Multiple sclerosis or MS is also called encephalomyelitis disseminate or disseminated sclerosis. It is an inflammatory disease that damages the insulating covers of nerve cells located in the brain and spinal cord. The damage then disrupts important parts of the nervous system for communication. The result is a wide range of signs and symptoms that include physical, mental and in some cases psychiatric issues. There are several forms of MS with symptoms either happening in isolated attacks or progressing gradually over time. In between attacks, it is possible for the symptoms to disappear. However, the problem is that it causes neurological problems permanently as the disease progresses.
Signs and Symptoms
Here are the early symptoms of MS:
- Blurry or doubled vision
- Problems regarding thinking
- Lack of coordination or clumsiness
- Balancing problems
- Tingling sensation in certain parts of the body
- Arm or leg weakness
As the disease advances, there are changes that happen to the mind and body of the person with MS
- Unusual sensations or “pins and needles” sensation
- Bladder issues and sometimes bowel issues
- Dizziness or light-headedness
- Fatigue or the constant feeling of tiredness
Causes and Risk Factors
The actual cause of multiple sclerosis is still a mystery. Experts believe that it is an autoimmune disease where the immune system attacks the body’s tissues. In the disease, the immune system destroys the myelin or the fatty substance protecting nerve fibers of the brain and spinal cord. Myelin is like the insulation found on electrical wires. Once it is damaged, the messages traveling along the nerve can be slowed or even blocked.
Experts believe that a combination of factors which includes the following cause the development of MS in certain people:
- Age: It often affects people older than 15 and younger than 60
- Sex: Women are around two times more likely to develop MS
- Family history: If a person has immediate family members with MS, they have a higher risk of developing it.
- Infections: Viruses like Epstein-Barr have been connected to MS.
- Race: People of Northern European descent have the highest risk of developing multiple sclerosis. Those of African, Asian and Native American descent have only very minimal risk.
- Smoking: Smokers are more likely to develop a second event after symptoms that may signal MS.
Types of Multiple Sclerosis
There are four types of MS which are:
Relapsing-Remitting MS or RRMS – This is the most common type affecting about 85% of people with the disease. These people have temporary periods that are called relapses or flare-ups of the appearance of new symptoms.
Secondary-Progressive MS or SPMS – The symptoms get worse gradually over time. Relapses and remissions may or may not occur. People with RRMS usually transition to SPMS eventually.
Primary-Progressive MS or PPMS – This is a rare type of MS that only affects about 10% of patients. It is characterized by the slow worsening of the symptoms, but there are no relapses or remissions.
Progressive-Relapsing MS or PRMS – This is an even rarer form of MS affecting only about 5% of patients. It is characterized by the gradual worsening of the disease state starting from the beginning. There are acute relapses but there are no remissions and there may or may not be recovery.
Tests and Diagnosis
There is no specific test for diagnosing MS. Diagnosis primarily involves ruling out other conditions that have similar signs and symptoms. The physician will typically start with by taking a thorough medical history of the patient followed by a physical examination. Then, the physician may recommend the following tests:
Blood tests – This is for ruling out infections or other inflammatory diseases.
Spinal tap or lumbar puncture – This can show abnormalities of the white blood cells or antibodies linked to MS. It also helps rule out other conditions like viral infections.
MRI – This will reveal if there are areas of lesions in the brain and spinal cord.
Treatments and Medications
There are a number of drugs that can be used to slow down the progress of multiple sclerosis in certain patients. These are referred to as disease-modifying drugs that include teriflumonide, interferon beta-1a, interferon beta-1b, fingolimod, glatiramer acetate, mitoxantrone and dimethyl fumarate. The drugs work by supressing or changing the activity of the immune system. Take note that these drugs don’t cure* MS but only reduces* frequency and severity of attacks while slowing down the development of brain lesions. Corticosteroids can also be used to reduce* inflammation of the nerves and control the different symptoms. If corticosteroids don’t work, plasma exchange can be done for relief of severe symptoms.
Watch Advances in Multiple Sclerosis (MS) Treatment Video – Brigham and Women’s Hospital
Precautions and Self Care
Multiple sclerosis is still not curable, but it can be managed to improve* the quality of life of the patient. Aside from following the doctor’s advice and taking the prescribed medication for slowing its progress, living a healthy lifestyle also helps. This includes eating well and becoming more active. Of course, physical activity needs to be limited and dangerous activities should be avoided.
- Compston A, Coles A (October 2008). “Multiple sclerosis”. Lancet 372 (9648): 1502–17. doi:10.1016/S0140-6736(08)61620-7. PMID 18970977.
- Compston A, Coles A (April 2002). “Multiple sclerosis”. Lancet 359 (9313): 1221–31. doi:10.1016/S0140-6736(02)08220-X. PMID 11955556.
- Murray ED, Buttner EA, Price BH (2012). “Depression and Psychosis in Neurological Practice”. In Daroff R, Fenichel G, Jankovic J, Mazziotta J. Bradley’s neurology in clinical practice. (6th ed.). Philadelphia, PA: Elsevier/Saunders. ISBN 1-4377-0434-4.
- Nakahara J, Maeda M, Aiso S, Suzuki N (February 2012). “Current concepts in multiple sclerosis: autoimmunity versus oligodendrogliopathy.”. Clinical reviews in allergy & immunology 42 (1): 26–34. doi:10.1007/s12016-011-8287-6. PMID 22189514.