What is Multiple Sclerosis?

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord. In MS, the immune system attacks the protective sheath that covers nerve fibers and causes communication problems between your brain and rest of your body. Eventually, MS can cause permanent damage or deterioration of nerve fibers. There is no cure for MS, but there are treatments that can help speed recovery from attacks and manage symptoms.

Symptoms of Multiple Sclerosis

The symptoms of MS will differ from person to person depending on the location of the affected nerve fibers. The most common symptoms include:

• Numbness or weakness in one or more limbs that typically occurs on one side of your body.
• Tingling
• Lack of coordination
• Inability to walk or imbalance.
• Partial or complete loss of vision, usually in one eye.
• Prolonged double vision.
• Blurry vision
• Vertigo
• Problems with sexual, bowel and bladder function.
• Fatigue
• Slurred speech
• Cognitive problems
• Mood disturbances

For most people with MS, it is a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are often followed by quiet periods of remission that can last ranging from weeks to years.

Signs of worsening symptoms typically include small increases in body temperature and problems with mobility and gait. Some people with MS experience a gradual onset and steady progression of signs and symptoms without any relapse.

Diagnosis and Treatment of Multiple Sclerosis

Your provider will perform a physical exam and review your medical history. With MS, there are no specific tests used to diagnose. Instead, your provider will rule out other conditions that produce similar signs and symptoms, known as a differential diagnosis. Other tests your provider may need include:

• Blood tests – to help rule out diseases with symptoms like MS.
• Spinal tap – a small amount of cerebrospinal fluid is removed from your spinal cord to test for abnormalities in antibodies that are associated with MS.
• MRI – can reveal areas of MS on your brain, cervical and thoracic spinal cord.

Since there is no cure for MS, treatment typically focuses on speeding recovery from attacks, reducing relapses, slowing the progression, and managing symptoms. A few treatment options for MS include:

• Corticosteroids – can help to reduce nerve inflammation. Side effects may include insomnia, increased blood pressure, increased blood glucose levels, mood swings and fluid retention.
• Plasma exchange – the plasma in your blood is removed and separated from your blood cells. The blood cells are then mixed with a protein solution and put back into your body. This treatment is common for new, severe symptoms.

Treating relapses in MS include a variety of disease modifying therapies (DMTs). Much of the immune response associated with MS occurs in the early stages of the disease. Aggressive treatment with DMTs can help to lower the relapse rate, slow formation of new lesions, and potentially reduce the risk of brain atrophy and disability accumulation.

Treatments for symptoms of MS include:

• Physical therapy – can help to build muscle strength, manage leg weakness and other gait problems.
• Muscle relaxants – can help with painful or uncontrollable muscle stiffness or spasms, especially in your legs.
• Medication – to help reduce fatigue and increase walking speed.