Multiple Sclerosis Research Paper
Running Head: Multiple Sclerosis- Liberation or Decimation?
Multiple Sclerosis- Liberation or Decimation?
Kaplan College
Multiple Sclerosis- Liberation or Decimation? After a long night out in town Alfonso was ready to call it quits. His friends were saying his speech was slurred, as expected after a few to many beers. He decided to go home take a shower and get some sleep. One of his friends drove him home as Alfonso mumbled that he could have driven home. Once home Alfonso took a shower and checked his email before finally falling asleep. It was around 10 A.M. before Alfonso finally got around to waking up. With a splitting headache Alfonso thought, “Great another hangover”. What Alfonso didn’t know was that that day was the end of life as he had known it and the beginning of a new stage in his life. The first thing he noticed was that he couldn’t see out of his left eye. He had always worn glasses to correct his vision, but he did not see blurred out of it-he did not see out of it at all! What was going on? Why couldn’t he see? Did something happen to him last night? He felt for his eye and it was still there; he quickly went to the mirror and as far as he could tell everything looked normal. Apart from the splitting …show more content…
headache he was feeling Alfonso did not feel any different than how he felt when he had a normal hangover. He closed his right eye trying to focus his vision in his left eye. He placed his fingers inches away from his eye but try as he might he could not make his eye see. Alfonso quickly headed to the emergency room. MRI’s CT scans and many different types of x-rays were performed on him. He was sent to the neurologist to examine the results and explain to him what had happened to his body. The neurologist said with a grim face, “Son you have Multiple Sclerosis”. Over 250,000 people in the United States alone have been diagnosed with Multiple Sclerosis (NCBIH, 2010). That is only the number of people that have been able to get the condition diagnosed. Multiple Sclerosis (MS) affects 50% more women; it is unknown why that is the case. The farther away a person lives from the equator, the more probable it is that a person will be diagnosed with MS. It is unknown as to why living farther away from the equator you are more likely to be diagnosed with MS but some neurologists believe it is from the lack of sun. Many countries that do not have the equipment to diagnose MS will misdiagnose their patients and can many times lead to a patients deteriorated health. Multiple Sclerosis can be a life threatening disease, but new procedures and new therapies can extend a person with MS’s life and can even lead to recovery from some of the symptoms. Multiple Sclerosis was discovered by French neurologist Jean Martin Charcot in 1868.
He was the first person to recognize MS as a distinct disease rather than believe like most neurologist of the time that the symptoms were caused by cerebral swelling. Charcot observed that patients with MS had cognitive changes and would seem to process thoughts at a slower pace. Charcot also found that patients with MS would have lesions on the brain and spinal cord. In 1863, Swiss pathologist Georg Eduard found that the inflammation associated lesions were distributed around many blood vessels ("nationalmssociety", 2011). These discoveries and modern technology have been able to explain more as to what happens when a person has multiple
sclerosis. Multiple Sclerosis is an autoimmune disease in which the neurons of the spinal cord and brain become demyelinated. When demyelination occurs the myelin sheath surrounding the axons of the neuron become scarred. The scarred myelin sheath causes the signals traveling to and from the brain to get lost or to slow down in its course. If certain tissues are scarred a patient may present signs and symptoms similar to a patient that has had a brain injury. There are different categories of MS, the most common being “relapsing, remitting”. In this category a person with MS will present symptoms “relapsing” and then enter a stage where no symptoms appear present “remitting”. Many patients that have this category of MS live in fear of not knowing when the next relapse might occur as these relapses tend to be at random intervals of their lives. Patients that have MS can present symptoms such as: slurring of words, loss of mobility, lack of muscle coordination, impaired mental ability, loss of bowel movement and may even become quadriplegic (Nursing, 2010). Even though it is not known why MS occurs and there is no known cure at the moment, there are many different treatments to try and prevent a patient from relapsing after being diagnosed. One of the newest Multiple Sclerosis treatments is “The Zamboni Treatment”. Dr. Paolo Zamboni is a vascular surgeon. He found that one of his MS patients had an obstructed vein going to the patient’s brain. He proceeded to perform and endovascular procedure in which a tiny balloon is inflated in the patients obstructed vein to allow blood flow to reach the affected area more easily. What surprised him was the result of that simple procedure. Although not intended the patients showed signs of betterment towards their MS symptoms. He decided to repeat the procedure in another MS patient and the result was the same. 73% of all patients he has performed the procedure on have shown no recurring symptoms of MS (Gizmag, 2011). A striking 90% of