Multiple sclerosis (M.S.) is an autoimmune illness of the central nervous system, including the brain and spinal cord.
Inflammation of materials that insulate the nerves causes problems with the signals that generally flow between the brain and nerves in the body.
M.S. is a progressive disease, meaning it typically worsens over time.
ABOUT MULTIPLE SCLEROSIS
The slowing down or blocking of messages between the brain and body cause several symptoms in people with M.S.
Typical multiple sclerosis symptoms include:
- vision disturbances
- poor balance or coordination
- feelings of numbness or tingling
- problems with movement
- problems thinking
- changes to bowel and bladder behavior
Scar tissue usually develops in the areas damaged by M.S.; the multiple scarring locations led to its name of multiple sclerosis.
Most people who have M.S. begin showing symptoms while young (between 20 and 40 years old).
The cause of M.S. is unknown, but the disease likely occurs from a combination of genetic (inherited gene) factors and environmental ones.
The risk of having an M.S. is nearly twice as high among women as it is among men.
Caucasian people are more likely to get MS than are people of other ethnicities.
Having a family member with M.S. can increase the risk of getting the disease.
Problems in the body’s immune system also are considered as part of the cause of M.S. inflammation. The immune system usually fights off infection and disease.
In MS, the immune system instead attacks the central nervous system. The corruption to the central nervous system destroys myelin, the fatty, protective coating that insulates the body’s nerves.
The myelin wraps around axons, which are nerve fibers, so axons also can be damaged by M.S.
There are four courses, or types, of M.S. disease. The clinically isolated syndrome refers to the first instance of neurological (brain, spinal cord, and nerve) symptoms.
Recurrence-remitting MS is the most common type of disease. In this type, people have episodes called relapses or exacerbations in which they have an attack of symptoms, or relapse, followed by remission, which is a period with no symptoms.
Secondary progressive M.S. follows the first course of relapsing-remitting M.S. In this type, a person’s symptoms tend to progress or worsen.
Primary progressive M.S. is continued worsening of symptoms and even disability from the disease.
The names of M.S. types can vary as researchers learn more about the condition and how it progresses.
Multiple Sclerosis Diagnosis
Doctors diagnose M.S. using clinical symptoms or signs and evidence of M.S. from tests such as magnetic resonance imaging (MRI).
No single test can diagnose M.S., but MRI scans can show whether the brain already has areas of damage from M.S.
Analyzing a sample of the clear fluid in the brain and spinal cord (cerebrospinal fluid) for specific proteins related to M.S. also might aid in diagnosis.
Doctors also can perform neurological tests that check a patient’s eye movement, muscle coordination, balance, speech, or reflexes.
Other diseases or conditions cause some symptoms of M.S., so a doctor might order tests to dismiss other causes of symptoms.
It can take several episodes of M.S. to diagnose the disease, yet identifying M.S. early is essential so that doctors begin to treat the patient before the loss of axons and progressive symptoms.
Doctors use a standard system to evaluate a patient’s symptoms and help determine the diagnosis.
Multiple Sclerosis Treatment
There is no known cure for M.S., but doctors will take steps to manage symptoms and reduce how often patients have attacks or how rapidly the disease progresses.
Managing MS also aims to help patients cope with its effects, including the disease’s emotional aspects.
As of 2018, at least a dozen medications had been approved by the U.S. Food and Drug Administration to help modify the disease by reducing how often it occurs or how severe attacks are.
Examples of these medications are interferon beta-1a (Avonex, Rebif) or glatiramer acetate (Copaxone), which are injected.
Some, such as teriflunomide (Aubagio) or fingolimod (Gilenya), are taken by mouth. Others are given through a unique infusion into the patient’s veins. Patients should be aware of all side effects of these M.S. medications.
M.S. patients might receive additional medicines to help ease symptoms of the disease. Antidepressants can help relieve depression, and some treatments can ease pain or fatigue.
Medications used to treat bowel and bladder problems also are available.
A patient might have an attack of M.S. severe enough to require immediate care. In the emergency setting, doctors ease symptoms and lower the risk of life-threatening effects from severe seizures.
A patient might receive steroids orally or in their veins to alleviate inflammation, for example.
If steroids do not work, plasmapheresis might be tried. This procedure exchanges the clear liquid part of the blood, called plasma, to remove harmful substances called antibodies.
If a patient has an infection, the doctor might prescribe an intense course of antibiotics.
People who have M.S. might receive occupational therapy or physical therapy to help them overcome symptoms of the disease and have a better quality of life.
A physical therapist can assist M.S. patients who have problems moving or offering devices to improve mobility.
Occupational therapy can make it easier to perform regular activities and functions affected by progressive M.S.
Some patients might choose complementary or alternative medicine approaches to deal with some of the effects of M.S.
For example, mindfulness training can improve thinking, memory, or emotions. Yoga can likely improve muscle tone or flexibility, and relaxation.
Finally, lifestyle adjustments often are necessary.
If an M.S. patient becomes intolerant of heat, it is best to time outdoor activities for the less warm part of the day and stays away from saunas or hot tubs.
“About MS.” MS International Federation. Phttps://www.msif.org/about-ms/ (accessed December 14, 2018).
Luzzio, Christopher. “Multiple Sclerosis.” Medscape. August 30, 2018. https://emedicine.medscape.com/article/1146199-overview (accessed December 14, 2018).
“Multiple Sclerosis.” MedlinePlus. February 7, 2019. https://medlineplus.gov/multiplesclerosis.html (accessed February 13, 2019).
“Types of MS.” National Multiple Sclerosis Society. https://www.nationalmssociety.org/What-is-MS/Types-of-MS (accessed December 13, 2018).
MS International Federation, 3rd Floor, Skyline House, 200 Union Street, London, SE1OLX, https://www.msif.org/.
National Institute of Neurological Disorders and Stroke, PO Box 5801, Bethesda, MD, 20824, (800) 352-9424, https://www.ninds.nih.gov/.
National Multiple Sclerosis Society, PO Box 4527, New York, NY, (800) 344-4867, https://www.nationalmssociety.org/.