What is Multiple Sclerosis?(MS)

 Multiple Sclerosis is an unpredictable disease of the central nervous system. It is usually diagnosed by a neurologist after an MRI (magnetic resonance imaging) of the brain and/or the spinal chord. The MRI will show lesions both old and "active" ones which will be lit up. However no single test can conclusively diagnose Multiple Sclerosis. Other diseases must first be ruled out for a provider to make a diagnosis. 

What are the symptoms of Multiple Sclerosis?

Multiple Sclerosis is very difficult to diagnose because a plethora of symptoms can occur in a person and no two people present with the same symptoms. There do tend to be some common ones amongst patients.

The most common symptoms are:

-Fatigue

-Walking Difficulties (gait)

-Numbness in face, body, arms or legs

-Vision problems

-Weakness

-Spasticity (stiffness, muscle spasms, etc.)

-Bladder or Bowel problems

-Dizziness or vertigo

-Cognitive issues

-Pain and itching

-Depression or emotional changes

-Sexual issues

Less common issues are swallowing, tremors, speech problems, seizures, breathing problems and hearing loss.

More information can be found at the National Multiple Sclerosis Society website. 

Multiple Sclerosis Drug Company Resources and Links to Live Learning Events





The following are Multiple Sclerosis drug company websites where most have a page that you can sign up for Live Events that are in your area to learn about Multiple Sclerosis Treatments and Therapies. The events are usually presented by prominent area doctors in the field and also some have patients who have taken the drug tell personal stories. Some companies now only host virtual events.
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VUMERITY
  • VUMERITY is a prescription medicine used to treat people with relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease in adults 
                                                                    Vumerity Events

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AUBAGIO
Aubagio - Aubagio is an Oral Disease Modifying Drug made by Genzyme also known as Teriflunomide. 


                                         ___________________________________

OCREVUSOcrevus is an infusion drug for both relapsing and progressive Multiple Sclerosis. The first infusion is split over 2 weeks and consecutive infusions are given every six months. 
                                                      Ocrevus Live Events Page

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GILENYA

Gilenya - Gilenya is an Oral Disease Modifying Drug Made by Novartis also know by the name Fingolimod. 

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REBIF

Rebif - Rebif is an injectable Disease modifying Drug made by EMD Serono also known as interferon
beta 1-a. 

Rebif Live Events Page

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AMPYRA

Ampyra - Ampyra, also known as "The Walking Pill" and by the drug name dafampridine, is one of the few types of Drugs that actually attempt to help MS symptoms made by the drug company Acorda.  Ampyra is made to help patients walk faster and achieve better balance. It does help some patients achieve much better results.              
      Ampyra Live Events Page
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PLEGRIDY




Plegridy - Plegridy is an injectable Disease Modifying     Drug made by Biogen also known as peginterferon beta-a. The drug is similar to Avonex only it is not given as frequently.

                                                        Plegridy Live Events Page
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LEMTRADALemtrada is an injectable infusion taken for a full week and only once per year. It is also know as alemtuzumab and like Tysabri is a monoclonal antibody drug.  
                                                               Lemtrada Live Events Page                                                                                                                      _______________________________________


TYSABRI

TYSABRI® (natalizumab)
is a once monthly infusion 
prescription medicine used to treat adults with relapsing  forms of Multiple Sclerosis (MS). Tysabri has one of the highest success ratings in preventing new lesions but
 carries considerable risks of PML. 

                                             Tysabri Live Events Page
                       ___________________________________
TECFIDERA



Tecfidera - Tecfidera is a pill that is usually taken twice per day. 
                                                         Tecfidera Live Events Page
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COPAXONECopaxone is an injectable drug taken daily or three times per week
                                              Copaxone Websitee 
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MAVENCLAD

Mavenclad (cladribine) tablets is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include relapsing-remitting disease and active secondary progressive disease in adults.  

       Mavenclad Live Events
  


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MAYZENT Mayzent is a pill for active secondary progressive MS.

        Mayzent Resources
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ZEPOSIA 
Zeposia is a pill approved for relapsing MS and Secondary progressive MS

                  Site information
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Multiple Sclerosis Medication Assistance Programs


MS Medication Payment Assistance Programs

Most pharmaceutical companies have assistance programs which help patients obtain their medication at a reduced cost. The drug companies really want you to use their medications, so they have programs set up to navigate insurance coverage, maximize reimbursement, and lower out-of-pocket costs for the patient.