all MS patients have been found to have obstructed veins. When Zamboni finally published his findings the medical community was extremely surprised that a vascular surgeon could have found a breakthrough in MS. Trials were immediately started all over the world, Dr. Zamboni was invited to the University of New York to perform surgeries on MS patients there. Never had a surgeon from another country been invited to the US to perform clinical trials on patients. Dr. Zamboni was asked during an interview if this procedure would be an alternative to Multiple Sclerosis medications in which he responded that the importance of the procedure was not to reduce medication use but to prevent a patient from ending up in a wheelchair. Dr. Zamboni has been trying to find a cure to this disease ever since his wife was diagnosed with MS (Cammarata, 2010). The procedure is still in trial and is very debatable, but it holds hope for patients dealing with MS. Zamboni’s procedure may seem like the best option at this moment, but it is still being run on clinical trials. Zamboni’s procedure is not covered by any medical insurance and can cost patients an upwards cost of ten thousand dollars or more. Furthermore patients are not guaranteed that their symptoms will become better and if they do become better they are not guaranteed that they will not come back. These are the troubling sides of the Zamboni treatment, the chance for a patient with MS to be able to recover some of their lost abilities had never been available before. By trials and tests Zamboni’s treatment can lead to the biggest breakthrough yet. The procedure is not yet available in the USA, but patients that are willing and able have been flying to Europe to receive this treatment. Although it is not a cure for the disease it definitely is a step in the right direction. The current medications for Multiple Sclerosis include disease modifying drugs and steroid injections. As of today six disease- modifying treatments have been approved by the FDA. The role of the DMT’s is to prevent a patient with MS from having a relapse. These treatments help increase the chance of a patient’s spinal cord from swelling. 30% of all patients that undergo these treatments do not respond to it. These treatments are also very expensive and require patients to undergo medication injections weekly or even daily sometimes. Two of the most common steroidal injections are Avonex and Betaseron these injections are administered weekly, usually in the gluteal region. These medications are to prevent a patient from relapsing by lowering the white blood cell count in a patient’s body. If the white blood cell count gets too high and the white blood cells were to get in a patients spinal cord and brain the results would be catastrophic. The human brain is not meant to have white blood cells pass through the cerebral filter if they do pass then the white blood cells would immediately start attacking the neurons of the brain. One this occurs a patient loses functions of their body. To prevent this from happening these drugs suppress those cells which in turn also compromise a patient’s health, since their immune system is so low. Patients taking these medications can feel lethargic and more fatigued than usual, they also cannot be exposed to people that are sick. These types of medications can sometimes prove to be more harmful than beneficial after a prolonged period of time, but currently these are the only medications approved by the FDA ("msaassociation", 2010). Due to the high cost of these medications many patients dealing with Multiple Sclerosis tend to look for alternative treatments.
There are alternative treatments to Multiple Sclerosis. Yoga is a very popular treatment with MS patients. MS patients suffer from a lot of fatigue since the muscles in their bodies never receive the adequate signals needed to function properly. 80% of patients with MS that perform yoga on a regular base report feeling less fatigued during the day than they normally would ("nationalmssociety", 2011). Yoga also helps by providing better muscle coordination and stimulates the body to produce more signals from the brain to the muscles. Patients that perform daily activities and remain active have a more likely chance to have better control over their bodies in the long run. This form of treatment is inexpensive and can be performed in their home and at their own time, which is one of the reasons MS patients and neurologists so highly recommend it. MS is a chronic disease and can lead to many complications in life, but it does not have to be that way as long as treatments continue to surface. Another treatment that has recently surfaced is endurance and resistance exercises. For a long time it was believed that people with MS should not over exert themselves and should lead a simple as life as possible. New research has shown that by performing certain exercises that were usually ignored a patient with MS may have more control over their bodies muscle system. Endurance exercises such as bike riding and running on a treadmill have been shown to reduce fatigue in MS patients by over 50%. One of the most common symptoms of MS is fatigue, patients with MS constantly report feeling fatigued at all times during the day (Nursing, 2010). Everyday normal activities can be a very tiring event for a person with increased fatigue. Resistance exercises have also been shown to improve a patient’s physical