Diagram of the ODFS

They found that people with multiple sclerosis using the stimulator increased walking performance, compared to the exercise group and also experienced fewer falls.

authors: Esnouf J, Taylor P, Mann G, Barrett C.

source: Mult Scler. 2010 Jul 2

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Total costs of MS varied widely across countries for which studies have been conducted but are substantial in all countries. The total (prevalence weighted) average annual cost per person with MS in 2007 (based on existing studies from 15 countries) was $41,334. Over a lifetime it is estimated that the average financial cost of MS in high income countries is more than $US 1.2 million per person. Loss of employment, or early retirement, is considered the single largest cost factor contributing to this financial cost.
Costs of MS
Types of costs were divided into three broad categories: direct, indirect and intangible costs, with the view to understand more fully the kinds of costs that MS demands of the individual and society.

Direct costs
Direct costs are those incurred by the individual or society as a direct result of the disease. In the report these costs were divided into medical and non-medical subcategories and cover everything from visits to neurologists to the costs of installing wheelchair ramps at home, and the value of care-giving provided by family, friends or professional carers. The responsibility of caring for the person with MS often falls on those closest to him/her and this can affect the carers’ ability to work. Often carers are forced to work shorter hours in order to care for their loved one, or increase working hours to compensate for their loss of income. For carers it is essential that employers are understanding, supportive, and flexible where possible to enable carers to continue working in order to support those who cannot work themselves. Direct costs accounted for 26% to 87% of the total costs of MS

Indirect costs
Indirect costs, which accounted for 13% to 74% of total MS costs, are those costs which are related to MS but cannot be attributed directly to the disease itself. Loss of work is often the most costly contributor to the overall cost of MS since the average age of onset of MS is 29.2 and can dramatically affect or curtail the working life of the individual. The symptoms of MS, which can include physical disability, fatigue, cognitive impairments, transportation difficulties and speech impairments, can make finding and retaining employment difficult especially where employers do not support the changing needs of the employee.

The costs incurred can include short-term and long-term absence from work during periods of relapse, reduced working hours, changing the type of work to a less physically challenging and stressful nature (often at a lower pay), and early retirement.

Intangible costs
Intangible costs are those costs that are often most difficult to measure and can include changes to the quality of life of both the individual and his/her friends and family. In the 13 studies that were analysed with relation to quality of life, several patterns emerged. Firstly, the impacts on physical functioning are larger than those on social functioning or mental functioning, and secondly that physical quality of life deteriorates as the disease progresses over time. Significant impacts on social and mental functional were also found over time. These studies show that a diagnosis of MS does not necessarily affect the ability of the individual to engage socially or mentally, but that physical engagement may be the biggest barrier to activity that the individual faces – especially in the early stages of the disease. With this in mind, it is important that employers offer a variety of solutions to make work more accessible to those with physical disabilities.

You can read the full article here

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Introduction

Vascular co-morbidity means that as well as MS you have  hypertension, hypercholesterolemia, diabetes, or heart disease too. It has recently been found that whether present at symptom onset, diagnosis, or later in the disease course, it  is associated with a substantially increased risk of disability progression.

Who found this ?

Published in Neurology. 2010 Mar 30;74(13):1041-7. was a study by

Marrie RA, Rudick R, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T.

Health Sciences Center, Winnipeg, Canada.

Background

On October 29 in Neurology, researchers outlined how co-morbidities may contribute to diagnostic delay in multiple sclerosis (MS) and increased disability at diagnosis. But Vascular co-morbidity adversely influences health outcomes in several chronic conditions so it became a question that needed to be answered about MS.( Vascular co-morbidities are common in multiple sclerosis (MS), but their impact on disease severity was unknown).

It could be that these “vascular co-morbidities” may contribute to the poorly understood variability in MS disease severity. So,  A total of 8,983 patients with MS enrolled in the North American Research Committee on Multiple Sclerosis Registry participated in this cohort study.

Method

Time from symptom onset or diagnosis until ambulatory disability was compared in these 8933 patients with or without vascular co-morbidities to determine their impact on MS

Models were adjusted in the analysis for sex, race, age at symptom onset, year of symptom onset, socioeconomic status, and region of residence.

Results

Participants reporting one or more vascular co-morbidities at diagnosis had an increased risk of ambulatory disability, and risk increased with the number of vascular conditions The median time between diagnosis and need for ambulatory assistance was 18.8 years in patients without and 12.8 years in patients with vascular co-morbidities.

