While researchers and developers are still unsure exactly how this drug affects the sleep process, ms provigil seems to specifically target the urge to sleep. Recent scientific research has shown that the drives regulating sleep and wakefulness are not controlled by a single process. They have been found to be separate, but still interrelated, functions in the brain. It is not like a throttle on a boat that’s used to control the speed. Instead, it’s more like the functions served by a brake and accelerator in an auto.

It is projected that sleep research into this area is going to provide not only specific drugs for wakefulness, but those to address insomnia or to provide more effective rest and relaxation, too. It’s estimated that anywhere from 20% to 40% of the population in America suffers from chronic insomnia.

FDA Approval Has Not Been Granted For Multiple Sclerosis Provigil

It is important to note that the US Food and Drug Administration has not approved multiple sclerosis provigil for specific use for ms-related fatigue. However, it has been widely prescribed for exactly that presenting symptom. Some of the other benefits reported by users include feelings of mental clarity, improved memory and experiencing an enhanced mood.

The FDA has also approved provigil for use of the drug to address shift work sleep disorder. It has been found to be very effective aid for those that work night or swing shifts. It is suggested one pill be taken an hour before the start of a work shift. Otherwise, it is recommended to be taken at the same time each day.

MS provigil does need to discussed thoroughly with your doctor as there are some side effects that could lead to serious complications. Some have reported ‘rashes, chest pain, depression, anxiety, or signs of psychosis or mania’ after taking provigil. Always provide your doctor with a complete list of all medications and supplements you are currently taking to avoid possible interactions. There can also be a possibility that a patient may experience an allergic reaction. There also may be a loss of appetite, so food intake will need to be monitored.

As with many medications prescribed for MS patients, the benefits of using MS provigil may exceed the risks. It has been used extensively by the US military and many use it without experiencing any adverse effects. One last concern is that so far, the long-term effects are virtually unknown.

Fingolimod has shown great promise in reducing flare-ups of multiple sclerosis symptoms in clinical trials. It has been tested against using the common injectable MS drug treatments and placebos. The effectiveness of fingolimod is accomplished by the drug preventing the movement of T cells out of the lymph nodes. Without getting into a lot of clinical details, this means that they are not released into the body so to attack the myelin sheaths that protect the nerve fibers. As most are aware, the protective covering on the nerve fibers is made up of a fatty compound of lipids and proteins that also helps in the proper transmission of the nerve signals from the brain to our bodies. When myelin becomes deteriorated by attack from a hyper-active immune system, it results in the symptoms exhibited by MS. So far the damage is irreparable.

Some Caution Is Required Regarding This New MS Drug Therapy

While Fingolimod has been shown to reduce the recurrence of MS symptoms by a significant degree, more research will be necessary to determine the effects of actually slowing the progression of the disease. Of course the advantage of using an oral drug for MS drug treatments offers great hope among the community of care-providers and those that are afflicted.

One major concern regarding the use of fingolimod is the need to monitor a patient, especially when they receive their first treatment. There is a high risk of them experiencing bradycardia, or slow heart rate. It is recommended that a patient be monitored for about 6 hours in the doctor’s office or other medical setting. The clinical trials have shown that most patients heart rates will usually return to normal levels within the first month of receiving the daily doses.

Other side effects of note include headache, diarrhea, back pain, fatigue. Because the auto-immune system is inhibited, patients may experience more risk of infections with the flu being a common complaint among those that were treated in the clinical trials. There may be higher than normal liver enzymes produced over time. Originally, it was suggested that monitoring occur within the first four months of beginning treatment and has been changed to six to nine months. Another potential side effect is the development of macular edema, an eye disease.

New Oral Ms Drug Treatments Are Being Tested

There are other promising oral MS drug therapies undergoing clinical trials. One is Ampyra (dalfampridine) which may improve the ability to walk. Nuedexta is a two-drug combination to address possible emotional outbursts from an underlying symptom known as pseudobulbar affect. Laquinimod, cladribine and teriflunomide are others that may make it on the market by the end of 2012.