Lastly, let your doctor know that the cost of medication is an important consideration for you. He or she might be able to suggest an equivalent medication, have a staff member help you fill out paperwork to one of the patient assistance programs or know of another solution, such as an open-label clinical trial.
Disease Modifying Medications
Aubagio - Patient Assistance Program – Sanofi Genzyme
Call to see if you qualify for free medication or payment assistance by calling - 1‑855‑676‑6326

Avonex - Patient Assistance Programs - Biogen Idec
Call to see if you qualify for free medication or payment assistance by calling - 1-800-456-2255

Betaseron - Patient Assistance Program – Bayer Pharmaceuticals
Call to see if you qualify for free medication or payment assistance by calling - 1-800-778-1467

Copaxone - Patient Assistance Program – Teva Pharmaceuticals

Call to see if you qualify for free medication or payment assistance by calling - 1-800-887-8100

Extavia - Patient Assistance Program – Norvartis
Call to see if you qualify for free medication or payment assistance by calling - 1-866-398-2842

Gilenya - Patient Assistance Program – Novartis Pharmaceuticals
Call to see if you qualify for free medication or payment assistance by calling 1-800-445-3692

Glatiramer acetate - Patient Assistance Program - Mylan
Call to see if you qualify for free medication or payment assistance by calling - 1-844-695-2667

Glatopa - Patient Assistance Program - Sandoz 
Call to see if you qualify for free medication or payment assistance by calling - 1-855-452-8672

Lemtrada - Patient Assistance Program - Sanofi Genzyme
Call
to see if you qualify for free medication or payment assistance by calling - 1-855-676-6326

Ocrevus - Patient Assistance Program - Genentech
Call to see if you qualify for free medication or payment assistance by clicking - 1-844-627-3887

Plegridy - Patient Assistance Program - Biogen Idec
Call to see if you qualify for free medication or payment assistance by calling 1-800-456-2255

Rebif - Patient Assistance Program -- EMD Serono, Inc. and Pfizer Inc
Call to see if you qualify for free medication or payment assistance by calling - 1-877-447-3243

Tecfidera - Patient Assistance Program – Biogen Idec
Call to see if you qualify for free medication or payment assistance by calling 1-800-456-2255

Tysabri - Patient Assistance Program - Biogen Idec
Call to see if you qualify for free medication or payment assistance by calling - 1-800-456-2255

MS Symptom Management Medications

Acthar - Support & Access Program (A.S.A.P.). Patient Assistance Program - Questcor
Call to see if you qualify for free medication or payment assistance by calling 1-888-435-2284

Ampyra - Patient Assistance Program – Acorda Therapeutics
Call to see if you qualify for free medication or payment assistance by calling -
1-888-881-1918

Botox (Bladder Dysfunction) - Patient Assistance Program - Allergan
Call to see if you qualify for free medication or payment assistance by calling - 1-800-442-6869 Option #4

Gooddays - Patient Assistance Program
Good Days from CDF, formerly known as Chronic Disease Fund, exists to improve the health and quality of life of patients with chronic disease, cancer, or other life-altering conditions. We help patients suffering from chronic medical conditions who have limited financial means get access to the medications they need. Our program helps qualified patients pay their insurance co-pays so they can get immediate access to prescription medications that will give them relief from pain and suffering.1-877-968-7233
FREE / DISCOUNTED    www.mygooddays.org/patients/assistance-types

MedicationCoupons.com
"take advantage of the FREE resources and information contained in Free Med Programs. Regardless of income, age, or health there are programs available to provide you"
FREE/DISCOUNTED    http://medicationcoupons.com/

Needy Meds

Patient Assistance Programs (PAPs) are programs offered by pharmaceutical companies to help those most in need gain access to their medications at no or low cost. Each program has varying financial and insurance guidelines - when in doubt, call the program.   www.needymeds.org/index.htm

Nuedexta - Patient Assistance Program - Avanir
to treat Pseudobulbar affect, a condition in which you suddenly start to laugh or cry - 1-855-468-3339
  www.nuedexta.com/savings-resources/savings-support

The Patient Access Network (PAN) Foundation - Patient Assistance Program
Call - 1-866-316-7263 or visit www.panapply.org 

Tafcares - Patient Assistance Program
Call - 1-855-845-3663
or visit www.tafcares.org/patients/apply/


Is there such a thing as a Multiple Sclerosis Diet?