endurance. In a recent study performed by neurologist Dr. Dalgas MS patients who performed resistance exercises to increase muscle strength improved muscular strength and functional capacity by 21%. In other words these patients were 21% less likely to end up in a wheelchair if they continued to perform the exercises. Patients who trained their legs and arms reported have better mobility and control over them. Dalgas found that the more muscle a patient was able to increase in size the easier it was for those muscles to respond to a patients stimuli and move accordingly to what a patient wanted to perform (Rehabilitation, 2011). My brother in-law Alfonso was diagnosed with Multiple Sclerosis in 2009 and since then has only had the initial relapse. He has not recovered the sight from his left eye and takes medication weekly for the condition. He suffers from symptoms of fatigue and blurred vision but that does not stop him from attending law school. He hopes to one day have the Zamboni treatment performed on him and hopes that his symptoms will decrease or even subside. In the meantime he performs endurance and resistance training exercises and has medication injected in him weekly. His medications are worth over four thousand dollars monthly and if not taken can lead to him relapsing again. Thousands of people a month are diagnosed with MS around the world. To some this may me certain doom but to the thousands of patients like Alfonso this is just a condition that they will deal with their whole life and they will continue to battle with until a cure is found. Multiple Sclerosis is a very serious neurological autoimmune disease if left untreated a patient may suffer from symptoms and may have no hope of recovering. Lately there have been more funds and resources added to patients with MS, when Zamboni was performing his clinical trials he was not funded the trials he performed were with his own funds. After the publishing of his findings funding is being provided all over the world for researchers and surgeons alike. Patients with MS have many resources now, resources like the National Multiple Sclerosis Society and foundations worldwide that provide help and medication for those with MS. Patients with MS that undergo treatments and take medications at a regular basis can expect to live a long life. The average age for a person that has MS is 70 years old. That age is based solely if you developed Multiple Sclerosis in your 20’s, if you were to have developed it at a later point in life a person may expect to live past their 80’s. What that means for a person like Alfonso who is at the prime of his age is that he can expect to live as normal a life as possible while battling this terrible condition.
The Zamboni treatment is now being offered in Mexico, India and Europe. MS patients wait anxiously for the treatment to become available in the United States. The waiting lists for the treatment are numbered in the thousands and everyday more patients are being added to those lists. Patients worldwide are waiting for the results of the clinical trials hoping for the moment when the FDA finally approves the procedure in the USA. While the clinical trials are being run a new oral medication has been approved by the FDA, but sadly this medication has proved to be 30% ineffective on patients. It is however an alternative to the injected disease modifying drugs on the market. Medications are very expensive and many health care plans do not cover 100% of the costs for these medications, to many Multiple Sclerosis can mean decimation, but to the patients that await treatments like Dr. Zamboni’s it means liberation. Liberation to a disease that forces their body to act in ways uncontrollable to them. Liberation to the fear that one day they may wake up like Alfonso did and be missing a bodily function. Most importantly though it means liberation from a disease that one day can end their life. If you have Multiple Sclerosis or know somebody that has Multiple Sclerosis talk to them about the Zamboni treatment and help they understand how this treatment can help them recover from this terrible disease. Help by donating to Multiple Sclerosis foundations worldwide and by making people aware of this disease. Help patients with MS finally become liberated!
References
Cammarata, A. (2010) Interview with Dr. Zamboni. Retrieved from http://espr3ssioni.wordpress.com/2010/02/01/ccsvi-un-nuovo-modo-di-guardare-alla-sclerosi-multipla/
Clinical Rehabilitation. Chapter 25: Pgs. 14-24 (2011) Comparing endurance- and resistance-exercise training in people with multiple sclerosis: a randomized pilot study.
Journal of Clinical Nursing. Vol. 18 Issue 9, p1231-1238. (2009) Fatigue in Multiple Sclerosis Patients.
Multiple Sclerosis Association of America. (2010) Treatments for Multiple Sclerosis. Retrieved from http://www.msassociation.org/about_multiple_sclerosis/treating/
National Center for Biotechnology Center. (2006) The social impact of multiple sclerosis a study of 305 patients and their relatives. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10864132
National Institute of Neurological Disorders and Stroke. (2010) What is Multiple Sclerosis? Retrieved from http://www.ninds.nih.gov/disorders/multiple_sclerosis
National Multiple Sclerosis Society. (2011) How can we treat Multiple Sclerosis? Retrieved from http://www.nationalmssociety.org/about-multiple- sclerosis/living-with
Multiple Sclerosis- Liberation or Decimation?
