Award-winning actress Christina Applegate revealed on social media that she had been diagnosed with multiple sclerosis (MS). “It’s been a tough road. But as we all know, the road keeps going,” wrote Applegate in a tweet.
Multiple sclerosis is a neurological autoimmune disease that has puzzled patients and health care providers for decades. The disease was first described by the French physician Charcot in the 1800s in the original report “sclerose en plaque.” It predominantly disrupts the cables connecting our nervous system. MS typically strikes between age 20 and 50, with nearly one million people living with MS in the United States, women more affected than men. To many, it still constitutes a rather puzzling and difficult to “pin down” constellation of symptoms. A burden that lies heavily on the shoulders of society, for it affects the well-being and productivity of a young and active segment of the population.
Many MS patients spend a good portion of the early stages of their disease trying to explain rather vague symptoms to which many non-targeted tests might not bring an adequate explanation. The rate of misdiagnosis is high at about 20 percent, and delayed or inappropriate treatment can cause unwanted results.
An MS diagnosis often leaves my patients feeling scared and lost. “What will happen to me? Are my symptoms going to improve? Why does MS occur?” are all typical questions asked in my practice. The invisible burden that my patients carry over the course of their disease is humbling. Although some patients appear to be “fine on the outside,” the effects of MS on movement, sensation, clarity of mind, energy level, and sexual functions tell a different and very individual story.
The picture is not completely bleak, however, and there is hope for MS patients. Over the last few decades, the MS community has come up with major breakthroughs, increasing our understanding of MS and our ability to change outcomes and prevent disability if caught in a timely manner. For example, the recent discoveries of new tests and therapies to detect and counter disorders earlier, ones that share similar pathology to MS, have given new hope to patients, who, in the past, would have acquired disabilities as a result of treatment delay.
The need for and use of predictive MS biomarkers and management models is ever so increasing. Precision medicine, which revolutionized the current understanding of certain diseases such as cancer, is being applied to autoimmune diseases, including MS, so we can answer those questions with more confidence. I see in a not-so-distant future our ability to collect patient-specific data that will help target and modify the errant immune system of the patients at the root of the illness, leading to the best outcomes.
Although the road ahead may seem tough for those who are initially diagnosed with this terrifying disease, many can now live with this disease with a high quality of life, and I am also greatly encouraged by the resilience of patients who do suffer its more serious symptoms, and buoyed by the dedication of so many researchers who work together to answer such puzzling mysteries.
Yasir Jassam is a board-certified neurologist Hoag Memorial Hospital Presbyterian, Newport Beach, CA.
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