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Hotline: MS may strike in prime with often-baffling symptoms

Published: Thursday, Aug. 11 2011 11:06 p.m. MDT

Dr. Viktoria Kaplan, a neurologist at LDS Hospital and Rocky Mountain MS Clinic, says multiple sclerosis is hard to diagnose.

Laura Seitz, Deseret News

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SALT LAKE CITY — Multiple sclerosis may first appear as blurred vision, muscle weakness on one side or sensory loss. It could make its debut with dizziness, balance issues, poor coordination, memory loss or extreme fatigue. Some people become blind in one or both eyes, a condition that could stay or leave or simply change. Or it can often be less specific: fatigue, bladder problems, heat intolerance.

Because its presentation may be episodic — symptoms can get better — it may be easy to blow it off unless it is severe, said Dr. Viktoria Kaplan, neurologist at LDS Hospital and Rocky Mountain MS Clinic. "I need new contacts." "I slept wrong."

And sometimes, because symptoms can go with other conditions as well, it's hard for a doctor to tease out what's happening to someone. That's bad news, because research shows that those with MS "do much better on treatment," Kaplan said.

Multiple sclerosis is the topic of Saturday's Deseret News/Intermountain Healthcare Hotline. From 10 a.m. to noon, Kaplan and Clare Wright, direct services director for the National MS Society Utah, will take phoned-in questions on symptoms, treatments, available services and more. They'll also answer questions posted on the Deseret News Facebook page, www.facebook.com/desnews.

Multiple sclerosis is poorly understood by the public and many doctors don't know what to do with it, either. Some people confuse multiple sclerosis and muscular dystrophy, two very different disease, said Wright. Some worry that it's contagious. When one is diagnosed, questions about how it will progress are understandable, but nonetheless hard to answer. It can be extremely unpredictable, although Kaplan said that "people who do better in the first year will do better down the road." That's why it's so important to get a good diagnosis and start treatment.

It's an autoimmune disease where one's immune system attacks the myelin or lining of the nerves in the central nervous system, which includes the brain, the optic nerves and the spinal cord. Loss of myelin messes up the body's nerve signalling system. Kaplan said most people are diagnosed between age 20 and 50, though there have been cases in children as young as 5 and new diagnosis in those as old as 75. Diagnosis itself hinges on finding white matter on imaging tests in more than one location and sufficient quantity to quality. It's a disease that affects more women than men, but men are more likely to see symptoms progress.

It's not usually a life-shortening disease, although complications can do that. But it is certainly life-altering.

Among the disease's sorrows is the fact that it strikes most people at the stage of their life when they are most productive. "They are in their prime career wise," Wright said.

And while it's true that genetics may make certain people more prone to MS than others, researchers don't believe it's directly inherited.

MS can be separated into four main categories, said Kaplan. In the most common, "relapsing-remitting MS," symptoms flare up, followed by remission and more flare ups and remissions, over the course of time. Treatments target preventing flare ups as well as treating symptoms when the flare ups do occur, Kaplan said.

Secondary-progressive MS may develop in those with relapsing-remitting MS, with cycles of symptoms and partial but not complete remission until it simply progresses.

In primary-progressive MS, there are no remissions, just an increase in severity over time. With progressive-relapsing MS, which is the rarest, Kaplan said, people experience both steadily worsening symptoms and attacks during periods of remission.

Some, but not all people with MS will end up in a wheelchair. Many will need helpful tools like canes and walkers. The society has active programs that help people diagnosed with MS make their surroundings more safe and user friendly. It can even help with short-term respite care in some cases, Wright said.

Tomorrow: Treatment options

EMAIL: lois@desnews.com, Twitter: Loisco, FB Lois M. Collins

Health hotline

The Deseret News/Intermountain Healthcare Hotline focuses on multiple sclerosis. From 10 a.m. to noon Saturday, Dr. Viktoria Kaplan, neurologist at LDS Hospital and the Rocky Mountain MS Clinic, and Clare Wright, direct services director of the National MS Society Utah, will answer questions. Call 1-800-925-8177 toll-free. You can also post questions during that time on the Deseret News Facebook page, www.facebook.com/desnews, and they will answer them during the hotline.Heady goes here

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