Multiple sclerosis is a neurological disease that directly affects the nerves of your body. In the following article, we’ll review the essentials of the condition.
Multiple sclerosis affects around 2 million people all over the world. It commonly affects women more than men. Also, the onset of symptoms usually happens around 20 to 40 years of age. White people and people who live in template climates are often the most affected. Though it is rarely fatal, multiple sclerosis has no cure available yet.
In the next reading, you will find all the frequently asked questions about multiple sclerosis. Like the symptoms, complications, diagnosis, and treatment explained directly from a doctor, in a nutshell, all you need to know about the symptoms, complications, diagnosis, and treatment. Don’t worry; it is all briefly and simply explained, so you end up with integral knowledge of this condition.
What is multiple sclerosis?
Multiple sclerosis (MS) is a chronic disease that affects the nerves of your central nervous system (CNS), which comprises the brain and spinal cord. In patients with MS, the immune cells destroy the myelin sheath that covers the nerves. This process is known as demyelination.
The myelin is in charge of covering the nerves and transmitting the nervous impulse through nerves. When this coverage is affected, transmitting nervous impulses becomes impossible. This results in the symptoms typical of multiple sclerosis. Since demyelination happens because of your immune system’s attack, multiple sclerosis can be considered an autoimmune disease.
Multiple sclerosis can affect nerve fibers in your CNS, which comprise your brain, spinal cord, and optical nerves (nerves that allow you to see).
The inflammation and damage of the nerves can be both temporary or permanent. This explains why MS patients can experience periods without symptoms and periods of relapses.
The cause of multiple sclerosis is not known. However, doctors think it can be a combination of genetic and non-genetic factors. Environmental factors can also be involved.
What kind of disease is multiple sclerosis?
First of all, there is no cure for multiple sclerosis; patients will have to live with it for life. This makes it a chronic condition. Also, due to the structures it affects, MS is classified among neurological disorders.
Multiple sclerosis can also be considered an autoimmune disorder. This because the cause for the damage of the nerves is the attack of your own immune system.
What are the four types of multiple sclerosis?
Multiple sclerosis is usually divided into four types. This division considers the frequency of relapses, time of progression, and lesions in the MRI. These four types are:
- Relapsing-remitting MS (RRMS): It is the most common disease course; around 85% of patients will experience this type of MS. The most important characteristic is that patients have clearly defined attacks of neurologic symptoms. After this, a period of partial or complete recovery follows. During periods of remission, all symptoms can go away, or some can continue and become permanent. Also, new symptoms can appear after a relapse.
- Secondary progressive MS (SPMS): This type usually starts as a relapsing-remitting course. Then, patients will transition to progressive worsening of neurological functions. It can also be categorized as SPMS with progression (disability accumulation over time) or without progression.
- Primary progressive MS (PPMS): In this type, patients experience worsening of their neurologic symptoms from the onset of the disease. However, they don’t experience early relapses or remissions.
- Progressive relapsing MS (PRMS): It is the least common type of disease. The main characteristic is that there is a progressive worsening of symptoms since the beginning. Patients will often experience relapsing or worsening of their symptoms.
What are the risk factors for MS?
Like we mentioned before, the cause of multiple sclerosis remains unknown. However, doctors have identified several risk factors that can make you more likely to develop this condition.
- Age: Although MS can occur at any age, the onset of symptoms usually starts between 20 to 40 years of age.
- Sex: Women are more likely to develop an autoimmune disease, including multiple sclerosis.
- Genetics: The development of MS can be linked to genetic factors. Patients with a family history of multiple sclerosis have a higher chance of having it too.
- Infections: Certain viral infections can act as a trigger for your immune system to attack your own cells. The most common virus associated with MS is the Epstein-Barr virus.
- Climate and Race: MS is more common in white people, especially in Northern Europe. Also, people who live in temperate climates countries like Canada, the US, and Europe have a higher chance of getting MS.
- Vitamin D: Lower levels of vitamin D are linked to a higher chance of having MS. This happens with poor exposure to sunlight.
