Multiple Sclerosis

A top, national multiple sclerosis program right here in southeast Michigan

Wayne Health’s Multiple Sclerosis (MS) program is one of the top MS programs in North America, right here in your backyard.

The Multiple Sclerosis Center serves a population of more than 4,000 MS patients with the largest group of African American patients in the country. It is designated by the National Multiple Sclerosis Society as a Center for Comprehensive MS Care and is a member of the Consortium of Multiple Sclerosis Centers. It is nationally and internationally recognized for patient care, innovative technology and leading-edge research. Our providers are a group of highly experienced MS specialists who offer high-quality care, while working closely with other specialists to care for you, including neuropsychologists, urologists, physical, occupational and speech therapists. We care for patients with a wide range of autoimmune disorders who come to us from around the state, country and world.

The MS Clinic coordinates comprehensive multidisciplinary care for thousands of patients. We also coordinate care with the services offered to MS patients by the National MS Society.

• Multiple Sclerosis
• Neuromyelitis optica
• Transverse myelitis
• Optic neuritis
• Central nervous system (CNS) vasculitis, including primary vasculitis, CNS lupus and CNS Sjogren’s syndrome
• Neurosarcoidosis
• Acute disseminated encephalomyelitis (ADEM)
• Autoimmune encephalitis

Multiple sclerosis, also called MS, is a disease that can affect the brain, spinal cord and nerves to the eyes. MS can cause problems with muscle control and strength, vision, balance, feeling and thinking. Whatever your symptoms, taking medicine correctly and following your doctor’s advice for home care can help you maintain your quality of life.

The symptoms of MS vary from person to person. Which symptoms you have will depend on which parts of the brain or spinal cord (central nervous system) are damaged. The loss of myelin and scarring caused by MS can affect any part of the central nervous system. Myelin is the insulating coating around a nerve. Symptoms may come and go, or become more or less severe from day-to-day or, in rare cases, from hour-to-hour. Symptoms may get worse with increased body temperature or after a viral infection.

Early symptoms

Common early symptoms of MS include:

Muscle or motor symptoms

These include weakness, leg dragging, stiffness, a tendency to drop things, a feeling of heaviness, clumsiness and a lack of coordination (ataxia).

Visual symptoms

These include blurred, foggy, or hazy vision, eyeball pain (especially when you move your eyes), blindness or double vision. Optic neuritis, sudden loss of vision that is often painful, is a fairly common first symptom.

Sensory symptoms

These include tingling, a pins-and-needles sensation, numbness, a band of tightness around the trunk or legs, and electrical sensations moving down the back and legs.

Advanced symptoms

As MS progresses, symptoms may become more severe. They may include:

• Worse muscle problems, and stiff, mechanical movements (spasticity) or uncontrollable shaking (tremor). These problems may make it hard to walk. A wheelchair may be needed some or all of the time.
• Pain and other sensory symptoms
• Bladder symptoms, such as loss of bladder sensation or not being able to hold urine (urinary incontinence) or to completely empty the bladder
• Constipation and other bowel disorders
• Male erectile dysfunction (impotence) and female sexual dysfunction
• Cognitive and emotional problems, such as problem-solving and depression. These are common in people who have had MS for some time.
• Feeling very tired (fatigue). This can be worse if symptoms such as pain, spasticity, bladder problems, anxiety or depression make it hard to sleep.

Experts don’t know why MS happens to some people but not others. There may be a genetic link, because the disease seems to run in families. Where you grew up may also play a role. MS is more common in people who grew up in colder regions that are farther away from the equator.

Diagnosing MS isn’t always easy. The first symptoms may be vague. And many of the symptoms can be caused by problems other than MS.

• The doctor will examine you, ask you questions about your symptoms, and do some tests.
• MS isn’t diagnosed unless a doctor can be sure that you’ve had at least two attacks affecting at least two different areas of your central nervous system. These areas are usually the brain, the spinal cord, or the nerves to the eye.

An MRI is often used to confirm the diagnosis. That’s because the patches of damage (lesions) caused by MS attacks can be seen with this test.

Multiple Sclerosis is a chronic progressive disease of the central nervous system with variable manifestations, severity and prognosis. Diagnosis and treatment can be challenging. Because several conditions can mimic MS, a correct diagnosis is critical to a successful therapeutic approach.

Some of the conditions that can mimic MS include:

• Neuromyelitis optica
• CNS Lupus
• CNS Sarcoidosis
• Lyme disease
• Vitamin B12 deficiency
• CNS vasculitis
• CNS viral infections
• Childhood and adult leukodystrophies

We provide consultations for a large number of patients with early MS, benign or aggressive MS, MS patients who are considering pregnancy, MS patients with co-morbidities, and healthy individuals with abnormal MRI scans. We offer comprehensive evaluation and treatment, including involvement in clinical trials, if appropriate and desired.

Special circumstances, such as pregnancy and delivery, excessive stress, or a new diagnosis, may add a significant burden on a woman with MS. We monitor, support and advise patients before, during and after pregnancy. Patients with abnormal MRI scans, but who are otherwise healthy, are closely examined and monitored.

Wayne Health uses the latest tools and technologies for diagnosis including: MRI scans, laboratory testing, lumbar puncture (spinal tap), Evoked Potential (EP) testing and Optical Coherence Tomography (OCT).

Because we participate in numerous clinical trials, our patients have access not only to approved FDA treatments, but also to investigational drugs. We emphasize an individualized approach, as MS is a multi-faceted and unpredictable disease. Our mission is to provide the best and most compassionate care, to control the disease and to minimize its impact on a patient’s quality of life. This is an extraordinary time for MS, as there is an explosion of new knowledge and new treatment options.

• Relapse management options:
  • IV steroids
  • Oral steroids
  • Acthar® gel
  • Plasmapheresis or plasma exchange (PLEX) for severe relapses
• Immunomodulatory (maintenance) therapy options:
  • Injectable medications
  • Oral medications
  • Infused medications
• Special symptomatic treatments:
  • 4-Aminopyridine (4-AP)
  • Intrathecal baclofen for severe spasticity
  • Management of MS-associated fatigue or MS-associated mental health problems
• Experimental clinical trials (see Clinical Trials section)
• Consultation services:
  • Physical Medicine & Rehabilitation
  • Neuropsychology
  • Urology
  • Neuro-ophthalmology
  • Pain management
• Treatment can make living with MS easier. Your treatment will depend on how severe your symptoms are and whether your disease is active or in remission.
• Different types of medicines may be used to help control a flare-up and to help slow how fast MS progresses.
• You and your doctor will set up a schedule of appointments. This helps your doctor monitor your MS, treat your symptoms, and find out if you may want to try a different treatment.
• Physical therapy, occupational therapy and speech therapy are used. They help you manage some physical problems caused by MS. You can also help yourself at home by eating balanced meals, getting regular exercise and rest, and learning to use your energy wisely.

Dealing with the demands of MS isn’t easy. If you feel overwhelmed, talk to your doctor. You may be depressed, which can be treated. A support group can also help.

Physicians and researchers at Wayne Health are also faculty at Wayne State University School of Medicine. We conduct basic, translational and clinical research that can make the latest treatments and clinical trials available to you sooner than other providers without a medical school affiliation, and before FDA approval or commercial availability.

As leaders in medical research, we participate in numerous clinical trials investigating the effectiveness of new treatments that target not only the disease process, but also symptoms of disease. Our research team has conducted more than 80 clinical trials, with more than 20 active clinical trials at any given time, including multicenter and investigator-initiated investigations.

For more information, please visit the links below at the WSU School of Medicine.