CONCLUSIONS

Vascular co-morbidity, whether present at symptom onset, diagnosis, or later in the disease course, is associated with a substantially increased risk of disability progression in multiple sclerosis. The impact of treating vascular co-morbidities on disease progression deserves investigation as treatment of vascular co-morbidities may represent an avenue for treating MS

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Now it seems to me that there is nothing more noble in the human condition than the ability to laugh at ourselves. Sounds like Melanie did this too. She is a normal person who happens to have a disability. This does not mean everybody should tip toe around her in case they say the wrong thing. If she was hurt it would be a different matter but since she wasn’t then yes, it was funny, could have happened to anybody  The apology she received was probably politically driven so doesn’t carry much weight anyway.

If I fall  over I’d rather laugh than cry.

If I misread something because of my eyesight problems  I’d rather laugh than cry.

If my coffee shimmers when I pick it up and my son is amused I’d rather laugh than cry.

There is time enough to cry, when the fatigue kicks in, when the pain kicks in, when the vertigo kicks in, when my bladder gives up and when my eyesight brings down the curtain.

Let’s laugh while we can and let’s share that laughter with the people around us.

I’d like to hear your views on his matter so please leave a comment below

.

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Epidemiology

• MS is a global disease – no country that responded to our survey was free of MS

• MS is a disease more common among women than men

• Symptoms appear at around an average of 30 years of age

• The survey revealed the geographical patterns associated with the disease

• Under-recording is likely in many tropical/equatorial countries

• There is a lack of reliable, valid and robust data from epidemiological/economic

impact studies/reports published in medical literature (especially in Africa and parts

of Asia where the prevalence is reported to be low) •

MS Organisations

• Many countries in the world have no patient-driven support for people with MS

Diagnosis

• The availability and accessibility of MRI technology varies widely

• Time from onset of symptoms to diagnosis varies widely – often drawn out over

many months or years

• Inequalities in global wealth impact on the provision of diagnostic services

Information

• There are inequalities in the provision of information – in many cases the gap

between information required and received is vast

Support and services

• The needs of people with MS do not inform decision making, the implications of

which will ultimately improve their quality of life

• Health care professionals are not receiving any (or enough) training to help them

identify and treat people with MS

• There is a lack of public and professional awareness of MS and its impact

• There is little understanding of the socioeconomic costs of MS to individuals,

families, carers and the community

• Without adequate education, advice and support, people with MS are unaware of

how best to cope with their MS and how to remain in education or employment

• In many countries mutual support groups are not available

• In many countries no aids or adaptations are available from any source

• Accessible public transportation is often not available or difficult to use and there is

little alternative transport support

• There is poor provision of respite

• There is a need for better understanding of how transport and drug delivery options

will overlap with care and treatment possibilities

• Significant income inequalities exist around provision of treatment.

• People with MS actively seek and use a wide range of untested and un-trialled

‘complementary’ or ‘alternative’ remedies, therapies and treatments

• The findings confirm the key role played by MS organisations

Human Resources

• In some countries the lack of MS neurologists hampers diagnosis and the provision

of treatments and therapy

• There is a general lack of MS nurses

• There is an inadequate use of interdisciplinary teams in community settings

• MS is being managed in a medical, not social, model of care

Disability entitlements, legislation and insurance

• There is a need to integrate health and employment teams to improve vocational

rehabilitation

• People with MS are often dependent on disability entitlements and means-tested

cash assistance for their income.

• The eligibility standards, payment levels and administration of disability entitlements

and cash assistance have a direct impact on the quality of life of people with MS

Major issues

The major issues for people living with MS are

• lack of social support

• lack of information/education of the public about MS

• non accessibility/availability of disease modifying treatments

• issues related to employment

• health insurance/social security related issues

The major issues for health professionals involved in MS care are

• lack of information/education of health professional about MS,

• issues related to the time it takes to diagnose and the process/technology required

• the non accessibility/availability of disease modifying treatments

• lack of research in MS issues

• lack of health services, including MS centres

The major changes needed to improve MS care are

• inform/educate the public and health professional about MS,

• make health services, including MS centres and rehabilitation facilities,

accessible/available

• develop MS societies/support groups

• improve and expand research into MS issues

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There are about 80 different types of sleep disorders, and about 25% of people (that’s 70 million Americans) suffer from them.  The inability to fall asleep or to stay asleep, called insomnia, is the most common. Multiple Sclerosis (MS) is well represented in the Sleep Disorders department.

