MS; Demyelinating disease
Multiple sclerosis (MS) affects women more than men. The disorder is most commonly diagnosed between ages 20 to 40, but it can be seen at any age.
MS is caused by damage to the myelin sheath. This sheath is the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve signals slow or stop.
The nerve damage is caused by inflammation. Inflammation occurs when the body's own immune cells attack the nervous system. This can occur along any area of the brain, optic nerve, and spinal cord.
It is unknown what exactly causes MS. The most common thought is that a virus or gene defect, or both, are to blame. Environmental factors may also play a role.
You are slightly more likely to develop this condition if you have a family history of MS or you live in a part of the world where MS is more common.
Multiple sclerosis can be a particularly debilitating disorder because your body essentially attacks itself. But you can learn to cope during attacks.So, what causes multiple sclerosis?Multiple sclerosis, or MS, is a disease in which your body's immune system eats away at the protective sheath that covers your nerves. The disorder disrupts communication between your brain and the rest of your body, meaning your nerve signals slow down or stop.We don't know exactly why this happens. The most common thought is that a virus or gene defect, or both, are to blame. Environmental factors may even play a role. We do know that the disorder affects more women than men, that you may get the disorder if you have a family history of MS, and that you are at higher risk if you live in a part of the world where MS is more common. It's typically diagnosed between the ages of 20 and 40, but we see the disorder at any age.Now you may ask, how do you know you have multiple sclerosis?Symptoms of MS can vary widely from person to person because the location and severity of each attack can be different. Episodes may last for days, weeks, or months. You may even have long periods where you have no symptoms. We call this remission.Because MS may damage nerves in any part of the brain or spinal cord, you may have symptoms in many parts of the body. You may have muscle problems, including loss of balance, muscle spasms, numbness, trouble moving your arms or legs, even trouble walking. You may have bowel and bladder problems, such as constipation, trouble urinating, or a frequent urge to urinate. You may have double vision, eye pain, or uncontrolled eye movements. You will probably be tired a lot, and it's often worse in the late afternoon. And those are just a few of the many possible symptoms of MS.Since symptoms of MS may mimic those of other nervous system disorders, your doctor will want to rule those out. Your doctor may suspect MS if you have trouble with two different parts of your central nervous system (such as abnormal reflexes) at two different times.A neurological exam may show you have reduced function in one area of your body, or it may be spread over many parts of your body. You may have abnormal reflexes, decreased ability to move a part of your body, a loss of sensation. An eye exam might show abnormal pupil responses, changes in your visual field, or trouble seeing.There is no known cure for MS, so your doctor will focus on therapies to slow down the disorder, to control your symptoms and help you maintain a normal quality of life. Your doctor can prescribe different medicines to help with this. You may have to take several medications.Life expectancy with MS can be normal, or almost normal. Most people with MS continue to walk and function at work with minimal disability for 20 or more years. The amount of disability and discomfort can depend on how often you have attacks, on how bad they are, and what part of the central nervous system is affected by each attack. Most people return to normal or near-normal function between attacks. But, over time, many people with MS will need a wheelchair.To help you maintain a normal quality of life, your doctor may suggest physical therapy, speech therapy, occupational therapy, and support groups, depending on your needs. Starting an exercising program early in the course of your disorder, eating right, and getting enough rest can also help.
Symptoms vary because the location and severity of each attack can be different. Attacks can last for days, weeks, or months. Attacks are followed by remissions. These are periods of reduced or no symptoms. Fever, hot baths, sun exposure, and stress can trigger or worsen attacks.
It is common for the disease to return (relapse). The disease may also continue to get worse without remissions.
Nerves in any part of the brain or spinal cord may be damaged. Because of this, MS symptoms can appear in many parts of the body.
Bowel and bladder symptoms:
Numbness, tingling, or pain:
Other brain and nerve symptoms:
Speech and swallowing symptoms:
Fatigue is a common and bothersome symptom as MS progresses. It is often worse in the late afternoon.
Symptoms of MS may mimic those of many other nervous system problems. MS is diagnosed by determining if there are signs of more than one attack on the brain or spinal cord and by ruling out other conditions.
People who have a form of MS called relapsing-remitting have a history of at least two attacks separated by a remission.
In other people, the disease may slowly get worse in between clear attacks. This form is called secondary progressive MS. A form with gradual progression, but no clear attacks is called primary progressive MS.
The health care provider may suspect MS if there are decreases in the function of two different parts of the central nervous system (such as abnormal reflexes) at two different times.
An exam of the nervous system may show reduced nerve function in one area of the body. Or the reduced nerve function may be spread over many parts of the body. This may include:
An eye exam may show:
Tests to diagnose MS include:
There is no known cure for MS at this time. But, there are treatments that may slow the disease. The goal of treatment is to control symptoms and help you maintain a normal quality of life.
Medicines are often taken long-term. These include:
Medicines are more effective for the relapsing-remitting form than for other forms of MS.
The following may also be helpful for people with MS:
Living with MS may be a challenge. You can ease the stress of illness by joining an MS support group. Sharing with others who have common experiences and problems can help you not feel alone.
The outcome varies, and is hard to predict. Although the disorder is life-long (chronic) and incurable, life expectancy can be normal or almost normal. Most people with MS are active and function at work with little disability.
Those who usually have the best outlook are:
The amount of disability and discomfort depends on:
Most people return to normal or near-normal function between attacks. Over time, there is greater loss of function with less improvement between attacks.
Call your provider if:
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Last reviewed on: 8/13/2015
Reviewed by: Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.