What is Multiple Sclerosis?
Multiple sclerosis, or MS as it is widely known, is an autoimmune disease that disrupts communication between your brain and other parts of your body, causing problems with muscle control, vision, balance, and sensation. This disease results in inflammation (called plaques) in various areas of your central nervous system, after which the protective coating of nerves, called the myelin sheath, is destroyed.
More Information about Multiple Sclerosis
The symptoms are different for each person with MS, in part depending on exactly where your myelin sheath is damaged. Some people have very mild symptoms while others become disabled by this disease. Your symptoms can come and go, with flare ups lasting days, weeks, or months.
The first sign of this disease is often blurred or double vision, red-green color distortion, or even blindness in one eye. Early on, you might also notice muscle weakness in your arms and legs and difficulty in balance and coordination.
Multiple sclerosis symptoms can include:
- Altered vision
- Muscle weakness
- Muscle stiffness
- Numbness, tingling, or tremors
- Thinking and memory problems
- Balance and coordination difficulties
- Loss of bladder or bowel control
- Partial or complete paralysis
The exact cause of MS is not known, however, heredity is thought to play a role. If you have a sibling with MS then your chances of getting this disease goes up and if you have an identical twin with MS then your risk rises even more.
Smoking increases your risk of getting this disease. It is thought that a combination of genetics, childhood infections, and environmental factors contribute to multiple sclerosis. Several different childhood viruses have been linked to the later development of MS.
In MS, your immune system mistakenly attacks your brain and spinal cord, damaging the fatty insulating material around nerves called myelin. Damaged myelin cannot properly send and receive nervous system messages.
Approximately 350,000 people in the United States have multiple sclerosis. Whites are more than twice as likely as other ethnic groups to get MS. Women are about twice as likely as men to have this disease.
Where you live may play a role since MS is more prevalent in temperate climates than tropical ones. In addition, where you live before the age of 15 may be particularly predictive. Most people with MS experience their first symptoms between the ages of 20-40.
It might take awhile for you to get a definitive diagnosis of multiple sclerosis, in part because MS symptoms often disappear for months at a time. Your doctor will consider your symptoms, neurological exam results, medical history, and rule out other potential health problems when considering a diagnosis of MS.
Your doctor may use several procedures to diagnose MS, such as:
Blood tests can rule out other infectious or inflammatory diseases that have symptoms similar to multiple sclerosis.
Your doctor will likely have you go to a neurologist who can check how your nervous system is working. These tests can check for problems with eye movements, muscle coordination, weakness, balance, sensation, speech, and reflexes.
Your doctor may take some fluid from your spine to check for abnormal amounts of blood cells or proteins that are associated with MS.
This test can show if you have lesions in your brain or spinal cord. Newer types of MRI such as magnetic resonance spectroscopy, magnetization transfer imaging, diffusion-tensor magnetic resonance imaging, or a functional MRI may also be used in your diagnosis.
Visual evoked potential (VEP)
This test measures how quickly your brain responds to visual stimuli. The results can indicate potential lesions in the brain.
Up to 10 percent of people are misdiagnosed with MS. Instead, they may have a viral infection, stroke, vitamin B12 deficiency, polyarteritis, lupus, syringomyelia, tropical spastic paraparesis, cancer, pernicious anemia, diabetes, Sjogren’s disease, or spinocerebellar ataxias.
Multiple sclerosis is not preventable, but certain factors might trigger a relapse. You should avoid both hot weather and becoming overheated (such as through exercise). Increased body temperature can cause your symptoms to temporarily worsen. Conversely, a cold bath might temporarily relieve your symptoms.
It is not uncommon for multiple sclerosis to cause depression, forgetfulness, paralysis (of the legs most frequently), muscle stiffness or spasms, epilepsy, bladder and bowel trouble, and/or sexual dysfunction. You may need a wheelchair someday, although that will probably be decades after diagnosis, if ever.
Your doctor might suggest that treatment be started immediately after diagnosis so your quality of life can be maintained. Although there is no cure for multiple sclerosis, there are medications that can manage your symptoms. Medications for MS include:
- Beta interferon (Avonex, Betaserone, and Rebif) for the treatment of relapsing-remitting MS
- Copaxone (a synthetic form of myelin basic protein) for the treatment of relapsing-remitting MS
- Novantrone, an immunosuppressant, for advanced or chronic MS
- Ampyra to improve walking ability
- Tysabri, a monoclonal antibody, to reduce the frequency of MS attacks in those with relapsing MS
- Steroids to reduce the duration and severity of MS attacks
- Muscle relaxants and tranquilizers to ease muscle stiffness or spasms
- Amantadine for fatigue
Most people with MS have a mild case and will be able to still function at home and work, as well as walk for many years after diagnosis, but in the worst case you could eventually lose the ability to walk and speak. However, most cases of MS have periods of remission when symptoms disappear for awhile.
Those with the best long term outlook are typically female, younger than age 30 when the disease started, and those who have infrequent attacks with long remissions in between.
Unfortunately, your life span is affected by MS, with women living six years less and men living 11 years less than those without this disease.
You should take part in physical therapy to help preserve your remaining muscle function. You may find that aids such as foot braces, a cane, or a walker can help you remain mobile. Assistive devices, such as bed lifts, shower chairs, and wall bars can also help maintain your independence.
Regular exercise can be helpful. However, avoid exercising in hot environments since an increase in body temperature can worsen symptoms. For this reason, swimming might be your best exercise choice.