Multiple Sclerosis (MS)
Topic Overview
What is multiple sclerosis?
Multiple sclerosis, often called MS, is a disease that affects the central nervous system—the brain and spinal cord. It can cause problems with muscle control and strength, vision, balance, feeling, and thinking.
Your nerve cells have a protective covering called myelin. Without myelin, the brain and spinal cord can't communicate with the nerves in the rest of the body. MS gradually destroys myelin in patches throughout the brain and spinal cord, causing muscle weakness and other symptoms. These patches of damage are called lesions.
MS is different for each person. You may go through life with only minor problems. Or you may become seriously disabled. Most people are somewhere in between. Generally, MS follows one of four courses:
- Relapsing-remitting, where symptoms fade and then return off and on for many years.
- Secondary progressive, which at first follows a relapsing-remitting course and then becomes progressive. “Progressive” means it steadily gets worse.
- Primary progressive, where the disease is progressive from the start.
- Progressive relapsing, where the symptoms come and go but nerve damage steadily gets worse.
Whatever your symptoms are, treatment and self-care can help you maintain your quality of life. There is no cure for MS, but it is not fatal except in rare cases.
What causes MS?
The exact cause is unknown, but most experts believe MS is an autoimmune disease. In this kind of disease, the body’s defences, called the immune system, mistakenly attack normal tissues. In MS, the immune system attacks the central nervous system—the brain and spinal cord
.
Experts don't know why MS happens to some people but not others. There may be a genetic link, because the disease seems to run in families. Where you grew up may also play a role. MS is more common in those who grew up in colder regions that are farther away from the equator.
What are the symptoms?
Symptoms depend on which parts of the brain and spinal cord are damaged and how bad the damage is. Early symptoms may include:
- Muscle problems—You may feel weak and stiff, and your limbs may feel heavy. You may drag your leg when you walk. You may drop things more than usual and be less coordinated.
- Visual problems—Your vision may be blurred or hazy. You may have eyeball pain (especially with movement), blindness, or double vision. Optic neuritis (a sudden loss of vision and eye pain) is a fairly common first symptom.
- Sensory problems—You may feel tingling, a pins-and-needles sensation, or numbness. You may feel a band of tightness around your trunk or limbs or a feeling of electricity moving down your back and limbs.
- Balance problems—You may feel light-headed or dizzy or feel like you're spinning.
As MS gets worse, you may have tremors and pain and feel stiff when you move. You may have problems with controlling urination, swallowing, and thinking clearly. MS can lead to depression.
Many people with MS are sensitive to heat. Hot temperatures, a fever, a hot shower, or too much exercise can make their symptoms worse until they cool down.
MS is very unpredictable. Your symptoms may suddenly get worse with no warning, or you may go for years without any problems.
How is MS diagnosed?
Diagnosing MS is not always easy. The first symptoms may be vague, and many of the symptoms can be caused by problems other than MS. Try not to be frustrated if months or even years go by before your illness is definitely identified as MS.
MS is not diagnosed unless a doctor can be sure that you have had at least two attacks. The doctor will examine you, ask you questions about your symptoms, and do some tests. An MRI is often used to confirm the diagnosis, because the patches of damage (lesions) caused by MS attacks can be seen with this test.
How is it treated?
Three kinds of medicines are used to treat the disease. They are used:
- During a relapse, to make the attack shorter and less severe.
- Over a long period of time, to keep down the number of attacks and how severe they are (disease-modifying therapy). This treatment may delay or at least reduce the damage MS does to the body.
- To control specific symptoms—like fatigue, depression, urinary problems, sexual difficulties, pain, or muscle stiffness.
You may find it hard to decide whether to take any of the drugs that slow the progression of MS, especially if your symptoms have been mild. The drugs do not work for everyone, and they often have strong side effects. But experts say it’s usually best to start taking medicine as soon as you are diagnosed, because damage may be going on even if you don't have symptoms. You and your doctor will decide whether you should try any of these drugs.
Physiotherapy, occupational therapy, and speech therapy can help you reduce some physical problems caused by MS. You can also help yourself at home by eating right, getting regular exercise and rest, and learning to use your energy wisely.
Dealing with the physical and emotional demands of MS is not easy. If you feel overwhelmed, talk to your doctor. You may be depressed, which can be treated. And finding a support group where you can talk to other people with MS can be very helpful.
Frequently Asked Questions
Learning about multiple sclerosis:
Being diagnosed:
Getting treatment:
Ongoing concerns:
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| Author: | Douglas Dana Shannon Erstad, MBA/MPH | Last Updated: August 14, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Colin Chalk, MD, CM, FRCPC - Neurology Barrie J. Hurwitz, MD - Neurology | |
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