Multiple sclerosis, or MS, is a chronic autoimmune disease that affects the central nervous system (CNS), which consists of the brain, spinal cord and optic nerves. With an autoimmune disease, your protective immune system mistakenly attacks healthy cells like it normally would attack foreign invaders, such as bacteria and viruses.
In MS, your immune system attacks myelin, the protective sheath that surrounds and insulates the nerves in the CNS. Without myelin, electrical impulses cannot travel efficiently from nerve to nerve. When the myelin is damaged, it leaves a scar, or sclerosis. Multiple sclerosis means “scar tissue in multiple areas.”
The interruption in nerve signaling from the brain to the rest of the body that occurs with MS results in a host of symptoms and disabilities. Symptoms vary among individuals in type and severity.
Vision problems, usually affecting one eye at a time, are a common early sign of MS. Some people may experience blurred or double vision. Others may experience a partial or total loss of vision. Inflammation of the optic nerve can result in pain with eye movement.
Other common MS symptoms include changes in gait and mobility; fatigue; loss of balance or coordination; muscle spasms; muscle weakness; tremors; speech issues; emotional changes and depression; tingling or numbness in your legs, arms or one side of your face; bowel or bladder problems; sexual difficulties; and pain. Sufferers feel a sensation like an electric shock when moving the neck. This is called Lhermitte’s sign.
There are four types of MS.
Clinically isolated syndrome (CIS) is a pre-MS condition. It’s a single, first episode of symptoms lasting at least 24 hours. Not everyone who has CIS goes on to develop MS.
Relapsing-remitting MS (RRMS) is the most common type, accounting for about 85 percent of MS cases. RRMS involves episodes of new or increasing symptoms, called relapses or flare-ups, followed by periods of remission, when symptoms stabilize or go away.
Primary progressive MS (PPMS) affects about 15 percent of people with MS. With this type, symptoms slowly and gradually worsen without early relapses or remissions. Some people with PPMS experience times of stability and periods when symptoms worsen and then get better.
Secondary progressive MS (SPMS) involves continued nerve damage and symptoms that progressively worsen. While you may still experience some relapses, you no longer have periods of remission afterward. Many people originally diagnosed with RRMS transition into SPMS.
The exact cause of MS is unknown, but researchers have identified risk factors. They include age (it is usually diagnosed in people between 20 and 40 years old), gender (it is more common in women), family history, race (white people of Northern European descent are at highest risk), climate (it is more common in temperate climates), Vitamin D deficiency and smoking.
In addition to a complete neurological exam and review of your personal and family history, your neurologist may use several tests to help make a diagnosis of MS. These tests may include blood tests, MRI scan, spinal tap (lumbar puncture) and an evoked potentials test, which stimulates the nerve pathways to analyze electrical activity in your CNS.
There is currently no cure for MS, but there are treatments for managing symptoms, reducing relapses and slowing disease progression. Disease-modifying therapies (DMTs) are the primary treatment for MS. They are FDA-approved medications that help to reduce relapses and slow progression of MS.
Your neurologist may recommend a high dose of corticosteroids to counter a severe flare-up. Steroids can quickly reduce inflammation and slow damage to the myelin sheath surrounding your nerves.
Physical rehabilitation, including physical, occupational and speech therapy, may be recommended to help you maintain mobility and function. Your doctor may also suggest mental health counseling to help you combat the emotional challenges of living with a chronic disease.
Making a few lifestyle changes can also help you live a better life with MS. Consider these tips:
- Eat a healthy diet rich in fruits and vegetables, whole grains, healthy fats and lean protein. Limit your intake of saturated and trans fats, added sugars and processed foods.
- Get regular exercise to maintain strength and flexibility, reduce stiffness and boost mood.
- Manage stress in your life. Try stress-relieving activities such as yoga, tai chi, deep breathing, massage or meditation.
- Don’t smoke. Smoking is bad for your health overall and can worsen MS symptoms.
- Limit alcohol use. Alcohol can also worsen MS symptoms and speed up disease progression.
The good news is that MS is rarely fatal, and most people who have the disease don’t become severely disabled and continue to lead long, full lives.