 


Recently I started working with a physician at University Hospitals Center for Integrative health. 

At age 58 in September of 2020, in the middle of the pandemic, my body was falling apart. Diabetes, heart disease, high blood pressure and of course Multiple Sclerosis, only to name a few of my issues. The all over body pain had me taking high doses of gabapentin and NSAIDS.

While I was hardly overweight and I really "thought" that I was eating healthy, I was encouraged by my physician to try a whole foods plant based diet. Of course the first book she recommended that I get is "Forks over Knives" This "idea" and plethora of follow up books really did not nudge me in the right direction, I hate to say. I just don't like reading books that have a lot of personal accounts and studies. I read it anyway but just not my style. 

The next book she recommended to me was called "What the Health: The Startling Truth Behind the Foods We Eat, Plus 50 Plant-Rich Recipes to Get You Feeling Your Best" by Kip Anderson. This book spoke to me and watching the companion documentary that can be found on Netflix or Amazon sealed the deal. Another video about a girl with MS you should check out is called "Code Blue." Proof that eating what I call a "mostly plant based diet" (MPBD henceforth) was not only something I had to do but something that most of the population should "probably" be doing. 

This has nothing to do with the whole "vegetarian craze" and "oooh I just can't eat anything that has a face"(I can not tell you how many times I have heard that one lol). No, it has everything to do with how corporate America has fooled us into believing that meat and dairy products are not only good for you but necessary "staples" for us. It simply is not true. The book/documentary film goes through step by step of what is really in the  meat and dairy that we consume and how the antibiotics and meds in farm meat and poultry are outright overused. It was enough to convince me that a MPBD was the diet that was best for me. 

So i started eating only fruits and vegetables(NO MEAT OR DAIRY), I didn't much miss the meat because I really only was eating mostly chicken and an occasional burger or steak. When I say occasional I mean once a week. I REALLY missed cream in my coffee and switched to Almond Milk. I followed this diet strictly and then the physician told me to remove all oils from my diet. That meant goodbye to my favorite House Italian salad dressing! And I have salad every night for dinner! I did not much like that suggestion but I gave it a try for a few months. Well after about 4 months of this diet I did lose about 20 pounds and was feeling much better, mentally at least. I was able to back down my night time insulin I took for my diabetes even. Then I had to have a round of steroids and my blood sugar went up and so did my night time insulin I needed. I was never able to get it back down again after that. 

I feel like on a MPBD that my MS symptoms did not EVER subside, nor did the pain I deal with go away. So after 5 months I went back to having my favorite salad dressing, and having very small bits of chicken or turkey every so often. I still haven't had a steak on the new diet but I have had a hamburger or two, which I immediately regret. 

I can honestly say that for the last 11 years I have heard people tell me "Oh you should do this diet...or that diet". They are wrong of course. As I can tell you that there really is no diet that "cures" Multiple Sclerosis.  There are diets that supposedly help reduce inflammation, but I have not found one. Truth be told in fact some diets can be downright harmful. 

The best diet is one that keeps your body healthy. The best diet uses as much fruits and vegetables and natural ingredients as you can find. The best diet is a reduction in dairy products (yes I mean Milk and Cheese). The best diet is one that avoids processed meats. The best diet is one that keeps you healthy enough to maintain a good healthy weight. At least for myself at this point in my life that is what I strive for. It clearly is not the best diet for everyone and you are on your own...seriously. 

If you ever come across the "best" diet for you though,(as I clearly have not done here at least when it comes to relieving pain goes, lol) keep it to yourself because those of us with Multiple Sclerosis really don't care to know! Our life is tough enough and we do what we can to make ourselves feel better. If we need advice we go to the professionals! We are happy one diet or another works for you, but it will not work for us! Seriously, NOT A TOPIC FOR CONVERSATION, EVER!

In conclusion I  personally can safely say that the MPBD I have chosen for myself works for me and one I plan to stick with. 

 DISCLAIMER: Kenzig.MS or Jim Kenzig do not recommend starting or stopping ANY diet without the consultation of a trained medical professional. This information is not meant to suggest one diet over another as a layperson should never suggest a diet to someone with a chronic disease. Period.

