Multiple Sclerosis

It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS.

Causes

MULTIPLE SCLEROSIS (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 a virus or gene defect, or both, are to blame. 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

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 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
• Tremor in one or more arms or legs
• Weakness in one or more arms or legs

Bowel and bladder symptoms:

• 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.

Diagnosis

THE OUTCOME VARIES, AND IS HARD TO PREDICT. ALTHOUGH THE DISORDER IS LIFE-LONG (CHRONIC) AND INCURABLE, LIFE EXPECTANCY CAN BE NORMAL OR ALMOST NORMAL. MOST PEOPLE WITH MS ARE ACTIVE AND FUNCTION AT WORK WITH LITTLE DISABILITY.

Those who usually have the best outlook are:

• Females
• People who were young (less than 30 years old) when the disease started
• People with infrequent attacks
• People with a relapsing-remitting pattern
• People who have limited disease on imaging studies

The amount of disability and discomfort depends on:

• How often and severe the attacks are
• The part of the central nervous system that is affected by each attack

Most people return to normal or near-normal function between attacks. Over time, there is greater loss of function with less improvement between attacks.

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 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 acupressure or cannabis, to help with muscle problems