Overview Of Multiple Sclerosis (MS)
Multiple sclerosis (MS) is an autoimmune disease that affects the brain and spinal cord (central nervous system).
Commonly Associated With
Demyelinating disease
Causes Of Multiple Sclerosis (MS)
MS affects women more than men. The disorder is most commonly diagnosed between ages 20 to 40, but it can be seen at any age.
MS is caused by damage to the myelin sheath. This sheath is the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve signals slow or stop.
The nerve damage is caused by inflammation. Inflammation occurs when the body’s own immune cells attack the nervous system. This can occur along any area of the brain, optic nerve, and spinal cord.
It is unknown what exactly causes MS. The most common thought is that it is caused by a virus, a gene defect, or both. Environmental factors may also play a role.
You are slightly more likely to develop this condition if you have a family history of MS or you live in a part of the world where MS is more common.
Symptoms Of Multiple Sclerosis (MS)
Symptoms vary because the location and severity of each attack can be different. Attacks can last for days, weeks, or months. Attacks are followed by remissions. These are periods of reduced symptoms or no symptoms. Fever, hot baths, sun exposure, and stress can trigger or worsen attacks.
It is common for the disease to return (relapse). The disease may also continue to get worse without remissions.
Nerves in any part of the brain or spinal cord may be damaged. Because of this, MS symptoms can appear in many parts of the body.
Muscle symptoms:
- Loss of balance
- Muscle spasms
- Numbness or abnormal sensation in any area
- Problems moving arms or legs
- Problems walking
- Problems with coordination and making small movements
- A tremor in one or more arms or legs
- Weakness in one or more arms or legs
- Constipation and stool leakage
- Difficulty beginning to urinate
- Frequent need to urinate
- Strong urge to urinate
- Urine leakage (incontinence)
Eye symptoms:
- Double vision
- Eye discomfort
- Uncontrollable eye movements
- Vision loss (usually affects one eye at a time)
Numbness, tingling, or pain:
- Facial pain
- Painful muscle spasms
- Tingling, crawling, or burning feeling in the arms and legs
Other brain and nerve symptoms:
- Decreased attention span, poor judgment, and memory loss
- Difficulty reasoning and solving problems
- Depression or feelings of sadness
- Dizziness and balance problems
- Hearing loss
Sexual symptoms:
- Problems with erections
- Problems with vaginal lubrication
Speech and swallowing symptoms:
- Slurred or difficult-to-understand speech
- Trouble chewing and swallowing
- Fatigue is a common and bothersome symptom as MS progresses. It is often worse in the late afternoon.
Exams & Tests
Symptoms of MS may mimic those of many other nervous system problems. MS is diagnosed by determining if there are signs of more than one attack on the brain or spinal cord and by ruling out other conditions.
People who have a form of multiple sclerosis called relapsing-remitting MS have a history of at least two attacks separated by a remission.
In other people, the disease may slowly get worse in between clear attacks. This form is called secondary progressive MS. A form with gradual progression, but no clear attacks is called primary progressive MS.
The health care provider may suspect MS if there are decreases in the function of two different parts of the central nervous system (such as abnormal reflexes) at two different times.
An exam of the nervous system may show reduced nerve function in one area of the body. Or the reduced nerve function may be spread over many parts of the body.
This may include:
- Abnormal nerve reflexes
- Decreased ability to move a part of the body
- Decreased or abnormal sensation
- Other loss of nervous system functions, such as vision
An eye exam may show:
- Abnormal pupil responses
- Changes in the visual fields or eye movements
- Decreased visual acuity
- Problems with the inside parts of the eye
Rapid eye movements triggered when the eye moves Tests to diagnose MS include:
- Blood tests to rule out other conditions that are similar to MS.
- Lumbar puncture (spinal tap) for cerebrospinal fluid (CSF) tests, including CSF oligoclonal banding, may be needed.
- MRI scan of the brain or the spine, or both are important to help diagnose and follow MS.
- Nerve function study (evoked potential test, such as visual evoked response) is less often used.
Treatment
There is no known cure for MS at this time, but there are treatments that may slow the disease. The goal of treatment is to stop progression, control symptoms, and help you maintain a normal quality of life.
Medicines are often taken long-term. These include:
- Medicines to slow the disease
- Steroids to decrease the severity of attacks
- Medicines to control symptoms such as muscle spasms, urinary problems, fatigue, or mood problems
- Medicines are more effective for the relapsing-remitting form than for other forms of MS.
The following may also be helpful for people with MS:
- Physical therapy, speech therapy, occupational therapy, and support groups
- Assistive devices, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars
- A planned exercise program early in the course of the disorder
- A healthy lifestyle, with good nutrition and enough rest and relaxation
- Avoiding fatigue, stress, temperature extremes, and illness
- Changes in what you eat or drink if there are swallowing problems
- Making changes around the home to prevent falls
- Social workers or other counseling services to help you cope with the disorder and get assistance
- Vitamin D or other supplements (talk to your provider first)
- Complementary and alternative approaches, such as acupuncture or cannabis, to help with muscle problems
- Spinal devices can reduce pain and spasticity in the legs