Kaplan College
Multiple Sclerosis- Liberation or Decimation? After a long night out in town Alfonso was ready to call it quits. His friends were saying his speech was slurred, as expected after a few to many beers. He decided to go home take a shower and get some sleep. One of his friends drove him home as Alfonso mumbled that he could have driven home. Once home Alfonso took a shower and checked his email before finally falling asleep. It was around 10 A.M. before Alfonso finally got around to waking up. With a splitting headache Alfonso thought, “Great another hangover”. What Alfonso didn’t know was that that day was the end of life as he had known it and the beginning of a new stage in his life. The first thing he noticed was that he couldn’t see out of his left eye. He had always worn glasses to correct his vision, but he did not see blurred out of it-he did not see out of it at all! What was going on? Why couldn’t he see? Did something happen to him last night? He felt for his eye and it was still there; he quickly went to the mirror and as far as he could tell everything looked normal. Apart from the splitting …show more content…
headache he was feeling Alfonso did not feel any different than how he felt when he had a normal hangover. He closed his right eye trying to focus his vision in his left eye. He placed his fingers inches away from his eye but try as he might he could not make his eye see. Alfonso quickly headed to the emergency room. MRI’s CT scans and many different types of x-rays were performed on him. He was sent to the neurologist to examine the results and explain to him what had happened to his body. The neurologist said with a grim face, “Son you have Multiple Sclerosis”. Over 250,000 people in the United States alone have been diagnosed with Multiple Sclerosis (NCBIH, 2010). That is only the number of people that have been able to get the condition diagnosed. Multiple Sclerosis (MS) affects 50% more women; it is unknown why that is the case. The farther away a person lives from the equator, the more probable it is that a person will be diagnosed with MS. It is unknown as to why living farther away from the equator you are more likely to be diagnosed with MS but some neurologists believe it is from the lack of sun. Many countries that do not have the equipment to diagnose MS will misdiagnose their patients and can many times lead to a patients deteriorated health. Multiple Sclerosis can be a life threatening disease, but new procedures and new therapies can extend a person with MS’s life and can even lead to recovery from some of the symptoms. Multiple Sclerosis was discovered by French neurologist Jean Martin Charcot in 1868.
He was the first person to recognize MS as a distinct disease rather than believe like most neurologist of the time that the symptoms were caused by cerebral swelling. Charcot observed that patients with MS had cognitive changes and would seem to process thoughts at a slower pace. Charcot also found that patients with MS would have lesions on the brain and spinal cord. In 1863, Swiss pathologist Georg Eduard found that the inflammation associated lesions were distributed around many blood vessels ("nationalmssociety", 2011). These discoveries and modern technology have been able to explain more as to what happens when a person has multiple
sclerosis. Multiple Sclerosis is an autoimmune disease in which the neurons of the spinal cord and brain become demyelinated. When demyelination occurs the myelin sheath surrounding the axons of the neuron become scarred. The scarred myelin sheath causes the signals traveling to and from the brain to get lost or to slow down in its course. If certain tissues are scarred a patient may present signs and symptoms similar to a patient that has had a brain injury. There are different categories of MS, the most common being “relapsing, remitting”. In this category a person with MS will present symptoms “relapsing” and then enter a stage where no symptoms appear present “remitting”. Many patients that have this category of MS live in fear of not knowing when the next relapse might occur as these relapses tend to be at random intervals of their lives. Patients that have MS can present symptoms such as: slurring of words, loss of mobility, lack of muscle coordination, impaired mental ability, loss of bowel movement and may even become quadriplegic (Nursing, 2010). Even though it is not known why MS occurs and there is no known cure at the moment, there are many different treatments to try and prevent a patient from relapsing after being diagnosed. One of the newest Multiple Sclerosis treatments is “The Zamboni Treatment”. Dr. Paolo Zamboni is a vascular surgeon. He found that one of his MS patients had an obstructed vein going to the patient’s brain. He proceeded to perform and endovascular procedure in which a tiny balloon is inflated in the patients obstructed vein to allow blood flow to reach the affected area more easily. What surprised him was the result of that simple procedure. Although not intended the patients showed signs of betterment towards their MS symptoms. He decided to repeat the procedure in another MS patient and the result was the same. 73% of all patients he has performed the procedure on have shown no recurring symptoms of MS (Gizmag, 2011). A striking 90% of all MS patients have been found to have obstructed veins. When Zamboni finally