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Allergies

Itching

Pruritis (itching) may occur as a symptom of MS. It is one of the family of abnormal sensations - such as "pins and needles" and burning, stabbing, or tearing pains - which may be experienced by people with MS. These sensations are known as dysesthesias and they are neurologic in origin.

Different from Allergic Itching

Dysesthetic itching may occur suddenly and intensely, but for brief periods. It may be present over any part of the body or face. It is different from the generalised itching that can accompany an allergic reaction, as there is no external skin rash or irritation at the site of itching. Corticosteroid ointments applied to the skin are not helpful in relieving this type of itch.

Medications Can Treat Itching Associated with MS

There are, however, several medications that are usually successful in treating dysesthetic itching.

Among them are:

People who experience itching should consult their physician.

Allergies

There is no evidence that an allergic reaction to a specific environmental allergen is involved in triggering MS. Therefore, there is no scientific rationale for the anti-allergy treatment regimens that are offered by some alternative medicine therapists to treat MS. Some of these treatments involve avoiding certain food groups or taking medication directed against a supposed allergen. They might actually cause harm by creating a nutritional deficiency and should therefore be discussed with a knowledgeable health-care professional.

Allergic reactions to many things in our environment, including synthetic chemical allergens, are commonplace. This has led people to suppose that such allergens may also be triggering agents in MS. MS is generally considered an "autoimmune" disease, one in which the body's immune system is directed against itself. Just what part or parts of the central nervous system the immune cells attack in people with MS has not yet been precisely identified, nor has the trigger that initiates this autoimmune process been identified.

Allergies Can Coexist in a Person with MS

Since allergies are common in the general population, allergies can coexist in a person with MS. Such allergies should be given appropriate medical attention. Maintaining good general health, including management of allergies, is a positive approach to living with multiple sclerosis.

Anticonvulsants

Anticonvulsants are medications that are designed to prevent convulsions and other types of seizures. Seizures occur in 3% to 5% of people with MS, which is somewhat higher than the incidence of epilepsy in the general population. Seizures may occur as part of the disease but may also be related to infection, fever, or abrupt cessation of certain medications.

May Be Used to Treat Pain

In addition to controlling seizures, several anticonvulsants may be used to treat some types of pain in MS. Carbamazepine (Tegretol®), phenytoin (Dilantin®) and gabapentin (Neurontin®) are used in the management of pain that results when nerve impulses cross from one fiber tract to another (like an eledctrical "short circuit"). Trigeminal neuralgia-a stabbing facial pain that may occur in MS-is most often treated with carbamazepine.

Side Effects Should Be Monitored

People who are taking these agents should be monitored by their physicians. Side effects can include dizziness, loss of balance, nausea, excessive gum growth and inflammation and blood abnormalities.

Antidepressants

Antidepressants are widely used in treating psychiatric and neurologic disorders. In addition to their role in fighting depression, they are also effective against several physical symptoms. In people with MS, tricyclic antidepressants, are often prescribed to treat different types of pain.

Some of the commonly used tricyclic antidepressants are:

Some of the commonly used selective serotonin reuptake inhibitors (SSRIs) are:

Other commonly used antidepressants include:

There is some evidence that these agents may help alleviate the uncontrollable laughing or crying (known as pathological laughing or crying) that is occasionally seen in people with MS. Because some of these agents can cause people to retain urine, they are also used in low doses to help control bladder incontinence. Common side effects include dry mouth, blurry vision, constipation, sexual dysfunction and a sedated or calmed feeling.

Symptoms

The initial symptoms of MS are most often:

Less common initial symptoms may include:

It is useful to divide the symptoms of MS into primary, secondary and tertiary categories.

PRIMARY SYMPTOMS: are a direct result of demyelination, the destruction of myelin-the fatty sheath that surrounds and insulates nerve fibers in the central nervous system - and of damage to the nerve fibers themselves. Demyelination and neuronal damage impair transmission of nerve impulses to muscles and other organs. The symptoms include weakness, numbness, tremor, loss of vision, pain, paralysis, loss of balance, bladder and bowel dysfunction and cognitive changes. Many of these symptoms can be managed effectively with medication, rehabilitation and other medically based methods.

SECONDARY SYMPTOMS: are complications that arise as a result of the primary symptoms. For example, bladder dysfunction can cause repeated urinary tract infections. Inactivity can result in disuse weakness (not related to demyelination), poor postural alignment and trunk control, muscle imbalances (adaptive shortening and/or stretch weakness), decreased bone density (increasing risk of fracture) and shallow, inefficient breathing. Paralysis can lead to the secondary symptom of bedsores. While secondary symptoms can be treated, the optimal goal is to avoid them by treating the primary symptoms.

TERTIARY SYMPTOMS: are the social, vocational and psychological complications of the primary and secondary symptoms. A person who becomes unable to walk or drive may lose his or her livelihood. The strain of dealing with a chronic neurologic illness may disrupt personal relationships. Depression is frequently seen among people with MS. It may be a primary, secondary, or tertiary symptom. Professional assistance from psychologists, social workers, physical and occupational therapists and public health agencies is indicated for managing many tertiary symptoms.

It is important to remember that many of the symptoms of MS can be effectively managed and complications avoided, with regular care by a neurologist and allied health professionals.

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