- Other autoimmune diseases: If you already suffer from an autoimmune disease like type 1 diabetes or psoriasis, you can develop MS more easily.
What are the symptoms of multiple sclerosis?
Multiple sclerosis can cause a large group of neurological symptoms. Also, no two patients with MS will experience the same symptoms. The progression of the disease is also different for each person who suffers it. Here, we’ll mention the most common multiple sclerosis symptoms:
- Pain: This trait is caused by the alteration in the way nerves pass the impulses. It can include band-like pain around the chest or pain in the neck, arms, legs, and feet.
- Vision problems: Like seeing double on lateral gaze. This is the result of optic neuritis (inflammation of the optic nerve).
- Numbness and tingling: Or an overall altered sensation as a result of sensory nerve damage.
- Muscle weakness, spasms, stiffness, and mobility problems: As a result of motor nerve damage.
- Cognitive impairment: Like having trouble thinking, planning, and learning.
- Bladder dysfunction: Affected nerves of your bladder may result in urinary incontinence. For the same reason, MS can cause bowel dysfunction.
- Impaired speech or swallowing in the advanced stages of the disease
- Anxiety and depression
How does multiple sclerosis begin?
There is no exact way in which multiple sclerosis can begin. It is usually very different from patient to patient. However, some of the MS symptoms we mentioned before acting as early alarms of MS.
- Optic neuritis: The inflammation of the optic nerve is one of the early signs of MS. This can cause symptoms like blurred vision, eye pain, and headaches. It usually starts on only one side, but it can rapidly affect your other eye. This can lead to partial or total vision loss.
- Partial transverse myelitis: Or, in simpler words, spinal cord inflammation. This causes symptoms like numbness, tingling, weakness, and sphincter dysfunction from a specific level of your spine.
Other common early symptoms include bowel problems (constipation, diarrhea, or incontinence), depression, fatigue, pain (acute or chronic), and sexual problems.
How common is MS?
As of today, 2.1 million people are affected by multiple sclerosis worldwide. As we mentioned before, the disease can be seen in all countries and races. However, it is most common in Northern Europe.
Furthermore, it is also more common for white people. In the US, around 58 to 95 new cases appear every 100,000. Health associations of the US estimate that around 400,000 people live with the condition nowadays. However, this condition can cause many symptoms that can be mistaken for other diseases. This makes it very difficult to diagnose. Difficulties in the diagnosis can cause a lower rate of reported cases of the disease.
Can you prevent multiple sclerosis?
To this day, there is no proven way to prevent multiple sclerosis from occurring. Doctors are putting a lot of effort into this. However, since there is no known cause for MS, it is not possible to know a way to prevent the disease.
We just have to wait for medical investigations to understand what causes this disease in order to prevent it. Identifying possible risk factors for the condition is a critical step in understanding and preventing MS.
What are the complications?
Like we mentioned before, MS is not a fatal disease. However, there is no cure available. This results in a chronic disease that will typically progress no matter what. Among the most common complications we find:
- Muscle stiffness or spasms: This can cause that a person can’t perform basic daily activities.
- Paralysis, especially of the legs: Resulting in a total impossibility to walk.
- Epilepsy or seizures
- Trouble swallowing or speaking: That can result in choking and complete loss of speech.
- Bowel and urinary incontinence
What is a multiple sclerosis relapse?
A multiple sclerosis relapse or “attack” is the worsening of existing MS symptoms or the appearance of new symptoms. MS relapses are usually different from each other, even in the same patient. They can go from mild to severe and affect a person’s daily activities.
Some relapses can include only one symptom or two or more symptoms at the same time. This last characteristic will depend on how many parts of the nervous system are being affected at the same time.
To be considered an attack, the exacerbation should last at least 24 hours. Also, it should be separated from the previous attack by at least 30 days and in the absence of infection. An MS exacerbation can last anywhere from few days to weeks or months.
Do you have MS or fibromyalgia?
Fibromyalgia is another chronic condition that can cause symptoms similar to the ones in MS. However, the most critical symptom in fibromyalgia is chronic, intense pain. Though many patients with MS can experience pain, many patients never experience pain.