On her “good” nights, she awoke as frequently as every hour; on the worst ones she lay awake until breakfast.

Sleep problems are common in MS, but are somewhat under recognised. In a study from the UK, as many as half of the patients with MS (of varying severity) studied had some sleep-related problem. The commonest was insomnia, usually related to spasm, pain, immobility, bladder problems, or medication.  It has also been felt that periodic leg movements may be more common in MS. Besides these relatively common problems, there are more than a few case reports of some unusual or rare sleep disorders in MS.

MS patients have pain, depression and anxiety all of which can cause insomnia However, most Insomnia is Psychophysiological- that is related to a pattern of sleep difficulties that is not specifically due to a physical trigger or a recurrent identifiable cause. This is true in MS too.

Sleep disorders are twice as prevalent among MSers than non-MSers. These disorders can be sleep-related movement disorder, nocturia (frequent visits to the bathroom), tinnitus (ringing in the ears), obstructive sleep apnea or OSA (tissues of the throat interfere with breathing), central sleep apnea or CSA (brain slows down regulation of breathing), REM sleep behavioural disorder (person acts out dreams during sleep), and narcolepsy (falling asleep unexpectedly and at inappropriate time). Throw in the usual MS symptoms, such as numbness, tingling, spasms, pain, and it’s no wonder that sleep becomes an issue for many of us.

Sometimes, unco-ordination in breathing, which is more common in MS than in those without it, can worsen the upper airway obstruction which is the major cause of OSA. In MS, the central control of breathing can be impaired due to plaques in the brain stem. This can cause Central Sleep Apnea. MS patients, like many others can have combinations of OSA and CSA when tested in an overnight Polysomnogram (PSG).

All of these can be operative in Multiple Sclerosis, the most common being OSA which is the leading cause of Excessive Daytime Sleepiness in the vast majority of people with or without a concurrent disease.

Improving your sleep

Is there anything we can do to make these sleep problems better? Try some of the following tips.

• Do not nap during the day.
• Do not consume caffeine within 4-6 hours of bedtime
• Do not smoke or use nicotine products close to bedtime or during the night.
• Do not drink alcoholic beverages within 4-6 hours of bedtime.
• If the need to use the bathroom is keeping you up at night, reduce fluid intake in the evening. It is still important to drink the recommended amount of fluids during the day. Also go to the bathroom immediately before you go to bed.
• Do not go to bed hungry or soon after a heavy meal. If you are hungry, eat a light snack or drink a glass of warm milk.
• Exercise regularly, preferably during the day. Avoid vigorous exercise 3 hours before bedtime.
• Set your alarm to wake up at the same time every day, even on days when you’re off work and on the weekends.
• If you have sleepless nights and lie in bed until it seems like the sun is coming up get back up if you have not fallen asleep after 10 to 15 minutes. Find something to do that is relaxing to you, such as putting together a puzzle, reading, or writing a letter to a friend.
• Rather than watching TV, which is a passive activity, do something active so that natural tiredness can build up–although you should avoid physical activity when trying to become sleepy.
• I’ve been told “Remember that your bed is only for sleeping. Any of the above activities should be done in another room, not your bedroom. Return to the bedroom only when you feel tired.” But personally I much prefer to stay warm in bed as I try things to tire me out.

Finally these relaxation techniques can help you fall asleep or improve your sleeping patterns:

• Repetitive mental exercises. Close your eyes, and silently repeat a word or short phrase. Let your breathing become slow and steady. Repeat the phrase for 10 minutes until you feel more relaxed.
• Visualization. Imagine that you are in a peaceful environment, such as lying on a beautiful beach, relaxing and taking in the rays.
• Progressive muscle relaxation. You can mentally put each part of your body to sleep by tensing and relaxing your muscles. People with spasticity should be careful because this exercise could trigger muscle spasms.

Here’s hoping there’s a way to make things better. If you have your own technique please leave a comment and share it with others.

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One of the first things is that a chronic illness does not conform to most people’s prior experience with illness. MS does not go away. Nothing is the same and you can’t tell how different it is going to be from one day to the next. This unpredictability makes it difficult to make plans and decisions.

