nerve cells in order to promote rapid conduction of nerve impulses. MS is a progressive disease, meaning that the nerve damage (neurodegeneration) worsens over time.

Central nervous system inflammation is the principal abnormality of MS. The inflammation results when the individual’s own immune cells attack the nervous system, destroying the myelin and leaving multiple areas of scar tissue (sclerosis). It also causes nerve impulses to slow down or become blocked, leading to the symptoms of the disease. Repeated episodes, or flare ups, of inflammation can occur along any area of the brain and spinal cord.

MS symptoms vary because the location and extent of each attack varies. Typically, MS episodes that last days, weeks, or months alternate with times when symptoms are reduced, or nonexistent (remission). Recurrence (relapse) is common, although non-stop progression without periods of remission may also occur.

There is no clear answer as to what triggers MS. The most common theories point to a virus or genetic defect, or a combination of both. There also appears to be a geographic link to the disease. MS is more likely to occur in northern Europe, the northern United States, southern Australia and New Zealand than in other areas, suggesting an environmental factor. People with a family history of MS and those who live in a geographical area with a higher incidence rate for MS have a higher risk of the disease.

Multiple Sclerosis

What are the symptoms of MS?
The most common symptoms of MS are blurry or double vision suggestive of an optic neuritis (inflammation of the optic nerve, the principal conducer of vision), or numbness and tingling in any area. Additional symptoms include decreased coordination, dizziness, facial pain, fatigue, loss of balance, movement problems, muscle spasms, pain in the arms or legs, paralysis in one of both arms or legs, tremor, vertigo, walking/gait abnormalities and weakness in one or both arms or legs. Symptoms may vary with each attack. They may last days to months, then reduce or disappear, only to recur periodically. With each recurrence, the symptoms may be different as new areas are affected.

Symptoms of MS may mimic many other neurologic disorders. Diagnosis is made by ruling out other conditions as well as by obtaining evidence of demyelination, such as magnetic resonance images (MRI) or studies indicating abnormal physiology such as visual evoked responses. If the health care provider can see decreases in any functions of the central nervous system (such as abnormal reflexes), a diagnosis of MS may be suspected.

Understanding our Mission and Vision
The Penn MS Center is a leader in MS training and in clinical and laboratory-based research. The Center’s core mission is to get to origination of this disease and to find better ways to treat it. The staff works tirelessly to gain a more comprehensive understanding of MS in order to give patients with MS a better quality of life.

How is MS Diagnosed?
The Penn MS Center provides cutting-edge imaging protocols and techniques. Testing for MS includes MRIs of the head or spine, blood studies, bladder ultrasounds, lumbar punctures (spinal taps), cerebrospinal fluid tests, electrical conduction studies and visual field testing.

How is MS Treated?
The MS Center offers state-of-the-art therapies for its patients, including:

  • Acute therapies, such as steroids, IV and oral medications.
  • Prophylactic therapies, including immunomodulators (Betaseron®, Avonex®, Rebif®, Copaxone®, Tysabri) and immunosuppressants such as Novantrone®, Cytoxan® and Rituxan®. In addition, there are a number of experimental clinical trials with new oral and IV medications that have an easier delivery schedule and potentially improved efficacy.
  • Symptomatic therapies including physiotherapy, occupational therapy and home health care.

Cutting-Edge Research Shapes the Future of MS Treatment
MS center research teams lead clinical and laboratory-based research programs that are recognized at both regional and international levels for their contributions to the advancement of MS treatment. Research projects focusing on a wide area of interests are supported by the National Institutes of Health and  the National MS Society. Research is being conducted in order to gain a better understanding of the disease process and pathology.  In addition, clinical trials are being conducted in the search to find new, and more effective, therapies and better medication delivery agents for MS.

 


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