HE was just 23 and in the navy when the disease hit him full in the face, without warning and without apparent cause.

Alvin Phua (above) was in the prime of his life, active, robust and full of promise when he contracted multiple sclerosis (MS).

'I had a bad bout of giddiness and was vomiting on and off for a few weeks. I put it down to a virus, but then my head started to jerk non-stop,' he recalls.

After a battery of tests and a whole year of agony, Alvin was finally diagnosed with MS, an unpredictable disease of the central nervous system. Now, almost seven years later and self-employed, Alvin has come to accept his condition, but not without some trepidation for the future.

'Multiple sclerosis changed my life. All my dreams and goals I had for myself are completely shattered, as I will never know when it's going to hit me, or which function of my body will be lost every time there's a relapse,' he says.

According to Dr Alvin Seah, a consultant at the Department of Neurology, National Neuroscience Institute (Singapore), and a visiting neurologist at the Singapore National Eye Centre, MS claims a dozen new victims each year.

The condition can range from relatively benign, to somewhat disabling, to totally devastating, as communication between the brain and other parts of the body is disrupted.

'To date, doctors are not sure what causes MS. There are no pre-disposing factors, nor any clinically proven triggers. All we know is that MS usually strikes the young between 20 and 40 years old, and females are almost four times more vulnerable,' says Dr Seah.

An incurable disease, MS is characterised by lesions in the central nervous system that interfere with nerve function. Many investigators believe MS to be an auto-immune disease - one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, it is the nerve-insulating myelin that comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus.

'The initial symptom of MS is often blurred or double vision, constant fatigue, pain or headaches. Most MS patients experience muscle weakness or difficulty with coordination and balance,' explains Dr Seah. Such symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis.

Some MS patients also feel numbness, prickling, or 'pins and needles' sensations. Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss. About half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment. Depression is another common feature of MS.

Treatment - in the form of disease modifying drugs - comes with a big price tag.

'Medication for MS is quite prohibitive. On average, a month's medicine will cost about $2,000,' says Dr Seah. This adds up to almost $25,000 a year - an amount that many MS patients cannot afford.

'Because of the nature of the disease, many patients engage in part-time work, so many cannot afford the drugs,' he explains.

The absence of cheap 'generic' drugs and the lack of drug subsidies for the majority of patients here prompted Dr Seah to help launch the M S Assistance Fund earlier this week. The charity hopes to raise $300,000 a year to help at least 40 needy MS patients annually.

'Unless you are destitute, you're unlikely to qualify for Medifund. Since those affected are mostly young people with not much work experience and little savings, treatment poses a real cost problem,' says Dr Seah.

For the fortunate few who can afford it, medication in the form of beta interferon has been shown to be quite effective. Drugs such as Betaseron and Rebif can reduce the number of exacerbations and may help to slow the progression of physical disability.

A synthetic form of myelin basic protein, called copolymer I or Copaxone, has also proven useful in the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third.

'While steroids do not affect the course of MS over time, they can often reduce the duration and severity of attacks in some patients,' explains Dr Seah.

In addition, patients usually take one or more muscle relaxants or painkillers to combat muscular spasms and stiffness. Physical therapy and regular exercise also help to preserve the body's remaining function.

Treatment for MS is available in three hospitals in the Public Sector - National University Hospital, National Neuroscience Institute @ TTSH Campus and National Neuroscience Institute @ SGH Campus. Those interested in supporting the charity, please call 6357-2497 or 6772-5945.