MS changes us. It causes us to rethink our plans, goals, dreams and aspirations: some changes may be relatively small but some are very significant, and affect several areas of our life.

Let’s take an apparently simple thing like socialising

MS can complicate socialising. The practical difficulties of getting out and about can affect friendships. The different lifestyle led by a person with MS may mean that some friendships are lost or changed, and there may be fewer opportunities to make new friends.

“You feel like being around people but find it hard. I can tolerate a couple of people but if I go into a room of 30 to 40 people I just feel like I need to get out of there and go home.”

We all have a sense of self, of “who we are”. It can refer to how we perceive ourselves, the kind of work we do, the activities we are involved in, the friends we have, and our place in a family that we care about. MS can play with this perception.

MS is not going to kill you but it is important to go through the grieving process of dealing with loss of the life you once had. Take control of the uncontrollable. Now this sounds la bit like holding the w aves back from the shore but  there is a lot you can do to live moiré comfortabley with this unpredictable disease.

• Educate yourself :The more you know the better prepared you are
• Create your support networks : you don’t have to do it alone
• Start your treatment early: There is no cure but several medications have been shown to slow the disease progression.
• Learn your own cues: For example does heat make your symptoms worse? Can you concentrate better earlier in the day? Are you sensitive to cold? When is your energy ay it’s best? Does it take you longer to do things than it used to? Share all these facts with those around you as nobody is a mind reader
• Always have a back-up plan: Every big plan should have a backup. One day you’re raring to go and the next you’re weighed down. Get into the habit  of thinking of alternatives just in case fatigue kicks in, symptoms flare up or a relapse happens.
• Tap that ang3er and frustration: Just reorganising your kitchen to make it easier for yourself  or do something big like advocate for the rights of peoples with disabilities  or add a comment to this psot and share with the others who come here, It all makes a difference

Summing Up

After being diagnosed, and as you manage your MS, it may be that your emotions and confidence are all over the place. It is very important to have good support networks to help you adjust, and to help you create new plans, goals and aspiration that are compatible with having MS.

The best piece of advice is don’t go it alone. Talking to others is crucial. It is important to have someone with a ready ear and an understanding of what you are going through.

Likewise, it is important that people with MS keep communication open between themselves, and others affected by their condition. This includes family, friends, medical professionals and caregivers. Effective solutions often depend upon a united approach to resolving the problem.

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Oral medications
A number of medications have been used to treat generalised spasticity. Although there is variability in response to and tolerability of different medications, most practitioners will suggest baclofen as a first line agent. It works at the level of the spinal cord to help the body inhibit muscle movement. A number of studies have shown that baclofen is effective in reducing pain, improving gait and overall function, as well as decreasing spasm frequency.

However, baclofen can cause fatigue, dry mouth, dizziness and nausea and many people start on baclofen and say it doesn’t work for them. However, if assessed carefully and consideration is given to dose and timing, the results may be more positive. A written regime, with slowly increasing doses that help a person with MS assess how baclofen affects them over a period of time, and regular review can make the use of baclofen much more successful. Even so, some people with MS still find they cannot tolerate the dose of baclofen required for efficacy because of the side effects.

Another medication clinicians frequently prescribe is tizanidine. Again starting at a low dose, tizanidine appears to be particularly effective for painful spasms at night. Like baclofen, it can cause sleepiness, dry mouth, dizziness and fatigue.

Diazepam is also effective in treating spasticity in some people. It appears to have a greater risk of causing sleepiness and muscle weakness, and it has the potential for dependence and addiction which can affect adherence.

Dantrolene can be used for spasticity and it works at the level of the muscles to limit contractions.

Besides sharing most of the side-effects of diazepam, baclofen and tizanidine, dantrolene also requires frequent laboratory monitoring to ensure the medication does not damage the liver. As a result, dantrolene is not prescribed as frequently as the other medications.

Other medications that may be prescribed include clonazepam and gabapentin, although again, side effects can be problematic.

A combination of therapies may also be helpful for some people, and this approach has become increasingly utilised by clinicians.