 Cheers! - Jim Kenzig

 

MULTIPLE SCLEROSIS TERMINOLOGY

 These are some multiple sclerosis (MS) terms to know. Of course, a definition is only part of truly understanding something. 

A

Antispasmodics

Medications capable of preventing or relieving spasms or convulsions.

Ataxia

Lack of coordination and unsteadiness that result from the brain's failure to regulate the body's posture and the strength and direction of limb movements. Most often caused by disease activity in the cerebellum or its connections with other parts of the brain.

Attack

See Exacerbation.

Autoimmune Disease

Process in which the body's immune system causes illness by mistakenly attacking healthy cells, organs, or tissues. MS is believed to be an autoimmune disease, as are systemic lupus, rheumatoid arthritis, scleroderma, and many others. The precise origin and an understanding of how these diseases occur are not yet well known.

B

Bell's Palsy

Paralysis of the facial nerve, which can occur as a consequence of MS, viral infection, or other infections. It has acute onset and can be transient or permanent.

Blood-Brain Barrier (BBB)

Semipermeable cell layer around blood vessels in the brain and spinal cord that prevents large molecules, cells, and potentially damaging substances and disease-causing organisms (eg, viruses) from passing out of the blood stream and into the central nervous system (brain and spinal cord).

C

Central Nervous System (CNS)

Collective term for the major part of the nervous system that is principally composed of the brain and spinal cord.

Chronic

Of long duration; not acute.

Cog Fog

A feeling of confusion or lack of mental clarity brought on by cognition issues related to MS. This cognitive symptom is common in people with MS and is also known as “brain fog.”

Cognition

High-level functions carried out by the brain, including comprehension and use of speech; visual perception and construction; calculation ability; attention (information processing); memory; and executive functions such as planning, problem solving, and self-monitoring.

Combined Bladder Dysfunction

Type of neurogenic bladder dysfunction in RMS (also called detrusor-external sphincter dyssynergia [DESD]). Simultaneous contractions of the bladder's detrusor muscle and external sphincter cause urine to be trapped in the bladder, resulting in symptoms of urinary urgency, hesitancy, dribbling, or incontinence.

Constipation

Condition in which bowel movements happen less frequently than is normal for the particular individual or the stool is small, hard, and difficult or painful to pass.

Contracture

Permanent shortening of the muscles and tendons adjacent to a joint, which can result from severe, untreated spasticity and interferes with normal movement around the affected joint. If left untreated, the affected joint can become frozen in a fixed position.

Corticosteroids

Often known as steroids, corticosteroids are an anti-inflammatory medicine prescribed for a wide range of conditions.

Cranial Nerves

Nerves that carry sensory, motor, or parasympathetic fibers to the face and neck. Included among this group of 12 nerves are the optic nerve (vision), trigeminal nerve (sensation along the face), oculomotor nerve (eye movement), facial nerve, auditory nerve, and vagus nerve (pharynx and vocal cords). Evaluation of cranial nerve function is part of the standard neurological exam.

D

Demyelination

Destruction of the myelin sheath—which surrounds the axons, or nerve fibers, in the CNS—that results in interruptions of communications between neurons. Regions of demyelination cause interruptions in the conduction of nerve impulses.

Depression

A mood disorder marked especially by sadness, inactivity, difficulty with thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and, sometimes, suicidal thoughts or an attempt to commit suicide.

Diplopia

Double vision or the simultaneous awareness of 2 images of the same object that results from a failure of the 2 eyes to work in a coordinated fashion.

Disability/Disabling

As defined by the World Health Organization (WHO), a disability (resulting from an impairment) is a restriction or lack of ability to perform an activity in the manner of, or within the range considered normal for, a human being.

Disease-Modifying Therapies (DMTs)

Disease-modifying therapies have been shown in clinical trials to modify the course of MS.

Double-Blind Clinical Study

A study in which neither the subjects (ie, patients) nor the examining healthcare providers (or attending nurses, or any other research staff) know who is taking the test drug and who is taking a control or placebo agent.

Dysesthesia

Impairment of sensitivity, especially to touch.

E

Expanded Disability Status Scale (EDSS)

A method of quantifying disability in MS and monitoring changes over time. It’s widely used to assess the level of disability in people with MS.