published his findings the medical community was extremely surprised that a vascular surgeon could have found a breakthrough in MS. Trials were immediately started all over the world, Dr. Zamboni was invited to the University of New York to perform surgeries on MS patients there. Never had a surgeon from another country been invited to the US to perform clinical trials on patients. Dr. Zamboni was asked during an interview if this procedure would be an alternative to Multiple Sclerosis medications in which he responded that the importance of the procedure was not to reduce medication use but to prevent a patient from ending up in a wheelchair. Dr. Zamboni has been trying to find a cure to this disease ever since his wife was diagnosed with MS (Cammarata, 2010). The procedure is still in trial and is very debatable, but it holds hope for patients dealing with MS. Zamboni’s procedure may seem like the best option at this moment, but it is still being run on clinical trials. Zamboni’s procedure is not covered by any medical insurance and can cost patients an upwards cost of ten thousand dollars or more. Furthermore patients are not guaranteed that their symptoms will become better and if they do become better they are not guaranteed that they will not come back. These are the troubling sides of the Zamboni treatment, the chance for a patient with MS to be able to recover some of their lost abilities had never been available before. By trials and tests Zamboni’s treatment can lead to the biggest breakthrough yet. The procedure is not yet available in the USA, but patients that are willing and able have been flying to Europe to receive this treatment. Although it is not a cure for the disease it definitely is a step in the right direction. The current medications for Multiple Sclerosis include disease modifying drugs and steroid injections. As of today six disease- modifying treatments have been approved by the FDA. The role of the DMT’s is to prevent a patient with MS from having a relapse. These treatments help increase the chance of a patient’s spinal cord from swelling. 30% of all patients that undergo these treatments do not respond to it. These treatments are also very expensive and require patients to undergo medication injections weekly or even daily sometimes. Two of the most common steroidal injections are Avonex and Betaseron these injections are administered weekly, usually in the gluteal region. These medications are to prevent a patient from relapsing by lowering the white blood cell count in a patient’s body. If the white blood cell count gets too high and the white blood cells were to get in a patients spinal cord and brain the results would be catastrophic. The human brain is not meant to have white blood cells pass through the cerebral filter if they do pass then the white blood cells would immediately start attacking the neurons of the brain. One this occurs a patient loses functions of their body. To prevent this from happening these drugs suppress those cells which in turn also compromise a patient’s health, since their immune system is so low. Patients taking these medications can feel lethargic and more fatigued than usual, they also cannot be exposed to people that are sick. These types of medications can sometimes prove to be more harmful than beneficial after a prolonged period of time, but currently these are the only medications approved by the FDA ("msaassociation", 2010). Due to the high cost of these medications many patients dealing with Multiple Sclerosis tend to look for alternative treatments.
There are alternative treatments to Multiple Sclerosis. Yoga is a very popular treatment with MS patients. MS patients suffer from a lot of fatigue since the muscles in their bodies never receive the adequate signals needed to function properly. 80% of patients with MS that perform yoga on a regular base report feeling less fatigued during the day than they normally would ("nationalmssociety", 2011). Yoga also helps by providing better muscle coordination and stimulates the body to produce more signals from the brain to the muscles. Patients that perform daily activities and remain active have a more likely chance to have better control over their bodies in the long run. This form of treatment is inexpensive and can be performed in their home and at their own time, which is one of the reasons MS patients and neurologists so highly recommend it. MS is a chronic disease and can lead to many complications in life, but it does not have to be that way as long as treatments continue to surface. Another treatment that has recently surfaced is endurance and resistance exercises. For a long time it was believed that people with MS should not over exert themselves and should lead a simple as life as possible. New research has shown that by performing certain exercises that were usually ignored a patient with MS may have more control over their bodies muscle system. Endurance exercises such as bike riding and running on a treadmill have been shown to reduce fatigue in MS patients by over 50%. One of the most common symptoms of MS is fatigue, patients with MS constantly report feeling fatigued at all times during the day (Nursing, 2010). Everyday normal activities can be a very tiring event for a person with increased fatigue. Resistance exercises have also been shown to improve a patient’s physical endurance. In a recent