Moreover, patients with MS often have mild pain. On the other side, fibromyalgia always causes pain. In fact, it is one of the diagnostic criteria to determine if a patient has fibromyalgia. Another important difference is the presence of vision problems. These are very common in MS due to inflammation of the optic nerve.
Conversely, fibromyalgia won’t cause any visual symptoms. In all the other aspects, MS and fibromyalgia can be very similar. Both conditions can cause depression, fatigue, memory issues, and numbness and tingling.
What is the link between transverse myelitis and multiple sclerosis?
As we mentioned before, transverse myelitis is basically inflammation of your spinal cord. This inflammation usually results in symptoms like numbness, tingling, sphincter dysfunction, and weakness or loss of movement.
The important characteristic here is that these symptoms occur from a certain level of your spine. The link between transverse myelitis and multiple sclerosis is basically that MS can cause myelitis. This happens because the problem in MS is precisely inflammation of the nerve and further damage and scar tissue.
The latter translates into problems for nerves to transmit the nervous impulse that goes up to your brain to process sensation and movement. This issue can occur in any nerve of your body, including your spinal cord.
How is MS diagnosed?
If you think you may have multiple sclerosis, you need to go to the doctor. Only trained medical professionals are qualified to make an MS diagnosis. And even for them, the diagnosis may be difficult.
A doctor will start by asking questions about the symptoms you’ve been having and your medical history. Then, they will perform a physical examination, checking for specific signs of the disease.
After this, a doctor may have a diagnostic impression that they’ll need to confirm. In the case of MS, the diagnosis is made through clinical findings, imaging studies, and cerebrospinal fluid examination. You must know that MS cannot be diagnosed after one single attack. You’ll have to wait and see if you experience those symptoms again later. Keep in mind that MS attacks last for at least 24 hours.
Magnetic resonance imaging (MRI) remains the best imaging study to confirm MS and study the disease progression. It can help observe both the brain and the spinal cord. An MRI shows abnormalities in around 90% of patients diagnosed with multiple sclerosis.
Another diagnostic method is evoked potentials. With this study, doctors record the timing of CNS to certain stimuli. This study helps identify lesions that are not visible in imaging studies. Also, a lumbar puncture can be done to obtain some cerebrospinal fluid and study it. This is not typically done anymore but can be useful when an MRI is not available.
What are gadolinium-enhancing lesions in multiple sclerosis?
Gadolinium enhancing is a way to observe the damage caused by multiple sclerosis in your brain and spinal cord. Gadolinium acts as a type of contrast to easily expose areas of nerve damage in the nerve cells and CNS. It is a useful marker of MS lesions and inflammation. It is widely used in both the diagnosis and monitoring of patients with typical MS lesions. With this method, doctors observe better these areas of damage, to determine if the disease progresses.
Which types of doctors and specialists treat multiple sclerosis?
If you think you have MS, you should go to the doctor. You can get help from your primary care physician in the first place. Then, if the PCP agrees that your symptoms may correspond to multiple sclerosis, they’ll refer you to a neurologist. A neurologist is a doctor with a special degree in diseases of the nervous system. The neurologist is the doctor that will officially make the diagnosis and start the right treatment. You can also attend to a neuropsychologist; they will help you with the mental symptoms of MS.
How is multiple sclerosis treated?
The treatment for multiple sclerosis can be very complicated. This is why you must get professional help in order to get the right treatment. The focus of the MS treatment is immunomodulatory treatment.
The latter means treatment to stop your immune system from destroying your own nerve cells. The treatment of MS is not able to cure the disease, but it will ease the symptoms. Also, the treatment available can help in preventing relapses or increasing the time in between relapses.
Furthermore, the treatment can also help slow down the progression of the disease—for example, glatiramer acetate, which is a synthetic protein that reduces the frequency of relapses. Many other medications are being studied right now, but they cannot be used until clinical trials are finished.
Do you have symptoms of this disease?
This tool is a Multiple Sclerosis Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for the condition. Therefore, the tool will tell anybody who uses it the likelihood of having MS. Using the tool is free and would only take a few minutes.