What is Multiple Sclerosis?
Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (the brain, optic nerves and spinal cord). It is considered an autoimmune disorder - this means the immune system incorrectly attacks the person's healthy tissue.
MS can cause blurred vision, poor coordination, slurred speech, extreme fatigue and more. These problems may be permanent, or may come and go. The MS symptoms vary greatly. Some people have the disease with no visible signs, while others require help to move.
Most people are diagnosed between ages 20 and 50, although individuals as young as 2, and as old as 75 have developed MS. MS is not considered a fatal disease; the vast majority of people with MS live a normal life-span, but often face increasing limitations. (NMSS site)
What causes Multiple Sclerosis?
Doctors still don't understand what causes multiple sclerosis, but data suggests genetics, a person's environment and possibly a virus may contribute.
MS is not due to a single gene mutation and is not strictly inherited. There have been multiple genetic markers identified for increased risk and an increased risk exists for relatives of people who have MS. Siblings of an affected person have a 2%-5% risk of developing MS.
Some scientists theorize MS develops because of a genetic predisposition to react to an environmental agent, which triggers an autoimmune response.
In addition, it has been suggested that many viruses such as measles, herpes and mono may be associated with MS. To date, this belief has not been proven. (NMSS site)
What are the typical symptoms of MS?
Symptoms of MS are unpredictable and vary. For example, one person may experience abnormal fatigue, while another could have loss of balance and muscle coordination.
Sometimes the lost functions are regained. In severe MS, people have symptoms on a permanent basis, including partial or complete paralysis, and difficulties with vision, cognition, speech, and elimination. (NMSS site)
The onset of multiple sclerosis may be dramatic, or so mild a person doesn't notice symptoms.
The most common early symptoms of MS include:
• Loss of balance
• Weakness in one or more limbs
• Blurred or double vision
Less common symptoms may include:
• Slurred speech
• Sudden onset of paralysis
As the disease progresses, other symptoms may include heat sensitivity, fatigue and sexual disturbances. (WebMD)
What causes the symptoms?
MS symptoms result when an immune-system attack affects myelin, the protective insulation surrounding nerve fibers of the central nervous system. Myelin is often compared to insulating material around an electrical wire. Loss of myelin interferes with the transmission of nerve signals.
Myelin is destroyed and replaced by scars of hardened "sclerotic" tissue. Some underlying nerve fibers are permanently severed. The damage appears in multiple places within the central nervous system.
How is MS diagnosed?
The diagnosis of MS is clinical, based on medical history and symptoms. A proper diagnosis requires an examination by a physician, preferably a neurologist.
Symptoms, lasting a few days or weeks, and then becoming less noticeable, may be an early indication of MS. This pattern often corresponds with the attack and remission cycle of MS. However, other conditions can cause these symptoms. (msassociation.org)
Why is MS so difficult to diagnose?
In early MS, symptoms that might indicate possible disorders come and go. Some people have symptoms that are difficult for physicians to interpret. While no single laboratory test is available to prove or rule out MS, magnetic resonance imaging (MRI) is a great help in a definitive diagnosis. Blood work, spinal fluid analysis and evoked potentials can also help. (NMSS site)
Who can tell me that I have MS?
A neurologist is the medical specialist who evaluates the symptoms of MS.
It may be helpful if the neurologist is affiliated with a MS center, research facility or teaching hospital. The initial neurologist visit will include a series of questions about the patient’s medical history and a neurological exam which may include balance testing, sensory evaluation and reflex eye movement.
The next step in confirming a diagnosis is a MRI (magnetic resonance imaging) of the brain. Repeat MRI scans may show change over time or active inflammation. This permits the neurologist to estimate the evolution of lesions. Evoked potentials (visual and somatosensory) and spinal fluid analysis also help physicians’ diagnosis.
Lesions on MRI can occur throughout the disease process even though there are no apparent symptoms present. (msassociation.org)
Can MS be cured?
Not yet. There are now FDA-approved medications that have been shown to "modify" or slow down the underlying course of MS. In addition, many therapeutic and technological advances help people manage symptoms and live fulfilling lives. Advances in treating and understanding MS are made each year; progress in research to find a cure is very encouraging. (NMSS site)
What medications and treatments are available?
The National Multiple Sclerosis Society recommends considering FDA-approved "disease-modifying" drugs as soon as possible following a definite MS diagnosis. These drugs help lessen the frequency and severity of MS attacks, reduce the accumulation of lesions (areas of damage) in the brain, and may slow the progression of disability.
In addition to drugs that address the basic disease, there are many therapies for MS symptoms such as pain, bladder problems, fatigue, sexual dysfunction and cognitive problems. A knowledgeable physician can help develop a comprehensive approach to managing MS. (NMSS site)
Is MS fatal?
Most people with MS have a normal or near-normal life expectancy. In extremely rare cases, MS is rapidly progressive, terminal or shortens life expectancy. (NMSS site)
Is Multiple Sclerosis fatal, contagious, or hereditary?
