Overview of Multiple Sclerosis

Common Symptoms, Diagnosis, Treatments, and How to Seek Help

Central Nervous System
The Central Nervous System. adam.about.net

Multiple sclerosis is a chronic disease of the central nervous system. It is also an  an autoimmune disease. What does this mean?

  • Chronic disease: MS is not curable. However, there are treatments that are showing great promise for slowing down the progression of the disease.
  • Disease of the central nervous system: The central nervous system is comprised of your brain and spinal cord.
  • Autoimmune disease: This means that your body’s own immune system is attacking itself - in this case, targeting the protective nerve covering called myelin in your brain and spinal cord. When myelin is damaged, nerve cells cannot communicate properly. This produces a number of different symptoms based on which nerves are affected.

    What are the Symptoms of MS?

    There are a vast array of symptoms linked with MS, all which can vary in severity, duration and associated disability - meaning what one person with MS experiences can be quite different from what another person experiences. That being said, there are symptoms of MS that are more common than others. Some of these include:

    It's important to note that many MS symptoms are found in other diseases. For example, just because you have fatigue does not mean you have MS - in fact, it's likely something more benign, especially if this is your only symptom.

    How is MS Diagnosed?

    MS can be difficult to diagnose on the basis of symptoms alone for a number of reasons:

    • There is such a large number of symptoms
    • Symptoms may appear alone or in combination
    • Symptoms can vary in severity
    • Symptoms can disappear suddenly
    • Symptoms are common to other diseases

    This being said, a careful assessment of your symptoms is still a paramount part of your diagnosis, as there no single blood or imaging test to diagnose MS. Instead, neurologists rely on a combination of the following:

    • MRI scans
    • Medical history
    • Neurological exam
    • Evoked potential testing
    • Lumbar puncture
    • Blood tests (used to rule out other things)

    What Types of MS Are There?

    It's important to note that there are different types of MS, and this often affects not only the type of symptoms you have but how your disease progresses and how its treated. The most common type is relapsing-remitting  MS in which a person experiences relapses of neurological symptoms that  either partially or fully recover. These relapses are also referred to as “exacerbations,” “flares” or “attacks.”

    Within 10 years of an MS diagnosis, about half of people diagnosed with relapsing-remitting MS will develop secondary-progressive MS, where the symptoms steadily worsen. However, this was the case before disease-modifying therapies. We don’t yet know the impact of these medications on progression to secondary-progressive MS - there are indications that the percent of people (who are taking disease-modifying therapy) who progress to this type might be much lower.

    In primary-progressive MS (affects about 15 percent of people), there are no relapses or remissions, rather a steady course of progression.

    In progressive-relapsing MS, the disease follows a steady course of progression, but the patient also experiences relapses of acute symptoms.

    Can MS be Treated?

    MS cannot be cured. However, there are medications, called disease-modifying drugs, that work to slow down the damage and symptoms caused by MS by preventing relapses.

     There are also excellent medications to address most MS-related symptoms. In addition, your doctor may prescribe behavioral or dietary modifications, physical therapy, or psychosocial therapy.

    There is also therapy for the attacks of neurologic symptoms that people with relapsing-remitting MS experience. High-dose corticosteroids, usually taken intravenously, are used to reduce inflammation in the central nervous system, which can shorten the duration and severity of MS relapses.

    What Causes MS?

    No one knows what causes multiple sclerosis (MS), only that it is probably an autoimmune disease. Four main theories have emerged to attempt to explain MS. Each of these theories can explain a piece of the MS puzzle, but none explain everything. It is likely that the cause of MS is a complicated interaction of these four factors:

    • the immune system
    • the environment
    • infectious diseases
    • genetics

    What is My Prognosis?

    This is difficult to predict, because everyone’s disease course and symptoms are different. Also, we don't yet know the long-term benefits of many MS therapies.

    The good news is that MS itself usually has very little effect on life span, except in very severe cases. In fact, many people with MS die from other health-related issues. So while its important to focus on your MS health, it's also important to focus on your overall health by:

    • eating well (a low fat, high fiber diet rich in whole grains, fruits, and vegetables)
    • staying active
    • maintaining a normal weight
    • managing stress
    • smoking cessation
    • seeing your primary care physician for regular check-ups and screenings (e.g., colon cancer and breast cancer screening, getting your flu shot

    I Think I Have MS. What Should I Do?

    If you are concerned you have MS, you should see a neurologist. You can either find a neurologist yourself, or get a referral from your primary care physician.

    Although this is a difficult and scary time, try not to panic and continue to take care of yourself, including getting adequate sleep and rest. While some of the MS symptoms are dramatic, MS itself is not an acute disease – there is very little that is an emergency. It is important that you see a specialist (even if it takes some time to get the appointment) and go through the tests required in a logical manner.

    Source:

    Hill, B A. Multiple Sclerosis Q & A: Reassuring Answers to Frequently Asked Questions. New York: Avery. 2003.

    National Multiple Sclerosis Society

    Edited by Dr. Colleen Doherty June 9th 2016.

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