Local treatments for spasticity
For those with spasticity affecting a small area (focal spasticity), or who do not get relief from oral medications, local injections of botulinum toxin or phenol into the muscles can improve quality of life. You probably know that “Botox” is now a well known and frequently used poison which paralyses the muscles and is used in non-surgical cosmetic treatment of moderate to severe frown lines.
A typical example of spasticity treatable with botulinum toxin would be the overactivity of muscles that flex the wrist, reducing the ability to reach and grasp objects. Making those muscles weaker can improve both function and pain.

There are two types of botulinum toxin, type A, known as Botox® in the United States and Dysport® in Europe; and type B, Myoblock®. A local injection of botulinim toxin can last 3–6 months and make functional activities easier to undertake.

Phenol or alcohol blocks are done less frequently, and involve identifying a point where nerve and muscle meet. Phenol is injected to destroy the nerve endings in that area only.

With both phenol and botulinum toxin, the effects are temporary and may require frequent injections. Also, individuals can build up antibodies to the botulinum toxin over time, making it ineffective. Some people are able to switch from the type A toxin to type B to prolong the therapeutic effect. The most appropriate treatment plan usually includes work with a physical and/or occupational therapist after the injection to improve functional movement of the affected area.

Surgery for spasticity
Orthopaedic surgeons and neurosurgeons might get involved in the management of spasticity in two ways. If a person experiences spasticity that has caused permanent deformity, a surgeon can lengthen tendons or fuse joints or otherwise address malformations. Surgical correction of deformity coupled with proper rehabilitation interventions can prolong sitting times in a chair, prevent skin breakdown or its recurrence, and reduce pain.

Cannabinoids and spasticity

Experimental pharmacological studies support the hypothesis that cannabinoid chemicals within cannabis, such as delta-9-tetrahydrocannabinol (delta-9-THC) and cannabidiol (CBD), exert muscle relaxant effects. While delta-9-THC does this via a specific cannabinoid receptor (the CB1 receptor) which was discovered in the central nervous system in the late 1980’s, CBD appears to have more complicated actions and may affect cytokines (proteins that are released by cells of the immune system and play a role in the generation of an immune response).

Initial clinical trial data did not support the efficacy of delta-9-THC in reducing spasticity. The first report from the “Cannabinoids in Multiple Sclerosis” (CAMS) trial, a blind and placebo-controlled trial in the UK, suggested that delta-9-THC had no statistically significant effect on spasticity when evaluated by the objective Ashworth scale.

However, in a 12-month follow-up study involving 630 patients, delta-9-THC was shown to have a small but significant effect. Nonetheless, in both studies the patients reported a subjective improvement in spasticity. It is a matter of some controversy whether the initial lack of effect using the Ashworth scale reflects the lack of sensitivity of that scale for quantifying spasticity.

The natural cannabis extract in the pharmaceutical product marketed as Sativex® has been reported to alleviate spasticity in a number of clinical trials. Clearly , since cannabis is illegal a pharmaceutical product would be welcomed.

The most common adverse side effects reported have been oral pain, dizziness, diarrhoea and nausea. Of the other cannabinoids that have been investigated, the synthetic cannabinoid, nabilone, has been reported to reduce pain related to spasticity in one recent study.

There have now been more than 12 clinical trials published on the effects of cannabinoids on spasticity and pain in MS. Although not all of these studies demonstrate a significant improvement in symptoms with delta-9-THC or CBD, evidence is accumulating that cannabinoid drugs may be useful in at least a subset of patients, and at least as an adjuvant therapy.

Long-term studies suggest that cannabinoids are reasonably well tolerated by patients but there is still concern about potential long-term adverse effects, such as cognitive impairment, impaired foetal development and psychiatric side effects. However, it must be recognised that many conventional anti-spasticity drugs such as baclofen also have significant side effects. It should also be noted that in many countries cannabis is an illegal drug, which affects its accessibility.

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Spasticity, ( feelings of muscle stiffness and involuntary muscle spasms), is a well defined consequence of MS.

It is recognised through various studies that spasticity occurs frequently in people with MS with Male gender, older age, and longer duration of the disease showing an increased severity of spasticity.

Quality of life can be affected with troublesome symptoms and functional limitations, and severe spasticity may even lead to medical complications such as skin breakdown or contractures, where a limb can become fixed in one position. So, as you can see, there is a  need to recognise and address spasticity and its consequences.

In many cases, initial interventions such as stretching, exercise and rehabilitation are helpful, but
they also enhance the efficacy of other interventions such as medication. Medications can  be useful and are usually safe, although the dosing and timing must be optimised to minimise potential side effects.

