Multiple Sclerosis

Updated: Jan 20

MS is a potentially disease of the central nervous system that affects the brain and spinal cord. In MS, the immune system attacks the protective layer that covers the nerve fibers (myelin sheath) affecting communication between the brain and body. Eventually, there is permanent deterioration of the nerves. 

Signs and symptoms vary widely depending on the nerve damage, nerves affected and the location of affected nerve fiber. Symptoms include numbness or weakness in one or more limbs that affect one side of the body, or legs and trunk, electric-shock sensation especially when bending the neck forward, tremors, lack of coordination or unsteady gait. 

Affected individuals may also have vision problems such as partial or complete loss of vision (usually in one eye at a time and can be accompanied with pain during eye movement), prolonged double vision, and blurry vision. Additional symptoms may include slurred speech, fatigue, dizziness, tingling or pain in parts of the body, problems with sexual, bowel and bladder function. 

Most people with MS have a relapsing-remitting type of MS where they experience periods of symptoms which develop over days or weeks and usually resolve partially or completely (remission) that can last months or years. However, at least 50% of those with relapsing-remitting MS eventually develop a steady progression of symptoms, with or without periods of remission, within 10-20 years from disease onset. This is known as secondary-progressive MS.

The worsening of symptoms usually includes problems with mobility and gait. The progression varies among people with secondary-progressive MS. Individuals with primary-progressive MS experience a gradual onset and steady progression of signs and symptoms without any relapses.

Th cause of MS is not known but it is considered an auto-immune disease where the body’s immune system attacks the protective coat over the nerve fibers. This damage to the myelin slows or blocks messages being sent through the nerves. A combination of genetics and environmental factors is believed to be responsible for causing MS. 

There are no specific tests for MS. Diagnosis is made by ruling out other conditions. Medical history and examinations are usual starting points, but the physician may recommend blood tests, spinal tap. MRI, and evoked potential tests. For individuals with relapsing-remitting MS, the diagnosis is based on the pattern of symptoms that are consistent with the disease and confirmed by MRI.

There is not cure for MS, treatment focuses on speeding recovery from attacks, slowing progression of the disease and management of symptoms. No treatment is needed for mild symptoms. Treatment of attacks is controlled with a prescription of corticosteroids (reduces inflammation of the nerves) and plasma exchange. There is only one FDA approved disease modifying therapy for primary progressive MS but there are several disease modifying therapies available for relapsing-remitting type. 

Information about current clinical trials can be found at Supporting organizations include National MS Society and Multiple Sclerosis Foundation.

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