Exacerbation

In RMS, the appearance of new symptoms or the aggravation of old ones, lasting at least 24 hours (synonymous with attackrelapseflare-up, or worsening).

F

Flare-up

See Exacerbation.

Foot Drop

Condition of weakness in the muscles of the leg caused by poor nerve conduction, which interferes with a person's ability to extend the ankle and walk with a normal pattern. The toes touch the ground before the heel, causing the person to trip or lose balance.

Formulary

List of prescription drugs covered by a health insurance plan that offers prescription drug benefits.

G

Gadolinium

Contrast medium injected prior to magnetic resonance imaging (MRI) scans. It passes through breaches in the blood-brain barrier and is therefore used to highlight new and active lesions. The usage of gadolinium greatly enhances the sensitivity of a T1-weighted MRI.

Gastroenterologist

A person who specializes in gastroenterology, a branch of medicine concerned with the structure, functions, diseases, and pathology of the stomach and intestines.

H

Health Maintenance Organization (HMO)

This type of health insurance plan usually limits care from doctors who work for, or contract with, the HMO. Generally, out-of-network care isn't covered, unless it's an emergency.

High-Deductible Health Plan (HDHP)

This type of plan has a higher deductible than a traditional insurance plan, with lower monthly costs. With an HDHP, you pay more healthcare costs before the insurance company starts to pay its share. An HDHP can be combined with a health savings account (HSA), which allows you to pay for certain medical expenses with money free from federal taxes.

I

Immune System

An immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells.

Immunity

Ability to resist infection and to heal. The process may involve acquired immunity (the body's ability to learn and remember a specific infectious agent) or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).

Immunosuppression

A reduction in immune response. It may be the means by which a drug achieves its intended effect, but it may also be an unintended side effect. For instance, immunosuppression may cause a drop in infection-fighting blood cells.

Incontinence

Also called spontaneous voiding; the inability to retain control of urine or bowel movements.

Inflammation

The immunologic response of body tissue to injury, characterized by mobilization of white blood cells and antibodies, swelling, and fluid accumulation.

Insomnia

Prolonged and usually abnormal inability to obtain adequate sleep.

Intramuscular Injection

Injected into the muscle.

Intravenous

Within a vein; often used in the context of an injection into the vein of a medication dissolved in a liquid.

L

Lesion

See Plaque.

L'hermitte's Sign

Abnormal sensation of electricity or "pins and needles" going down the spine, into the arms and legs, that occurs when the neck is bent forward.

Lymphocyte

A type of white blood cell. Lymphocytes are made in the bone marrow and found in the blood and lymph tissue. The 2 main types of lymphocytes are B lymphocytes and T lymphocytes. B lymphocytes make antibodies, and T lymphocytes help kill tumor cells and help control immune responses.

Lymphopenia

Lower-than-normal numbers of lymphocytes (a type of white blood cell) result in this condition. It is also called lymphocytic leukopenia and lymphocytopenia.

M

Magnetic Resonance Imaging (MRI)

Imaging technique based on detection of the response of water molecules to strong magnetic fields. It produces visual images of different body parts without the use of X-rays. MRI allows the neurologist to identify MS lesions in the brain and spinal cord at different stages of their development. T1 scans and T2 scans refer to the different scanning sequences that help distinguish tissue features.

Marcus Gunn Pupil

An abnormal physical examination finding in the pupil of the eye that may result from an episode of optic neuritis.

MRI T1-Weighted Scans

See Magnetic Resonance Imaging.

MRI T2-Weighted Scans

See Magnetic Resonance Imaging.

Multiple Sclerosis (MS)

Presumed autoimmune disease of the central nervous system that is usually first diagnosed in young adults and whose origin is unknown. It damages myelin (nerve fiber insulation) and axons (nerve fibers) in a random and patchy manner, causing a wide range of neurological defects.

Myelin

Soft, white coating composed of lipids (fats) and protein, surrounding nerve fibers in the central nervous system. A complex natural electrical insulator, myelin serves to speed up the conduction of electrical signals along nerve fibers.

N

Neuritis

Nerve inflammation, usually with direct nerve damage. Part of a degenerative process.

Neuroendocrine

Relating to, or involving both, nervous stimulation and endocrine secretion

Neuropsychologist

Psychologist with specialized training in the evaluation of cognitive functions. Neuropsychologists use a number of standardized tests to evaluate specific cognitive functions and identify areas of cognitive impairment. They also may suggest possible treatments for individuals with relapsing MS–related cognitive impairment. See Cognition.

