Multiple sclerosis, commonly referred to as MS, is an autoimmune disease of the central nervous system which impacts the brain and the spinal cord. It presents across a variety of demographics, often in very different ways with progressive or recurring symptoms. Multiple types and stages of MS make it one of the more complicating disease to diagnose and treat, however, breakthroughs in research are being made every year.
What Exactly is it?
When it comes to understanding MS, you must first grasp the anatomical components of the nervous system in play, including the myelin sheath. The myelin sheath is a protective plasma membrane which wraps around nerve fibers and facilitates the conduction of electrical signals. When brain cells communicate with other cells, they send messages via electrical signals. The myelin sheath in part helps keep the messages on the right track to where they need to go.
With MS, the body’s immune system actually attacks that myelin sheath, damaging and breaking it down, eventually leading the nerve fibers themselves to deteriorate or become permanently damaged. Overtime, progressive forms of the disease can lead to immobility, trouble talking, incontinence, and other debilitating effects while relapsing forms of the disease may result in multiple years of remission where symptoms dissipate and do not affect day to day life.
There are four primary types:
- Relapsing-Remitting: The most common form of MS, RRMS results in periods of clearly defined symptom flare-ups (relapses) neurological in nature followed by remission where symptoms might partially or totally disappear.
- Secondary-Progressive: This disease track typically follows an RRMS diagnosis but only when symptoms stop remitting and progressively worsen.
- Primary-Progressive: A rare form of MS, PPMS is characterized by the continual worsening of symptoms progressively over time leading to worse and worse disability with no relapsing or remitting.
- Progressive-Relapsing: This rare form of MS encompasses a steadily worsening condition accompanied by acute flare-ups of new symptoms with no remission – also rare.
Who Gets it?
While there is no known cause for MS, there are trends in the demographics of people who develop the disease. MS is typically diagnosed between 15 and 60 years of age, and affects women twice as much as men. Caucasian people of European descent are at highest risk of developing MS, and it is far more common in regions further away from the equator with temperate climates like the United States, New Zealand, and Europe.
A family history of MS as well as existing conditions like Type 1 Diabetes or thyroid disease may put you at higher risk, and smoking can increase your chances of developing it as well. While MS is not required to be reported by doctors, it is believed that more than 2.3 million live with the disease according to the National Multiple Sclerosis Society.
What Are the Symptoms of it?
Depending on which nerve fibers are affected by the autoimmune disease, as well as how severely damaged they are, symptoms can vary drastically across patients with MS. They may include:
Lack of coordination and trouble balancing or walking
Weakness typically on one side of the body accompanied by numbness, often in the leg or trunk
Tremors, especially in the hand when reaching for something (intention tremor) or in a limb when sitting or standing (postural tremor)
Fatigue – mild to extreme
Incontinence – problems with bladder or bowel function
Problems swallowing (dysphagia)
Jumpy eye movements (tremors called Nystagmus)
Involuntary muscle spasms (muscle spasticity)
How is it treated?
While no one single test exists for diagnosing MS, doctors may administer an array of tests including blood tests, spinal taps, MRI’s, and evoked potential tests (electrical signal tests). These help them rule out other potential conditions which could be the cause of your symptoms, as well as provide insight into how your body is processing electrical signals, and whether MS lesions have formed on your brain.
Treatment is targeted to managing symptoms, mitigating the effects of acute flare-ups, and slowing the progression of the disease and degeneration of a patient’s brain. Corticosteroids are prescribed to help relieve nerve inflammation while an exchange of the plasma in your blood to filter in proteins might be executed if corticosteroids are ineffective.
For progressive forms of the disease, few pharmaceutical interventions are ever used, but relapsing-remitting types of MS might benefit from humanized immunoglobulin antibody medication, beta interferons, and other drugs which help reduce relapse rate. In addition to pharmacological aid, physical therapy, exercise, yoga, modified diet, acupuncture, and massage might address symptoms and side effects like depression or sexual disfunction.
Ease of use tools to support gait and aid immobility can simplify daily tasks for someone with MS – these might include car transfer tools, reacher grabbers, overbed tables and other assistive devices (click for more info). If you are concerned about the potential for symptoms you are experiencing to be caused by MS, consult your doctor about your need to see a neurologist. Their expertise will help you find answers and a customized treatment plan to keep you living the life you want as long as you can.