Multiple Sclerosis (MS)
Multiple sclerosis (MS) damages the protective cover around nerves called myelin in your central nervous system. It can cause muscle weakness, vision changes, numbness and memory issues. While there isn’t a cure, treatment options can help you manage symptoms and slow disease progression.
What is multiple sclerosis?
Multiple sclerosis (MS) is an autoimmune condition that affects your brain and spinal cord (central nervous system).
With MS, your immune system mistakenly attacks myelin cells. These are the protective covers (sheaths) that surround brain and spinal cord nerves. Myelin sheath damage interrupts messages (signals) that your nerves send throughout your body to perform functions like vision, sensation and movement.
Myelin damage can occur in your brain, spinal cord and nerves that supply your eyes. There’s no cure for MS, but treatment is available to help minimize ongoing damage from it and help you manage symptoms.
What are the types of multiple sclerosis?
There are four types of multiple sclerosis. You can think of the types as a way for your provider to describe your symptoms, instead of being four different conditions:
Three rare MS variants include:
How common is multiple sclerosis?
MS organizations estimate that 2.3 million people in the world have MS. Prevalence is the number of people living with a diagnosis at a particular time. Incidence is the number of newly diagnosed people at a given time.
What are the early symptoms of multiple sclerosis?
Early signs and symptoms of MS include:
What are the symptoms of multiple sclerosis?
Common symptoms of MS include:
These symptoms vary from person to person and may fluctuate in severity from one day to the next. You may have a few of these symptoms but it’s unlikely you’ll experience all of them at once.
Do you ever feel normal with MS?
This can be challenging to predict because everyone perceives “normal” in their own way. With MS, you may have periods of remission where your symptoms go away, and you feel more like yourself. You might even forget you have MS until symptoms flare up (return) again. This feeling of normalcy, and the degree of normalcy, can vary by type and stage.
What causes MS?
Demyelination, or the destruction of myelin, causes multiple sclerosis. Myelin is a protective cover (sheath) around nerve cells (neurons) in your brain and spinal cord. It moves messages (signals) between your brain and the rest of your body to control functions like vision, sensation and movement.
Your immune system’s job is to protect your body from things that can harm it, like bacteria or viruses. With MS, your immune system becomes overactive and mistakes healthy myelin (and sometimes, the nerve cells below the myelin) as a threat to your body. Your immune system’s attack on the healthy myelin damages it. This is demyelination.
On an imaging test (an MRI), your provider can find evidence of myelin damage. They may refer to it as a scar, lesion or plaque. Messages don’t pass between nerve cells easily where there is myelin damage, which leads to the development of MS symptoms.
Experts aren’t sure why some people develop MS. Research suggests the following may contribute to an elevated risk of developing MS:
What are the complications of multiple sclerosis?
Worsening or progressive symptoms of MS may lead to complications such as:
How is multiple sclerosis diagnosed?
There isn’t a single diagnostic tool available to pinpoint the condition. Instead, a provider will diagnose MS after a physical exam a neurological exam and testing. During an exam, your provider will learn more about your symptoms and medical history. Testing may include blood work, MRIs of your brain and spinal cord, and an analysis of your spinal fluid.
It can take time before you receive an official MS diagnosis. You may need to make multiple trips to see your provider before you know for sure. This happens because MS symptoms can look like or happen with several other common conditions. While the delay in an official diagnosis can be frustrating, getting the right diagnosis helps your provider accurately treat your symptoms.
What tests diagnose multiple sclerosis?
Diagnostic testing helps your provider rule out conditions with similar symptoms to MS. It may include:
Who diagnoses MS?
If your primary care provider suspects you may have MS, they may refer you to see a neurologist. A neurologist is a doctor who specializes in treating conditions that affect the nervous system, which includes your brain and spinal cord.
Is there a cure for multiple sclerosis?
There isn’t currently a cure for MS.
How is multiple sclerosis treated?
Multiple sclerosis treatment focuses on minimizing further damage, managing symptoms and preventing complications. Your treatment plan may include:
Other types of symptom management vary based on how the condition affects you. It may include:
Your healthcare provider may recommend plasma exchange (plasmapheresis)if your body doesn’t respond well to certain medications in the midst of an MS attack. This is more effective in minimizing damage from an ongoing attack as opposed to preventing additional attacks in the long term.
Your provider can also discuss if any clinical trials are available for you to participate in. Clinical trials are tests of new medications or uses of existing medications on humans to find new treatment options for MS and other conditions.
Multiple sclerosis medications
Medications for multiple sclerosis can reduce relapses (periods when symptoms worsen or new symptoms develop) and the development of new lesions/scars, and slow the disease’s progression. Common types of medications for MS include:
DMTs for MS
Common disease-modifying therapies (DMTs) for MS and their administration types include:
Can multiple sclerosis be prevented?
There isn’t a known way to prevent MS.
How can I lower my risk of multiple sclerosis symptom flare-ups?
Disease-modifying therapies are the most effective way to reduce the number of flare-ups (also called relapses or attacks) you experience.
Leading a healthy lifestyle is also important. The choices you make can help slow disease progression. Your provider may recommend the following to stay healthy:
Coping with a chronic condition can be emotionally challenging. MS can sometimes affect your mood and memory. Working with a neuropsychologist or a mental health provider is an essential part of managing the condition long term.
What’s the outlook for multiple sclerosis?
Multiple sclerosis is a lifelong condition without a cure. However, available treatment options are very effective in helping manage symptoms and minimize the frequency of flare-ups. Regardless of treatment, MS can lead to disability and make it difficult to do routine things without assistance over time. Your care team is available to help you throughout your MS journey, to take steps to prevent complications and to improve your quality of life.
Does multiple sclerosis affect your life expectancy?
You can expect to have a normal life expectancy with MS. Older studies have shown that MS can take up to 10 years off your life expectancy, but advances in treatment options have significantly improved this outlook. Only in very rare cases is MS fatal.
Can a person with MS live a normal life?
Yes. MS can be a challenging condition to diagnose and manage, but your care team will help you every step of the way. Despite having a condition without a cure, you can still lead a fulfilling and active life with MS. Support is available to help you maximize your function both physically and mentally, from medications to therapy. There are even support groups you can join to help you connect with people who share a similar experience.
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