For some individuals a degree of spasticity serves as a functional crutch and helps them to walk or carry out other physical activities, so the biggest challenge with spasticity management is determining what the optimal level of muscle tone is for an individual.

What’s going on?

What is happening with the nervous system to cause spasticity? To explain this you must review the fact that there are two types of motor neurones.

The nerve pathway connecting the brain and spinal cord is made of upper motor neurones. The pathway between the spinal cord and muscles is made of lower motor neurones. Spasticity is a consequence of an “upper motor neuron (UMN) syndrome”. The interruption of signals caused by MS lesions means that the upper motor neurones can no longer regulate messages to the lower motor neurones. The lower motor neurones can then become overactive and hypersensitive, causing stiffness or spasms in the muscles.

Some of the detrimental consequences associated with spasticity are:

• interference with mobility, ability to exercise and the range of motion in joints
• negative impact on endurance and energy expenditure
• interference with the activities of daily living
• discomfort or pain
• sleep disturbance
• increased difficulty for caregivers (for example with transfers or hygiene).

Treating Spasticity .

Hot temperatures may cause a decrease in spasticity for people with MS while infections and exacerbations may cause a significant increase in spasticity. The cause of any change must first be identified. If it is due to an infection, it is crucial that the infection be treated first. Many people with MS recognise increased spasticity as a sign of a bladder or other infection, or of the increase in core body temperature that is associated with a fever or excessive exercise, or of a full bladder or colon.

When treating spasticity it is important to focus the aim on management and not necessarily on the elimination of the spasticity since some individuals use their spasticity to assist with functional movements. In addition, for individuals who have restricted movement, spasticity may help promote circulation by maintaining muscle contractions which can promote the return of blood to the heart.

The most important principle of treating spasticity is to develop reasonable and flexible goals that target specific manifestations of spasticity – pain, fatigue, stiffness or weakness – and, together with the person with MS, frequently reassess the effectiveness of treatments.

Spasticity can affect just a few parts of the body (focal spasticity), or it can manifest in multiple places (generalised spasticity). It can range from insignificant to incapacitating, with many levels in between. Spasticity can also increase and decrease.

Other causes of increased spasticity include:

• noxious stimuli such as a skin lesion
• a bladder or kidney stone
• fractures
• tight clothing
• menstruation
• psychological stress
• extreme environmental temperature
• hunger
• an MS exacerbation
• treatment with some disease modifying or antidepressant pharmaceutical agents.

In the next article I will be dealing with the treatments used in spasticity

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“Research from Taiwan indicates that capnellene (GB9), a compound extracted from the soft coral Capnella imbricata, could prove useful for treating neuropathy and neuropathic pain.”

When pain is the result of a disruption or alteration of nerve conduction, it is termed neurogenic or neuropathic. Pain caused by nerve damage can range from a mild prickling to severe burning, itching or aching and usually requires different treatment from musculoskeletal pain.

Pain management is approached medically, behaviourally, physically and in some cases, surgically. If it is treated with drugs it is always a balance of risk versus benefit. In other words, medication side effects need to be considered and continually evaluated in terms of their impact on a person’s quality of life.

Neuropathic pain responds variably to currently available drugs; painkillers, antidepressants and anti-epilepsy drugs often have no effect.

Usual medications

Carbamazepine (anticonvulsant): Side effects Drowsiness, Dizziness, Coordination difficulties

Phenytoin (anticonvulsant): Side effects Dizziness, Nausea, Insomnia, Uncontrollable eye movements, Coordination difficulties, Slurred speech, Confusion

Baclofen (muscle relaxant): Side effects Weakness, Drowsiness, Dizziness

Gabapentin (anticonvulsant) may also help: Side effects Dizziness, Coordination difficulties, Fatigue

Zhi-Hong Wen. said “Capnellene could be the first of a new generation of painkillers that are more effective than steroids or opiates and do not have their potential side effects or their addiction-forming properties,”

CB09 and its derivative GB10 have been looked at with two proinflammatory molecules which were reduced to almost control levels at the highest GB9 and GB10 concentrations tested.

“We are currently investigating the effects of GB9 and GB10 in other animal models of osteoarthritic pain, multiple sclerosis and Parkinson disease, as the compounds could also be potent therapeutic agents for a range of neuroinflammatory diseases,” says Wen.

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