What is MS anyway

It's unlikely that the reader has encountered much about MS in their general pleasure reading. But I can report, after devoting a good amount of time to the topic that my illness is not an uninteresting read. It's an illness rich in scientific conjecture but still very much a mystery. The epidemiological and genetic distribution alone pose a first class "who done it". The illness becomes more common the farther one gets from the equator. It is encountered more frequently among the "North Sea People", those of Germanic, Scandinavia and Anglo-Saxon heritage. Some racial groups, Eskimos for example, actually get no MS at. More woman get the disease than men..Jean Martin Carcot, the father of Neurology, first noted the symptom picture that he named Multiple Sclerosis in 1868. The understanding that have emerged since then have involved some of the most gifted physicians of the modern era. To read of the advances in MS is to be reminded how recent much of what we know about our biology is. Seen from this perspective, the rate of medical understanding seems to be accelerating. Seen from the perspective of my computer table it's accelerating at an almost imperceptible snails pace.

Medical experts believe that certain vulnerable people acquire the "cause" of MS around the time of puberty. What this "cause" is remains a mystery, but a viral agent of some sort is the likeliest suspect. Something additional appears necessary to kick start this latent potential into the active disease of MS. Symptoms indicative of MS generally don't appear for fifteen or more years beyond the exposure to the mysterious "cause".

So what does MS do? It reeks havoc on the central nervous system. That includes the brain, the spinal column and closely related structures. These, I think we can agree, are not unimportant chunks of our anatomy. The damage occurs in this way: Within the central nervous system there are bundles of nerve fibers that serve as the information carrying pathways. These fibers are composed of specialized nerve cells that coordinate their efforts in transmitting nerve impulses from one cell to another along the route. Our ability to utilize our bodies depends on these impulses being successfully conveyed to the brain and the brain sending back it's instructions.

The movement of nerve impulses is somewhat analogous to the transmission of electric current along an electric wire. A substance called myelin is produced by these specialized cells and wraps itself around the nerve fibers. This material insulates the fibers and prevents leakage in much the same way that the plastic coating on electrical wire protects and enhances the flow of electric current. If this myelin sheathing is damaged the transmission of nerve impulse may be slowed or interrupted entirely. It appears that when MS takes root, cells and proteins of the immune system leave the blood vessels that serve the central nervous system and pour into the brain and spinal cord. They then set about destroying the myelin sheathing. The myelin becomes a casualty of friendly fire. The outcome of this misdirected aggression is the formation of hardened (sclerosed) areas, or plaques ( sometimes called lesions), scattered throughout the brain and nervous system. And this, dear readers, is why MS is referred to as a demyelinating disease.

The central unanswered mystery is what triggers this destructive immune response. The preponderant belief is that a virus invades a person with a genetic vulnerability. The virus then attacks the myelin or myelin producing cells directly, or acts indirectly by changing the nervous system and eliciting an autoimmune response. Others believe that the disease is chiefly a disorder of the bodies immune system. Something triggers a false alarm and the white blood cells go haywire producing antibodies that attack the individuals myelin. A yet more complicated hypothesis is that a viral infection disturbs the immunity in a susceptible individual and another virus is able to slip by the compromised immune system and attack the nervous system.

And this, patient reader, concludes the hard science portion of our discussion. There are other mysterious aspects concerning who gets MS and who doesn't. Fortunately these questions are more productively pondered by those of us who long ago recognized our limitations and gravitated towards the social sciences.

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