Multiple Sclerosis

Neurology and Neuroscience

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About Multiple Sclerosis

Multiple sclerosis (MS) is a chronic disease in which the body's immune system attacks the myelin, the fatty sheath covering and insulating the nerve fibers that carry signals from the brain to other parts of the body. As a result of this, scar tissue called sclerotic plaques form, and the nerve fibers themselves may also be damaged. Nerve signals traveling through these damaged areas are distorted or interrupted, and this faulty transmission produces the variety of symptoms people with MS experience. Multiple sclerosis is one of the most common disorders of the central nervous system in younger adults, and affects three times as many women as men.

The course of MS – its progression, severity, and specific symptoms – varies greatly from patient to patient. Most patients (85 percent) initially have a relapsing-remitting form of the disease in which patients experience relapses (also called attacks or exacerbations) interspersed with periods of remission from the disease. During a relapse patients may have symptoms including blurred or double vision, weakness, numbness, tingling, balance problems, or dizziness. In many people these symptoms do not resolve completely when a relapse concludes. When MS is untreated, by fifteen to 20 years after diagnosis about 60 percent of people with relapsing-remitting MS have entered a phase of the disease called secondary progressive MS. During this phase many people experience no remission from the disease, while in some the disease plateaus. Disabilities accumulate in this form of MS, but not necessarily more rapidly than in relapsing-remitting MS.

About 15 percent of people with multiple sclerosis are diagnosed with primary progressive MS, which is characterized by a gradual decline in functioning in the absence of exacerbations or remissions.

NewYork-Presbyterian's Approach to Multiple Sclerosis

At NewYork-Presbyterian Hospital we provide comprehensive care for people with MS through a coordinated multidisciplinary approach. Specialists from different departments – neurology, urology, psychiatry, rehabilitative medicine, physical and occupational therapy, neuroradiology, pain management, neuroophthalmology, and clinical social work services – work as a team in the care of each patient. At our two clinical centers dedicated to the care of people with MS, the Judith Jaffe Multiple Sclerosis Center at NewYork-Presbyterian/Weill Cornell Medical Center, and the Columbia University Multiple Sclerosis Clinical Care & Research Center at NewYork-Presbyterian/Columbia University Medical Center, we provide the latest diagnostic and therapeutic services and work toward maximizing function, improving quality of life, and increasing independence for each patient.

Patient Education Series

NewYork-Presbyterian is hosting a Multiple Sclerosis Patient Education Series at its Weill Cornell Medical Center campus. More information and a schedule of lectures is available in PDF format here.

Medical Treatment for Multiple Sclerosis

Because MS is such as variable disease, treatment for each patient is highly individualized. For most patients, treatment is likely to include some combination of medications. These include:

Drugs that modify the course of the disease. Medications currently approved by the Food and Drug Administration are beta interferons including Avonex®, Betaseron®, and Rebif®; glatiramer acetate (Copaxone®); natalizumab (Tysabri®); and mitoxantrone (Novantrone®).
A variety of therapies that alleviate the daily symptoms of MS (fatigue, depression, bowel and bladder problems, pain, numbness, tingling, stiffness, spasms, cognitive problems, weakness, and sexual problems) are integral to the treatment of MS.
Intravenous anti-inflammatory corticosteroids can hasten recovery from acute relapses.

Rehabilitation for Multiple Sclerosis

Most people with MS find that their symptoms are best managed when they combine medication with rehabilitation, exercise, and/or lifestyle modifications. Physical and occupational therapists can help people with MS.

Improve, strength, mobility, balance, and posture.
Manage fatigue and pain.
Maintain skills essential to a good work and home life.

Over time, some patients with MS become increasingly disabled, and may need devices such as canes and wheelchairs. Rehabilitation specialists help patients obtain and learn to use these assistive devices.

Research for Multiple Sclerosis

Investigators at NewYork-Presbyterian Hospital are involved in many clinical trials of novel investigational treatment and symptomatic therapies for patients with MS.