Multiple sclerosis is not considered a fatal, contagious, or a directly inherited disease, although there may be a familial predisposition for MS. Prevalence in families of individuals with MS is somewhat higher than in the general population. (WebMD)
Who gets MS?
Anyone may develop MS, but some patterns exist. More than twice as many women as men have MS. Studies suggest that genetic factors make certain individuals more susceptible than others, but there is no evidence that MS is directly inherited. MS occurs in most ethnic groups, but is more common in Caucasians of northern European ancestry. The incidence of MS also becomes more common the further you live from the equator. There may be a link between Vitmain D deficiency and risk of MS. (NMSS site)
How many people have MS?
Approximately 400,000 Americans have MS. Every week about 200 people are diagnosed. World-wide, MS affects about 2.5 million people. Because the Center for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, and because symptoms can be completely invisible, many people consider it an underestimate. (NMSS site)
Can I get pregnant even though I have MS?
For a woman with MS, the decision to have a baby can be difficult. MS does not hinder a woman’s chance of becoming pregnant and carrying a child to full term. Planning the pregnancy and getting all the information you need can help the decision process.
Women tend to have fewer relapses during pregnancy, but there appears to be an increased risk of relapse post partum. Visit your neurologist to discuss current disease activity and possible progression. With flexibility and a proactive approach, solutions to various challenges presented by MS are attainable. Attend a local MS support group meeting and talk to others who are successfully parenting with MS.
To learn more, request a copy of Pregnancy for Women with MS by calling 1-888-MSFOCUS (673-6287). (msfocus.org)
Does diet affect MS?
Although diet is not currently considered a causative factor in MS, anecdotal evidence from individuals with MS suggests health benefits with an improved diet. Eating consistently well over a period of time may help reduce fatigue, improve bladder and bowel problems, and prevent bone loss. Adequate water and fiber is very helpful. A healthy diet may also positively impact mental and emotional health.
To learn more, request a copy of Nutrition & MS by calling 1-888-MSFOCUS (673-6287). (msfocus.org)
Does stress affect MS?
Understanding the psychological changes that accompany chronic disease can lead to a healthier mental state. Psychotherapy or counseling, and body cooling are ways to relieve stress. Some prefer alternative treatment options, including relaxation techniques (exercise, yoga, massage therapy, meditation). With MS, the stress to manage is the “distress” that may hamper coping abilities. (msfocus.org)
Am I going to need a wheelchair because of Multiple Sclerosis?
Most people with multiple sclerosis usually get around without assistance. However, you may eventually need assistance. Approximately 25% of people with MS will need a wheelchair, and others may use some other type of walking aide. This is usually more than 10 years after diagnosis (this estimate comes from studies following people without MS treatment). (WebMD)
Why do doctors feel that I am imagining my symptoms?
In the beginning phases of multiple sclerosis, diagnostic tests may be inconclusive, but the patient may experience subjective sensory symptoms. These symptoms can include numbness, tingling or fatigue, and will not be seen on diagnostic tests. This leads doctors to believe there is no illness, or that anxiety is present. You should also know a clinical diagnosis of MS may take years. Neurologists are generally consulted and use diagnostic tests such as MRI's and evoked response potential.
If you are not sure you have MS, don't be afraid to ask. Do not let symptoms continue without further investigation. (msfocus.org)
Which Multiple Sclerosis therapy is best for me?
Choosing to begin therapy for multiple sclerosis can be a difficult decision. Learning about your treatment options and discussing them with your doctor is the first step. Other factors to consider are effectiveness, side effects, your current lifestyle and how the therapy is given. (WebMD)
What alternative therapies are recommended for Multiple Sclerosis?
• Positive Attitude. Having a positive outlook cannot cure multiple sclerosis, but it can lower your stress and help you feel better.
• Exercise. Exercises, such as tai chi and yoga can lower your stress, increase relaxation, and increase your energy, balance, and flexibility. As with any exercise program, check with your doctor before getting started.
• There is some evidence suggesting aerobic exercise may be neuro-protective and that it helps maintain cognitive function and improve fatigue.
• Diet. It is important for people with MS to follow a healthy, well-balanced diet. Ask your doctor what diet is right for you. (WebMD)
What is Optic Neuritis?
Optic neuritis is the inflammation of the optic nerve, the nerve located in the back of the eye that is responsible for vision. According to the National Multiple Sclerosis Society, 55% of people with MS will have an episode of optic neuritis. Frequently, it is the first symptom of the disease. Although having optic neuritis suggests MS, it does not mean that a person has or will get MS.
The symptoms of optic neuritis are the acute onset of any of the following:
• Pain in the eye
• Blurred vision
• Graying of vision
• Blindness in one eye
It is rare that both eyes are affected simultaneously. Loss of vision tends to worsen over the course of a few days before getting better. This usually takes about four to 12 weeks. Treatment may include intravenous and/or oral steroids to control the inflammation. (WebMD)
Are there factors that may make MS symptoms worse?
Infection, being overheated or stress may make your old MS symptoms act up. This does not mean you are having a new relapse. The previously injured nerves often do not function well under increased stress or temperature.