The NeuroMedical Center | Patient Education Library | Multiple Sclerosis
What Is Multiple Sclerosis?
Your immune system — a network of cells, tissues and organs designed to produce antibodies that fight infection or illness — is your body’s natural defense mechanism. When you have MS, instead of fighting off infection, your immune system mistakenly attacks your own central nervous system instead. These “attacks” can damage your brain, spinal cord and optic nerves, slowing down or blocking communication between your brain and body. Researchers don’t know the exact cause of MS, but believe the environment and genetics may play a crucial role. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than one million people in the United States and 2.1 million people worldwide. Currently there is no cure for MS.
MS Causes & Symptoms
Doctors still don’t understand what causes MS, but they believe the following factors may increase the risk:
- Family history of MS or other autoimmune conditions
- Being 20–40 years old
- Being female
- Living in a temperate climate away from the equator
Also, people with MS often have low vitamin D levels.
The symptoms of MS are quite varied–no two people have exactly the same symptoms and each person’s symptoms can change or fluctuate over time. MS symptoms are also unpredictable– virtually any region of the central nervous system may be affected in varying degrees of intensity, ranging from mild to severe.
The most common symptoms include:
- Numbness or Tingling
- Dizziness and Vertigo
- Emotional Changes
- Gait (Walking) Issues
- Stiffness & Muscle Spasms
- Vision Problems
- Bladder/Bowel Problems
- Cognitive Changes
Less common symptoms include:
- Speech Difficulties
- Breathing Problems
- Swallowing Problems
- Hearing Loss
Diagnosing Multiple Sclerosis
Since all of the symptoms associated with MS can also be related to other health conditions, diagnosing the condition can be difficult. In fact your physician must be able to rule out other possible diagnoses that could explain the symptoms you are experiencing. Some of these diagnoses are easy to rule out with a simple blood test (e.g. vitamin B12 deficiency), while others, such as sarcoidosis, may require a biopsy. Some are much rarer than others. It’s important to work with a healthcare provider who is familiar with these conditions in order to arrive at a correct diagnosis as quickly as possible — and begin the appropriate treatment — whether you have MS or not.
The following tests may also be recommended to help reach a diagnosis, including ruling out other conditions.
- lumbar puncture, to test cerebrospinal fluid for antibodies that may suggest an autoimmune condition
- MRI scans which can detect lesions on the brain or spinal cord
- Evoked potentials (EP) which measures how well messages travel through the nervous system
The Different Types of MS
While there is no way to predict with any certainty how a person’s MS will progress, four basic disease courses have been defined:
People with this type of MS experience clearly defined flare ups (also called relapses, attacks or exacerbations). These are episodes of acute worsening of neurologic function. They are followed by partial or complete recovery periods (remissions) that are free of disease progression.
People with this type of MS experience a slow but nearly continuous worsening of their disease from the onset, with no distinct relapses or remissions. However, there are variations in rates of progression over time, occasional plateaus and temporary minor improvements.
People with this type of MS experience an initial period of relapsing-remitting MS, followed by a steadily worsening disease course with or without occasional flare-ups, minor recoveries (remissions), or plateaus.
People with this type of MS experience a steadily worsening disease from the onset but subsequently have clear acute relapses (attacks or exacerbations), with or without recovery. In contrast to relapsing remitting MS, the periods between relapses are characterized by continuing disease progression.
MS Treatment and Therapies
Because there is currently no cure for multiple sclerosis, managing MS is an ongoing process, beginning with the very first symptoms and continuing throughout the disease course. Treatment focuses on slowing the disease’s progression and minimizing the damage it can cause to your central nervous system. These services can include injectable and oral medications to modify the disease course, treat relapses, and manage symptoms.
If you have a type of relapsing-remitting MS and your condition is acting up, your doctor may first treat you with a disease-modifying drug aimed at slowing down the advance of your disease and preventing flare-ups. The drugs work by curbing the immune system so that it doesn’t attack the protective coating called myelin that surrounds the nerves.
Beta interferons ease the severity and frequency of flares (sudden episodes of either new symptoms or a worsening of existing MS symptoms) and are also used to treat relapsing multiple sclerosis.
A professional PT program will help improve your strength and physical function. However, it needs to be carefully tailored to people with MS.
Changes to your lifestyle can help ease MS symptoms. It can also put off flare-ups and keep symptoms from getting worse. Your coping skills and outlook about your illness can also help manage MS. Some habits you can add are:
- A Daily Dose of Exercise
- Get Plenty of Rest
- Eat a Healthy Diet
- Reduce Stress Levels
- Avoid Excessive Heat
- Stop Smoking
- Avoid people who are sick