Understanding Multiple Sclerosis

The brain and spinal cord make up the body’s central nervous system, a vital complex of nerve tissues that controls various activities in the body. When the immune system attacks the protective layers of nerve fibers in the central nervous system, this is a disease called multiple sclerosis.

Multiple sclerosis (MS) can lead to the disabling of the brain and spinal cord through nerve deterioration and can cause permanent damage in some cases. There is no cure, though there are various types of treatment that can reduce symptoms for many courses of MS. Here’s the basic information you need to know about multiple sclerosis:

MS Courses (Types)

There are four different primary courses, or types, of multiple sclerosis:

Clinically Isolated Syndrome (CIS): CIS is a first episode of neurologic symptoms, caused by inflammation and demyelination (the reduction or elimination of myelin, the coating that protects nerve structures). These episodes last at least 24 hours and contain many characteristics of MS, but they do not yet meet the final criteria for diagnosing MS—some people with CIS may not ever develop MS.
Relapsing-remitting MS (RRMS): The most common course of MS (about 85 percent of cases), RRMS is characterized by clearly defined attacks with new or increasing neurological symptoms. Attacks are followed by remissions—periods of recovery.
• Primary progressive MS (PPMS): PPMS does not include early relapses or remissions and leads to worsening neurological symptoms directly from the onset. It’s present in about 15 percent of MS cases.
Secondary progressive MS (SPMS): SPMS begins with a relapse and remission course, but usually transitions into a second, progressive course with accumulation of disability over time.

Symptoms and Complications

Symptoms of multiple sclerosis vary between cases and courses, and they include:

Numbness or weakness in limbs, generally occurring on one side of the body or the other—can also be present in the legs or trunk
Loss of vision, either complete or partial, usually in one eye at a time and with pain during eye movement. In other cases, prolonged double vision may occur
Tingling or pain
Tremor, lack of coordination, dizziness or unsteady gait
Electric-shock sensations during certain neck movements
Fatigue
Slurred speech
Issues with bowel or bladder function

MS patients may also be at risk for the following complications:

Muscle stiffness or spasms, or paralysis (usually in the legs)
Epilepsy
Mental changes or depression
Bladder, bowel and sexual function issues

Causes and Risk Factors

The exact cause of MS is unknown. Doctors know that it’s an autoimmune disease where the body’s own immune system attacks myelin, which helps protect nerve fibers. Risk factors for MS include:

Age: MS is most common for people between ages 15 and 60.
Gender: Women are roughly twice as likely to develop MS as men.
• Race: White people, particularly of Northern European ancestry, are at the highest risk. People of Asian, African or Native American ancestry have the lowest risk.
• Family history: MS present in parents or sibling can increase risk.
Climate: MS is more common in temperate climates, including northern North America, New Zealand, southeastern Australia and many parts of Europe.
Certain previous viral infections
Autoimmune diseases: Thyroid disease, Type 1 diabetes and inflammatory bowel disease all slightly raise MS risk.
Smoking: In people who experience an initial symptomatic event related to MS, smoking makes it more likely that a second event will also occur.

Treatment and Coping

If a positive MS diagnosis is found after a series of tests and exams, treatments focus on improving symptoms and slowing the progression of the disease. It also prioritizes speeding up recovery after specific attacks—corticosteroids and plasma exchanges are the two frequent treatments in this area.

For reducing symptoms and modifying progression, a number of different treatments and medications might be used. There are also several basic lifestyle elements that have shown success with reducing symptoms, including exercise, a balanced diet and lowering stress levels.

Like with many chronic illnesses, living day-to-day life with MS can be difficult. Support networks are important, as is continuing to maintain normal activities and recreation. For people struggling, there are support groups available. You can also speak with your doctor about any concerns you have with your MS diagnosis, treatment or management, and he or she will help you determine the best plan for you.

Our neurologists are trained specialists and work with your primary care physicians to develop a treatment plan personalized for you. We have access to the latest in imaging technology and our specialists are up to date on the most recent treatment options.