Multiple Sclerosis/Spasticity Disorders

MS drawing

Multiple sclerosis (MS) is an autoimmune condition whereby the body’s own immune system destroys the protective wrapping of nerve cells (myelin) as if it were an invader, like bacteria or a virus (demyelination). If one thinks of the long portion of a nerve cell (axon) as a wire, the effect of demyelination on communication between the brain and the rest of body is like that of removing a wire’s insulation: wrapped (insulated) wire conducts electricity faster than uninsulated wire. Slowed communication from or to the brain causes many different kinds problems. (There are some inflammatory disorders that can mimic the autoimmune condition of MS).

Symptoms of the condition vary with the portion of brain affected: early or late findings may include transient or permanent sensory loss/numbness, muscle cramping/spasticity, inflamed optic nerve, bowel/bladder or sexual dysfunction, trouble walking, facial tics, eye symptoms, heat intolerance, memory or judgment impairment, and emotional issues. MS is related to, but not necessarily caused by, a history of severe mononucleosis, and is made worse by smoking. There are generally two MS types: one that either comes and goes or slowly progresses (relapsing form), and a less common one that rapidly progresses. As a general rule, the younger the onset of MS, the more severe the symptoms and more likely significant progression. Thankfully, Western medications and interventions now dramatically improve the impact and progression of MS.

A neurological team diagnoses MS by assessing a criteria list (MacDonald criteria) that includes symptoms, MRI results, visual (or other) evoked potentials, blood work, and possibly a lumbar puncture when the diagnosis is uncertain. Once diagnosed, medical treatment should start immediately. Medications can truly modify the course of MS progression: immune suppressors (interferon, others), ­­­­­­­­­­­­­a synthetic polypeptide (protein), antibodies that block the myelin-attack, and one agent that may prevent antibody-producing cells from entering the blood stream all address the relapsing form. Steroids (and sometimes direct removal of antibodies from the blood) are used for acute bouts/relapses. Those with the more severe, progressive MS forms may receive medications in the anti-cancer class.

Since the MS affects the mind and the body, other medications and interventions can help manage MS: for example, fatigue (a very common and severe symptom) is sometimes addressed with medications in the antiviral, stimulant and anti-depression categories. Spasticity is usually treated with baclofen, and depression with SSRI antidepressants. Additionally, neurological rehabilitation for balance, gait and other disturbances can do much to manage the effects of MS. [1]

Traditional Chinese Medicine (TCM) intervention for MS’s manifestations is always complementary to that of Western Medicine. In TCM, MS starts as “Wei Qi” or defensive Qi deficiency/misdirection resulting from overall “Qi, Yin, Ying, and Blood” deficiency/damage. Neurological Scalp Acupuncture can dramatically help manage symptoms, especially spasticity, tremor, tic, weakness and vision changes, as is discussed in this article. These improvements, if realized, are temporary and require repetition, but can immeasurably improve quality of life and/or functioning. Body acupuncture and Chinese Herbal Medicine can be invaluable for helping heat intolerance and emotional complaints. Those taking interferon should never use the Chinese herb Chai Hu (Bupleurum root); in fact, this is one of the few well-documented interactions between pharmaceuticals and Chinese Herbs. [2] [3] [4]

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These brief overviews of conditions represent distillations of basic and current medical reviews from the following sources:

[1] Conventional Medical Sources

“Harrison’s Principles of Internal Medicine: Volumes 1 and 2, 18th Edition”. Dan Longo Anthony Fauci, Dennis Kasper, Stephen Hauser, J. Jameson, Joseph Loscalzo. McGraw-Hill Professional; (July, 2011)

Medscape eMedicine Physician’s online resource. Various review articles:

Complex Regional Pain Syndromes Treatment & Management.
Anthony H Wheeler MD. Medscape Reference Chief Editor: Stephen A Beman, MD PhD MBA.

Essential Tremor
Deborah A Burke, MD Clinician, Sub-Investigator, Movement Disorder/Parkinson’s Disease Center, University of South Florida College of Medicine; Investigator, Physician, Roskamp Institute Memory Clinic

Bell Palsy
Danette C Taylor, DO, MS Clinical Assistant Professor, Department of Neurology and Ophthalmology, Michigan State University College of Osteopathic Medicine; Senior Staff Neurologist, Henry Ford Health Systems

Meniere Disease (Idiopathic Endolymphatic Hydrops)
John C Li, MD Private Practice in Otology and Neurology; Medical Director, Balance Center

Restless Legs Syndrome
Ali M Bozorg, MD  Assistant Professor, Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida College of Medicine

Postherpetic Neuralgia
W Alvin McElveen, MD  Director, Stroke Unit, Lakewood Ranch Medical Center; Neurologist, Manatee Memorial Hospital

Sleep disorders
Roy H Lubit, MD, PhD  Assistant Clinical Professor, Mount Sinai School of Medicine; Clinical Faculty, Department of Child Psychiatry, New York University School of Medicine; Private Practice

Aaron G Benson, MD  Director, Ohio Hearing and Balance Institute, Maumee, Ohio; Consulting Staff, Toledo Ear, Nose and Throat, Inc

Multiple Sclerosis
Christopher Luzzio, MD  Clinical Assistant Professor, Department of Neurology, University of Wisconsin at Madison School of Medicine and Public Health

Parkinson Disease
Robert A Hauser, MD, MBA  Professor of Neurology, Molecular Pharmacology and Physiology, Director, USF Parkinson’s Disease and Movement Disorders Center, National Parkinson Foundation Center of Excellence, Byrd Institute, Clinical Chair, Signature Interdisciplinary Program in Neuroscience, University of South Florida College of Medicine

Tourette Syndrome and Tic Disorders
William C Robertson Jr, MD  Professor, Departments of Neurology, Pediatrics, and Family Practice, Clinical Title Series, University of Kentucky College of Medicine

Post Concussive Syndrome
Roy H Lubit, MD, PhD  Assistant Clinical Professor, Mount Sinai School of Medicine; Clinical Faculty, Department of Child Psychiatry, New York University School of Medicine; Private Practice

Traumatic Brain Injury
Segun T Dawodu, MD, JD, MBA, LLM, FAAPMR, FAANEM  Associate Professor of Rehabilitation Medicine and Interventional Pain Medicine, Albany Medical College

Dizziness, Vertigo, Imbalance
Hesham M Samy, MD, PhD  Head of Hearing and Balance Unit, Otolaryngology Department, Minia University, Egypt

CNS Causes of Vertigo
Marcelo B Antunes, MD  Resident Physician, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System

Communication Disorders
Renee S Melfi, MD  Consulting Staff, Orthopaedic Associates of Central New York

[2], [3]

  • “Acupuncture Energetics: A Clinical Approach for Physicians”. Joseph M. Helms. Medical Acupuncture Publishers; 1st Edition. (1995)
  • “Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists”. Giovanni Maciocia. Churchill Livingstone; 2 Edition (July, 2005).
  • “Diagnosis in Chinese Medicine: A Comprehensive Guide”. Giovanni Maciocia. Churchill Livingstone; 1st Edition (January, 2004).

Chinese Scalp Acupuncture”. Jason Ji-shun Hao, Linda Ling-zhi Hao and Honora Lee Wolfe. Blue Poppy Press; 1st Edition. (November, 2011)