Multiple Sclerosis, Mouth Sores and IBD

First of all, it is important to point out that, in many patients, multiple sclerosis does not occur in isolation. Many patients with multiple sclerosis also have other diseases or conditions. It has actually been shown that people with one inflammatory disease are highly likely to develop another. In keeping with this observation, people suffering from inflammatory bowel disease (IBD) have demonstrated an elevated risk of developing multiple sclerosis.

The symptoms of IBD can affect the entire gastrointestinal tract. They are also often exhibited outside the digestive system. Thus, it is not unusual for those suffering from IBD to have fever, stomach cramps, diarrhea, weight-loss, joint-swelling and mouth ulcers. The mouth ulcers are of particular interest because they may occur in a patient who also has multiple sclerosis. When that happens, the patient may associate the mouth ulcers directly with the multiple sclerosis and refer to them as multiple sclerosis mouth sores.

In such patients, the precise relationship between IBD and multiple sclerosis is worthy of further consideration. It is worth investigating whether the IBD triggered the multiple sclerosis or whether the two conditions were in fact triggered by the same set of genetic or environmental factors. Another possible link between the two inflammatory conditions has been identified by researchers: it has been suggested that some of the newer medications used to treat IBD play a role in causing multiple sclerosis. However, this latter association does not account for all cases in which IBD and MS coincide: the medications in question are relatively new while observations of an association between IBD and MS go back further in time.

MS, Mouth Sores and Lyme Disease

Mouth sores are sometimes attributable to Lyme disease, a bacterial infection that is transmitted to humans by ticks. Some of the effects of Lyme disease are felt in the CNS. Additionally, Lyme disease triggers an autoimmune process of sorts in the body, causing inflammation and associated problems. In these two ways, Lyme disease is similar to MS. Given that mouth sores have been associated with Lyme disease, it is possible for patients suffering from both Lyme disease and MS to suffer from mouth sores. For these patients with Lyme disease and MS, mouth sores can be terribly painful.

Other Explanations for Suspected Multiple Sclerosis Mouth Sores

A number of MS patients experience the sensation of burning pain in the mouth. They may assume they have mouth sores or ulcers, but close examination reveals none of these. These patients may actually be suffering from pain triggered by MS lesions in the tissue of the nervous system.

First of all, it is important to establish what causes the lymph nodes to swell. Various factors have been implicated in the development of swollen lymph nodes. They include bacterial and viral infections of various kinds, some autoimmune diseases, and certain forms of cancer. These conditions can all impact healthy patients as well as patients who are suffering from MS. Hence, it is not unusual for patients to experience the MS-swollen lymph nodes coincidence. The concurrence of the two conditions may be a coincidence with no causal relationship. Alternatively, the multiple sclerosis-swollen lymph nodes coincidence may be significant enough to imply a relationship between the two conditions. As you will see below, this relationship does not have to be a direct one.

MS, Swollen Lymph Nodes, and the Epstein-Barr Virus

The Epstein-Barr Virus (EBV) is one virus in the family of herpes viruses. In some people, it causes infectious mononucleosis, whose symptoms include swollen lymph glands, sore throat and fever. Afterwards, they may recover from these symptoms and the virus may remain dormant for an unspecified period of time. What happens next is particularly interesting. You see, EBV is not just associated with swollen lymph nodes: It is also associated with multiple sclerosis.

According to several studies, MS patients have higher than normal levels of EBV antibodies. It also happens to be the case that, when MS first strikes, it often comes on the heels of mononucleosis. Most people with MS can attest to having previously had an EBV infection. The results of one study on the relationship between EBV and MS stand out: They indicate that the active replication of EBV is rare in people experiencing MS remissions, but common in people experiencing MS flare ups. Clearly then, EBV is somehow implicated in the development of MS. However, this implication is unlikely to involve the virus’ direct action as no active virus has been found in MS lesions.

Mechanisms have been suggested to explain how EBV may be implicated in the development and progression of MS. One of them posits that, in response to an EBV infection, the immune system attacks some of the virus’ protein structures. Afterwards, the immune system is primed to be sensitive to any molecule that resembles this protein; it starts to attack a similar type of protein in the myelin sheaths of nerve cells. The result is MS as we know it.

