Multiple sclerosis (MS) is a chronic, often disabling disease that attacks the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves. The progress, severity and specific symptoms of MS are unpredictable and vary from one person to another.
Multiple sclerosis usually affects women more than men. The disorder most commonly begins between ages 20 and 40, but can be seen at any age.
The exact cause is not known, but multiple sclerosis is believed to result from damage to the myelin sheath, the protective material which surrounds nerve cells. It is a progressive disease, meaning the nerve damage (neurodegeneration) gets worse over time.
In addition to nerve damage, another part of multiple sclerosis is inflammation. Inflammation occurs when the body's own immune cells attack the nervous system. The inflammation destroys the myelin, leaving multiple areas of scar tissue (sclerosis). It also causes nerve impulses to slow down or become blocked, leading to the symptoms of MS. Repeated episodes, or flare ups, of inflammation can occur along any area of the brain and spinal cord.
Because we do not know what causes multiple sclerosis, there is no solid information on how to prevent it.
Scientists believe that a combination of several factors may be involved. Studies in the areas of immunology, epidemiology and genetics are conducted in an effort to answer this important question.
In multiple sclerosis, damage to the myelin in the central nervous system and to the nerve fibers themselves interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. This disruption of nerve signals produces the primary symptoms of MS, which vary depending on where the damage has occurred.
Over the course of the disease, some symptoms will come and go, while others may be more lasting. MS symptoms include:
- Blurred or double vision, red-green color distortion or even blindness in one eye
- Muscle weakness in the extremities and difficulty with coordination and balance. These symptoms may affect walking or even standing.
- In the worst cases, partial or complete paralysis
- Feelings such as numbness, prickling, or "pins and needles" sensations
- Speech impediments
- Hearing loss
- Cognitive impairments, such as difficulties with concentration, attention, memory and poor judgment
- Problems with bladder control
- Sexual dysfunction
Diagnosing MS is not always simple and may require a combination of the information provided in a patient’s history, physical findings as well as imaging and laboratory testing. Since symptoms of MS can mimic many other neurological disorders, diagnosis is made by ruling out other conditions.
A history of at least two attacks separated by a period of reduced or no symptoms may be a sign of relapsing-remitting MS. Also, if the healthcare provider can see decreases in any functions of the central nervous system (such as abnormal reflexes), a diagnosis of MS may be suspected.
Among the tests for MS are:
- A neurological exam
- Eye examination
- Head or spine MRI scan
- Cerebrospinal fluid tests
There is no known cure for multiple sclerosis at this time. However, there are promising therapies that may slow the disease. The goal of treatment is to control symptoms and maintain a normal quality of life.
Medications used may include:
- Immune modulators to help control the immune system
- Steroids to decrease the severity of attacks when they occur
- Medicines to reduce muscle spasms
- Medications to reduce urinary problems
- Antidepressants for mood or behavior symptoms
- Medication for fatigue
Physical therapy, speech therapy, occupational therapy and support groups can help improve the person's outlook, reduce depression, maximize function and improve coping skills. A planned exercise program can help maintain muscle tone.
Adequate rest and relaxation can help maintain energy levels. Attempts should be made to avoid fatigue, stress, temperature extremes and illness to reduce factors that may trigger an MS attack.
According to the National Institute of Neurological Disorders and Stroke, one of the most promising MS research areas involves naturally occurring antiviral proteins known as interferons.
Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. In addition, there are a number of treatments under investigation that may curtail attacks or improve function.