study performed by neurologist Dr. Dalgas MS patients who performed resistance exercises to increase muscle strength improved muscular strength and functional capacity by 21%. In other words these patients were 21% less likely to end up in a wheelchair if they continued to perform the exercises. Patients who trained their legs and arms reported have better mobility and control over them. Dalgas found that the more muscle a patient was able to increase in size the easier it was for those muscles to respond to a patients stimuli and move accordingly to what a patient wanted to perform (Rehabilitation, 2011). My brother in-law Alfonso was diagnosed with Multiple Sclerosis in 2009 and since then has only had the initial relapse. He has not recovered the sight from his left eye and takes medication weekly for the condition. He suffers from symptoms of fatigue and blurred vision but that does not stop him from attending law school. He hopes to one day have the Zamboni treatment performed on him and hopes that his symptoms will decrease or even subside. In the meantime he performs endurance and resistance training exercises and has medication injected in him weekly. His medications are worth over four thousand dollars monthly and if not taken can lead to him relapsing again. Thousands of people a month are diagnosed with MS around the world. To some this may me certain doom but to the thousands of patients like Alfonso this is just a condition that they will deal with their whole life and they will continue to battle with until a cure is found. Multiple Sclerosis is a very serious neurological autoimmune disease if left untreated a patient may suffer from symptoms and may have no hope of recovering. Lately there have been more funds and resources added to patients with MS, when Zamboni was performing his clinical trials he was not funded the trials he performed were with his own funds. After the publishing of his findings funding is being provided all over the world for researchers and surgeons alike. Patients with MS have many resources now, resources like the National Multiple Sclerosis Society and foundations worldwide that provide help and medication for those with MS. Patients with MS that undergo treatments and take medications at a regular basis can expect to live a long life. The average age for a person that has MS is 70 years old. That age is based solely if you developed Multiple Sclerosis in your 20’s, if you were to have developed it at a later point in life a person may expect to live past their 80’s. What that means for a person like Alfonso who is at the prime of his age is that he can expect to live as normal a life as possible while battling this terrible condition.
The Zamboni treatment is now being offered in Mexico, India and Europe. MS patients wait anxiously for the treatment to become available in the United States. The waiting lists for the treatment are numbered in the thousands and everyday more patients are being added to those lists. Patients worldwide are waiting for the results of the clinical trials hoping for the moment when the FDA finally approves the procedure in the USA. While the clinical trials are being run a new oral medication has been approved by the FDA, but sadly this medication has proved to be 30% ineffective on patients. It is however an alternative to the injected disease modifying drugs on the market. Medications are very expensive and many health care plans do not cover 100% of the costs for these medications, to many Multiple Sclerosis can mean decimation, but to the patients that await treatments like Dr. Zamboni’s it means liberation. Liberation to a disease that forces their body to act in ways uncontrollable to them. Liberation to the fear that one day they may wake up like Alfonso did and be missing a bodily function. Most importantly though it means liberation from a disease that one day can end their life. If you have Multiple Sclerosis or know somebody that has Multiple Sclerosis talk to them about the Zamboni treatment and help they understand how this treatment can help them recover from this terrible disease. Help by donating to Multiple Sclerosis foundations worldwide and by making people aware of this disease. Help patients with MS finally become liberated!
References
Cammarata, A. (2010) Interview with Dr. Zamboni. Retrieved from http://espr3ssioni.wordpress.com/2010/02/01/ccsvi-un-nuovo-modo-di-guardare-alla-sclerosi-multipla/
Clinical Rehabilitation. Chapter 25: Pgs. 14-24 (2011) Comparing endurance- and resistance-exercise training in people with multiple sclerosis: a randomized pilot study.
Journal of Clinical Nursing. Vol. 18 Issue 9, p1231-1238. (2009) Fatigue in Multiple Sclerosis Patients.
Multiple Sclerosis Association of America. (2010) Treatments for Multiple Sclerosis. Retrieved from http://www.msassociation.org/about_multiple_sclerosis/treating/
National Center for Biotechnology Center. (2006) The social impact of multiple sclerosis a study of 305 patients and their relatives. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10864132
National Institute of Neurological Disorders and Stroke. (2010) What is Multiple Sclerosis? Retrieved from http://www.ninds.nih.gov/disorders/multiple_sclerosis
National Multiple Sclerosis Society. (2011) How can we treat Multiple Sclerosis? Retrieved from http://www.nationalmssociety.org/about-multiple- sclerosis/living-with