The ease with which some patients bruise, and the scars left behind when their bruises heal can leave them feeling self-conscious about their appearance. They may stop wearing shorts and short-sleeved shirts because they are alarmed about the appearance of the bruises and scars and do not want to draw too much attention to themselves. With the above considerations in mind, bruising in MS patients can be described as both a medical problem and an aesthetic problem. Attempts to understand what is behind the bruising and to manage it should take into account both of these concerns on the part of patients.

The Circumstances Behind MS Bruising

It is worth noting that, like other symptoms associated with MS, bruising can result for a number of different reasons. In some patients, the progression of MS results in greater problems with balance and coordination. Not surprisingly, these patients may tumble or experience accidents more frequently than they otherwise would. When this happens, their likelihood of developing injuries like bruises increases.

In other patients, bruising is connected with the medication that they take to treat their multiple sclerosis. Bruising can result in some patients who use Avonex (Interferon beta-1a). Avonex is an immune system-modulating drug which is injected subcutaneously. Sometimes bruises form at the sites of injection. This bruising constitutes a side effect of the medication. If it is severe or persists, affected patients should consult a doctor about it. Copaxone, Rebif and Betaseron, other interferon-based drugs, may also cause easier bruising in patients. In these cases, the bruising may be indicative of liver damage, and should immediately be brought to the attention of a medical professional.

There are additional medication-related causes of bruising in MS patients. For instance, when MS medication is administered by an auto-injection device, bruising may result if the patient hits a capillary while injecting himself or herself. Bruising may also result in patients who have been using steroids to treat MS inflammation over the long-term. In these cases, the steroids cause the skin to thin, which in turn results in easier bruising.

In some MS patients, bruising may be caused by a condition that just happens to coincide with their MS. For instance, some patients may have a medical condition that affects their ability to clot while bleeding. Alternatively, they may be on medications like aspirin or ibuprofen, herbs, or supplements like vitamin E, which similarly hinder blood clotting.

MS Vomiting as a Symptom of the Disease or a Side Effect of the Medication

What are the circumstances that provoke vomiting in multiple sclerosis patients? In some patients with MS, vomiting results directly from lesions in the nervous tissue. These patients’ vomiting is spontaneous and positional. Thus, they may vomit when they lean forward, and have a tendency to experience vertigo and headaches. Further examination can reveal these patients to suffer from nystagmus, a condition which results in the involuntary movement on the eyes. It makes sense that patients with little control over the motion of their eyes can develop vertigo. The visual images being transmitted by their optic nerves to their brains are interpreted to mean that the body is in motion and the body responds accordingly. In some patients, these symptoms may be provoked by overheating and other circumstances that would ordinarily provoke MS exacerbations.

In cases where vomiting is a direct result of MS lesions, it could actually be one of the first symptoms that alerts patients that something is wrong and leads to their diagnosis with MS. Before such diagnoses, vomiting can be a tremendously frightening symptom, coming as it does out of the blue and not being directly linked to gastrointestinal issues. Finally getting an MS diagnosis and being able to treat the condition is a great relief for these patients. Sometimes vomiting develops later in the progression of the disease, after the patients have already been diagnosed, and is actually a side effect of MS medication.

Multiple Sclerosis, Vomiting and Gastrointestinal Conditions

Vomiting could easily be a symptom of a disease or condition distinct from multiple sclerosis. Remember that multiple sclerosis patients also have the capacity to develop other health conditions. These health conditions may be somewhat similar to MS (in the sense that they may be associated with similar risk factors). Inflammatory bowel disease comes to mind. IBD and MS are both inflammatory diseases that a particular demographic (of young, affluent adults) is predisposed toward developing. In fact, the two diseases have been shown to coincide in a statistically significant proportion of the population. IBD exists in two forms: ulcerative colitis and Crohn’s disease. Vomiting may be a symptom in either case. When it does occur, the vomiting often accompanies other symptoms that are indicative of gastrointestinal distress (e.g. diarrhea, weight loss, bleeding of the rectum). This may help patients get an accurate diagnosis, which is important: For many patients with multiple sclerosis, vomiting is especially distressing when they can’t readily determine what is causing it or treat it.