Nocturia

The need to urinate during the night.

Nystagmus

Rapid, involuntary movements of the eyes in the horizontal or, occasionally, vertical direction.

O

Optic Nerve

The main nerve leading from the eye to the brain that transmits visual signals to the brain.

Optic Neuritis

Inflammation or demyelination of the optic (visual) nerve, with temporary or permanent impairment of vision; associated with pain during the acute phase of MS.

P

Plaque

An area of inflamed or demyelinated central nervous system tissue.

Point-of-Service (POS) Plans

A type of health insurance plan in which you pay less when you use doctors, hospitals, and other healthcare providers that belong to the plan’s network. In a POS plan, you’re required to get a referral from your primary care doctor to see a specialist.

Preferred Provider Organization (PPO)

A type of health plan that creates a network of participating medical providers, such as hospitals and doctors. You can visit doctors, hospitals, and other providers outside of the network, but you pay less if you use providers within the plan’s network.

Primary-Progressive MS (PPMS)

The clinical course of PPMS is characterized by worsening neurologic function (accumulation of disability) from the onset of symptoms, without early relapses or remissions. PPMS can be further characterized at different points in time as either active (with an occasional relapse and/or evidence of new MRI activity) or not active. It can also be characterized as with progression (evidence of disease worsening on an objective measure of change over time, with or without relapse or new MRI activity) or without progression.

Pseudo Relapse

Temporary aggravation of MS symptoms that have occurred before. Although these relapses can feel like a genuine relapse, they are not a sign of new inflammation within the central nervous system. Usually, symptoms come and go within 24 hours.

R

Reflex

Involuntary response of the nervous system to a stimulus, such as the stretch reflex, which is elicited by tapping a tendon with a reflex hammer, resulting in a muscle contraction. Abnormal reflexes can be indicative of neurologic damage, including RMS, and are therefore tested as part of the standard neurological exam.

Relapse

See Exacerbation.

Relapsing-Remitting MS (RRMS)/Relapsing MS

Clinical course of MS that is characterized by the occurrence of new symptoms or the worsening of old symptoms (relapses or exacerbations). Symptoms may evolve over several days or weeks and then fully or partially disappear. The pattern of attacks is unpredictable even in the same person.

Remission

Lessening in the severity of symptoms or a “return” to the level of health equal, or similar to, the one experienced prior to the last attack.

S

Safety

Events that may present a risk of harm or injury and/or require medical attention. Safety may be evaluated by laboratory testing, special tests and procedures, and evaluation of patients.

Sclerosis

An abnormal condition in which tissue has become hard, produced by overgrowth of fibrous tissue (scars). The term multiple sclerosis refers to multiple scars in the brain.

Secondary-Progressive MS (SPMS)

With SPMS, neurological symptoms worsen progressively. At first, there may still be some relapses; then relapses generally stop completely, and a slow but steady progression of disability takes place.

Spasm

An involuntary and abnormal contraction of muscle.

Spasticity

Increased muscle tone associated with involuntary muscle contractions, spasms, and stiffness. In MS, spasticity is most prominent in the lower limbs.

Steroids

See Corticosteroids.

Subcutaneous Injection

Injected under the skin.

Symptom

Subjectively perceived problem or complaint reported by the patient. In MS, common symptoms include visual problems, fatigue, sensory changes, weakness or paralysis of limbs, tremor, lack of coordination, poor balance, bladder or bowel changes, and psychological changes.

T

T Cells

Any of several types of white blood cells that develop in the thymus gland and play a role in the control of immune response.

Titration

Gradual stepping up of a dose of medicine. It allows the body to adjust and become used to the medicine's effects, thereby reducing the likelihood and severity of potential side effects that may occur at the beginning of a treatment.

Tolerability

Tolerability is related to how much you can tolerate the side effects. Sometimes, people can tolerate certain side effects to meet their treatment goals. Other times, side effects can be unbearable, so a change of treatment may be recommended.

Trigeminal Neuralgia

Chronic condition that may cause acute pain in the face caused by demyelination of nerve fibers in the trigeminal nerve root (the nerve responsible for relaying feeling/sensation signals to the brain).