Understanding Multiple Sclerosis (MS)
Multiple sclerosis (MS) is a disease of the brain and spinal cord. Unfortunately, there is no cure for MS. But there are many treatments available. Many people with MS can manage their symptoms and lead active, healthy lives. Read on to learn more about MS and its treatments.
What is MS?
The brain is the body’s control center. Each part of the brain controls specific functions. These include movement, balance, sensation, and reasoning. The brain controls these functions by sending and receiving messages through nerves. Nerves have a protective covering (myelin). With MS, the myelin on nerves in the brain and spinal cord is damaged. The loss of this covering causes messages traveling along affected nerves to slow or stop. This results in MS symptoms.
Causes and risk factors for MS
Experts don't know what causes MS. But most research suggests that the body’s immune system attacks and destroys myelin by mistake. MS most often begins in adults between ages 20 and 40. It happens in women more often than men. It also is more likely to occur if a person has a family history of MS. Smoking does not cause MS, but can make it worse.
Types of MS
There are 4 main types of MS. These are:
Relapsing-remitting MS. This type of MS is the most common. It is marked by isolated episodes of symptoms (also called attacks or flare-ups). Periods of partial or complete recovery follow these episodes. Each attack may be worse than the one before it.
Primary-progressive MS. This type of MS is marked by a slow onset of symptoms that gradually worsen over time. There are no periods of recovery.
Secondary-progressive MS. This type of MS begins as relapsing-remitting MS. After a period of stability, the disease steadily gets worse. About 50% of people with relapsing-remitting MS have secondary-progressive MS within 10 years of their first attack. About all of them have it within 25 years.
Progressive-relapsing MS. This type of MS includes both slowly progressive symptoms and periods of flare-ups together.
Symptoms of MS
MS symptoms vary from person to person. The type of symptoms a person has depends on which nerves are affected. It also depends on how much nerve damage there is in the brain and spinal cord. A person can also have different symptoms during the course of the disease. Symptoms can include:
Extreme tiredness (fatigue)
Numbness, tingling, or loss of feeling
Muscle spasms or weakness in the arms, legs, or both
Vision problems, such as rapid eye movements, double vision, or vision loss
Balance and coordination problems
Problems walking or moving the arms, legs, or both
Bowel and bladder control problems
Problems with sexual function
Trouble concentrating, focusing, or remembering things
Trouble reasoning and solving problems
Trouble speaking or swallowing
MS can be hard to diagnose. Symptoms come and go. They also may seem like those of other health problems. A diagnosis of MS is not made unless a person has had at least 2 or more separate episodes of MS symptoms. To confirm a diagnosis of MS, your healthcare provider will take a detailed history of symptoms. He or she will also give you a neurologic exam to check your muscle strength, balance, coordination, and reflexes. Skills such as thinking, memory, vision, hearing, and talking are also checked. In addition, healthcare providers may also give you the following tests:
MRI. This test provides detailed pictures of the brain and spinal cord. It helps check for areas of damaged nerves. These are often referred to as lesions or plaques.
Visual evoked potentials. This test is done to see how well your optic nerves are working.
Spinal tap (also called lumbar puncture). This test checks the health of the fluid around your brain and spinal cord for signs of nerve sheath damage (demyelination).
Blood tests. These help rule out other causes of the symptoms.
The goal of treatment is to manage your symptoms and slow the rate at which the disease worsens. You can manage your symptoms in 1 or more of the following ways:
Medicines. Some medicines help keep your body’s immune system from attacking the myelin. This may reduce the frequency and severity of attacks. Other medicines help control symptoms or relieve pain when attacks happen.
Rehabilitation (rehab). Symptoms or problems due to MS can interfere with daily living. Rehab includes physical, occupational, or speech therapy. This can help you maintain strength and function. If needed, your healthcare provider will prescribe aids such as canes, walkers, or wheelchairs. You can also make changes in your work or living space to improve your safety.
Supportive services. These include counseling and support groups to help you cope with the challenges of living with MS. Family members and friends may also benefit from these services.
Lifestyle changes. Making certain changes in your lifestyle and daily routine may help you manage symptoms. This includes getting enough rest and regular exercise. It also includes eating healthy foods and reducing stress. It's helpful to figure out and stay away from things that trigger MS episodes.
Other treatments. Researchers are exploring new treatments for MS. Many of these are in clinical trials. This means they are being tested for safety and effectiveness. Your healthcare providers can give you more information about any treatments that might be an option for you.
MS is an unpredictable disease. Your experience will be different from other people's experiences. In general, if you have MS, you should have regular visits with your healthcare provider. He or she will watch your symptoms. Your healthcare provider will review how well your medicines and other treatments work. MS symptoms may get worse as your disease progresses. If this happens, you may need more aggressive care and treatments. Visit the resources below to learn more about MS and what advances researchers are making to find a cure:
National Multiple Sclerosis Society, www.nationalmssociety.org
Multiple Sclerosis Association of America, www.mymsaa.org
February 09, 2018
Clinical features of multiple sclerosis in adults. UpToDate, Diagnosis of multiple sclerosis in adults. UpToDate, Disease-modifying treatment of relapsing-remitting multiple sclerosis in adults. UpToDate, Evoked Potentials (EP). National Multiple Sclerosis Society
Fetterman, Anne, RN, BSN,Jasmin, Luc, MD