One of the symptoms experienced by MS patients is arrhythmia of the heart. This is basically a problem with the rhythm of the patient’s heartbeat. The heart may beat too quickly, too slowly or irregularly. Arrhythmia is harmless in some cases. In other cases, it is a dangerous condition that threatens patients’ lives. In these latter cases, the arrhythmia may hinder blood flow to organs such as the brain and heart. Damage to these organs can be life-threatening.

MS Heart Problems and Brain Stem Lesions

When arrhythmia is accompanied by breathing problems, the condition is often referred to as having palpitations. Palpitations can be experienced by MS patients as a direct result of their MS lesions. To be more specific, if MS patients happen to have MS lesions in the brain stem area, then it is possible for the lesions to affect the autonomic nervous system.

The autonomic nervous system constitutes part of the peripheral nervous system and primarily regulates those bodily functions that are involuntary. They include the heart’s rhythm, respiration, digestion, sweating, urination, sexual arousal and the expansion or contraction of the pupils. Not surprisingly, then, lesions in this region can cause an MS patient’s heart to beat irregularly.

Such a patient may notice that her heart suddenly starts beating rapidly while she is quietly reading a book or in the middle of a meal that has previously caused her no trouble. When consulted, her doctors might dismiss her symptoms, describing them as a panic attack. But imaging will subsequently reveal that she has lesions in the brain stem. MS heart problems of this nature can be classified under the heading of autonomic dysfunction.

Multiple Sclerosis Heart Problems and Magnesium Deficiency

Other sufferers of multiple sclerosis may experience arrhythmia, not because they have lesions in the brain stem area, but because they are suffering from magnesium deficiency. Among the symptoms of magnesium deficiency are arrhythmia, increased heart rates, and irregular contraction of the heart. Muscle weakness, tremors and spasms, osteoporosis, nystagmus and headaches are associated with magnesium deficiency. Interestingly, these are all symptoms that have been associated with multiple sclerosis. It shouldn’t come as a surprise that various studies have shown lower than average magnesium levels within the cells, outside the cells, or within the nervous system organs and visceral organs of MS patients. With this in mind, it makes sense that some multiple sclerosis heart problems are associated with magnesium deficiency.

Muscle Weakness and MS Muscle Aches

One of the prominent features of multiple sclerosis is muscle weakness, experienced when the nerves that regulate muscle function are affected by demyelination and inflammation. The development of lesions in the relevant parts of the nervous system affects the transmission of impulses between the nervous system and the patient’s muscles. As a result the muscular movements may be weaker than they typically would be. This results in muscle weakness and exhaustion. The muscles may overcompensate to make up for this, resulting in MS muscle aches.

It is also possible for the patient’s lesions and their impact on his or her muscles to result in general balance and posture problems. Problems with the leg muscles can completely shift the alignment of the patient’s body, changing its center of gravity. In order to remain upright while walking, the patient will have to adopt an irregular gait. This has an impact on the musculoskeletal system, straining some muscles more than they are accustomed to. This affects the patient’s posture negatively. The bad posture that the patient adopts while sitting also strains his or her muscles, causing MS muscle aches in the lower back.

Spasticity and MS Muscle Aches

There is another source of MS muscle aches in patients, and that is spasticity. Spasticity refers to unusual rigidity or tightness in the patient’s muscles. It is a direct result of lesions in the patient’s nervous system and entails the sustained contraction of the patient’s muscles. It is normal for muscles to contract, but not for sustained periods of time as is the case in multiple sclerosis. Rather, they should be able to relax when it is called for. Because of spasticity, a patient’s fist may remain clenched indefinitely, and it may be impossible to alternately bend the arm at the elbow and straighten it. Spasticity combines with muscle weakness (as described in the previous paragraphs) to make it especially difficult for patients to use their muscles to walk or to maintain an upright posture.

Some patients experience pain constantly because of the sustained contraction of their spastic muscles. They gain relief from using medications like Tizanidine and Baclofen, which relax the muscles, consequently eliminating the pain. The problem with medications such as these is that their action is not limited to the affected muscles. They have a general effect, impacting the whole body. Thus, they can cause drowsiness and general lethargy. Botox injections may be used for a more local effect, but they also have possible side effects. Apart from medication, physical therapy and occupational therapy that target the affected muscles are a great help.

