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Multiple Sclerosis
Multiple sclerosis is a puzzle that has
perplexed medical science since it was
first described by the French
neurologist Charcot in 1868. The
disease affects the central nervous
system and can, to varying degrees,
interfere with the transmission of
nerve impulses throughout the brain,
spinal cord and optic nerves.
Since identification, MS has been the
subject of intense, world-wide
research but still its cause and cure
remain elusive.
A simple explanation is conveyed by
the term itself. Sclerosis is a Greek
word meaning “hardened tissue or
scars” and multiple means many.
Recurring episodes of MS can cause
many scars to appear in the central
nervous system as a result of the
breakdown of the myelin, the
insulating material that covers the
nerve fibres. This can result in
impairment of motor, sensory and
cognitive functions to a greater or
lesser extent.
But multiple describes other aspects
of what is often a frustratingly
unpredictable disease. Episodes can
occur at varying time intervals
affecting different areas of the central
nervous system. There is no one
symptom that indicates the presence
of MS. No single test can establish an
accurate diagnosis. It can be benign -
in rare cases apparently disappearing
altogether after one or two episodes.
Or it can progress steadily over many
years, bringing about a slow
deterioration in an individual’s
capabilities.
[Source: MS: The Mystery Disease, MS
Australia, 2005]
■ Causes
The causes of MS are unknown, but
research suggests that a combination
of genetic and environmental factors
may play a role in its development. It is
not directly inherited and, unlike some
conditions, there is no single gene that
causes it. It is possible that a
combination of genes make some
people more susceptible to
developing MS; however, these genes
are also common in the general
population.
MS is more common in areas further
away from the equator. It is not clear
why, but it is possible that something
in the environment, perhaps bacteria
or a virus, plays a role. No single virus
has been identified as contributing to
MS, but some researchers think that a
common childhood virus may act as a
trigger, although this theory remains
unproven.
■Types of MS
There are different types of MS, each
with its own characteristics. Yet MS
remains unpredictable and no two
people are affected in the same way.
Some people may be only mildly
affected throughout their lives while,
for others, progression may occur
quite quickly.
• Relapsing remitting MS
Most people are first diagnosed with
this type of MS. They experience a flare
up or ‘relapse’ of symptoms followed
by a remission. In the early stages
symptoms can disappear completely
during remissions. However, after
several relapses there may be some
residual damage to the myelin,
resulting in only a partial recovery.
• Secondary progressive MS
Most people who start out with relapsing
remitting MS later develop a form that is
known as secondary progressive MS. In
this form of the disease symptoms do
not go away completely after a relapse
and there is a steady increase in
disability. On average, 65 per cent of
people with relapsing remitting MS later
develop secondary progressive MS, the
form of the disease which Stephanie is
assumed to have in Duet for One.
“My chief discovery in sickness and misfortune is the callousness of people to our case — not
from hard-heartedness (everyone is kind), but from absence of sympathetic imagination. People
don’t know the horrors and they can’t imagine them — perhaps they are unimaginable. You will
notice how suicides time and again in farewell notes to their closest and dearest have the same
refrain, ‘I don’t believe even you can realise all I suffer.’ Poor devil! of course not. Beyond a certain
point, suffering must be borne alone, and so must extreme joy. Ah! we are lonely barks.”
WNP Barbellion, The Diary of a Disappointed Man, January 8, 1919
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