The various forms of pain endured by sufferers of multiple sclerosis can often be directly or indirectly tied to the damage wrought by multiple sclerosis. They may result directly from lesions and inflammation in the nervous tissue. They may also result when various bodily organs or systems are undermined by a damaged nervous system. Muscles may weaken and atrophy, for example, resulting in pain when patients try to walk or to sit up for long stretches of time. Pain may also result when patients’ react to their medication and experience pain as a side effect.

Some Causes of MS Lower Back Pain

MS lower back pain typically presents as a musculoskeletal pain. Musculoskeletal pains are generally pains that affect the musculoskeletal system- the system of muscles and bones that makes up the framework of the human body and that is responsible for movement. Musculoskeletal pain is persistent rather than acute. It often results from muscle weakness and exhaustion, imbalance and spasticity.

All of these symptoms follow from the demyelination and inflammation of neural tissue and the consequent interruption of normal signal transmission from the nervous system to the individual muscles. The muscles, tendons and other parts of the musculoskeletal system are no longer able to function normally. Thus, they may overcompensate to make up for the abnormalities, resulting in exhaustion and pain. It may also prove so difficult for a multiple sclerosis patient to engage in any form of activity that he or she chooses to minimize movement. As a result, the muscles, ligaments and tendons may remain out of use for long. The result tends to be the weakening and atrophying of muscles. This ultimately results in pain when one tries to use them.

When multiple sclerosis patients suffering from the problems described above try to walk or to sit up, they often have problems with their posture. They lose their previous sense of balance, developing an abnormal gait instead or may have to adopt improper posture while sitting. The cumulative effect of these experiences is to develop multiple sclerosis lower back pain.

There is a neuropathic pain associated with MS that may be felt in part of the lower back, but is not limited to this area. It is called Lhermitte’s sign, and it feels like an electric shock. This pain originates in the back of the head and moves downwards through the spine. Afterwards, it often moves into the trunk, the arms or the legs. This pain results, not so much from muscular weakness, exhaustion or spasticity, but rather from injury and inflammation in the area of the cervical spine.

The MS “hug” is typically described as an MS chest pain, but the truth of the matter is that it can be felt on the chest or on the abdomen. It can also be a one-sided pain or one that encircles the patient’s torso. Some patients describe it as a pressure on the chest that is more irritating than painful. But others describe it as pain so terrible that they fear they may be experiencing a heart attack. The MS “hug” can last a very short time (mere seconds) or it can last for hours and hours. Clearly, the presentation of the MS “hug” varies from individual to individual.

The Causes of MS Chest Pain

The MS “hug” is so named because it happens when the intercostal muscles of the patient’s ribcage go into spasm. When this occurs, it can often feel like there is a grip around the front of the patient’s torso, sometimes going all the way to the back. That the pain or pressure encircles the patient’s torso makes it like a physical hug. But that is where the similarity ends. Hugs are supposed to be affectionate and they tend to communicate a sense of welcome and security to the recipient. The MS “hug” is nothing close to that: it antagonizes and frustrates the patient, doing nothing to make him or her feel secure.

The question as to why the intercostal muscles go into spasm in the first place is worth considering. The MS “hug” or multiple sclerosis chest pain is attributable to the development of lesions on the patient’s spinal cord. The lesions are indicative of damaged tissue in the nervous system. The damaged tissue, which was previously responsible for regulating the movement of the intercostal muscles, can no longer function optimally. Hence, it provokes the continuous contraction of the intercostal muscles, thus sending them into spasm.

Treating Multiple Sclerosis Chest Pain

Like other symptoms of MS, the MS “hug” tends to be worst when patients are exhausted, overheated or under stress. These are the conditions that trigger exacerbations or flare ups of MS. Various forms of treatment exist for the MS “hug.” Likely, the severity of the pain felt by the patient helps to determine which ones are ultimately adopted. The options include breathing exercises, massages, the application of pressure or warmth to the affected area, analgesic creams, neuropathic medications for pain relief and anti-spasticity medications.