What is Multiple Sclerosis (MS)?
Multiple sclerosis (MS) is an autoimmune disease, affecting the central nervous system which involves the brain, spinal cord and optic nerves.
This condition affects more than two million people worldwide. It is more prevalent in females, affecting about two to three times more women than men. (1)
The exact causes of multiple sclerosis remain unknown. Genes, environmental factors, such as lack of sunlight and smoking, and viruses are thought to play a part. (2)
Symptoms
To better understand the symptoms associated with this condition, we will look at how the central nervous system works and explain how multiple sclerosis affects it.
The central nervous system contains nerve fibers (axons), which transmit messages from the brain throughout the rest of the body. Within nerve fibers are nerve cells (neurons) which enable us to move, feel, speak, hear, see and think.
Each nerve fiber is covered by a protective sheath called myelin. This is made up of fatty substances (lipids) and proteins. Myelin protects and insulates the nerve fibers. This, in turn, helps transmissions from the brain travel quickly and smoothly to the rest of the body.
The immune system protects our body from unwanted infections and foreign tissues which might invade the body. It produces white blood cells, called T cells, which attack these threats.
When a person has multiple sclerosis, the body’s immune system sees myelin as a threat and attacks it. The myelin sheath becomes damaged or stripped from the nerve fibers.
The damage to the myelin can be complete or partial. It can lead to formation of scar tissue, called plaque or lesions.
The central nervous system becomes inflamed. When this happens, the messages traveling through it become slower, interrupted or stop altogether.
This response by the immune system can also damage the nerve fibers. (3, 4)
The symptoms associated with multiple sclerosis (MS) are many and varied. Many of them can interfere with daily life and a person’s ability to function.
The most common symptoms include:
Fatigue
Fatigue, a feeling of extreme tiredness and lethargy is a common symptom of multiple sclerosis (MS). This symptom affects about 80 percent of people with the condition.
Walking Difficulties
Weakness and a loss of balance interfere with a person’s ability to walk. Spasticity, which causes muscles to permanently contract, results in tightness and stiffness in the muscles.
Numbness and Tingling
Often, one of the early symptoms of this condition is numbness or tingling. It might be felt in the body, face, arms or legs.
Spasticity
Feelings of stiffness and involuntary muscle spasms will be present in the extremities. This occurs most often in the legs.
Weakness
Damage to the nerves which control and stimulate the muscles causes them to become weak. This is especially the case when they are not being used.
Vision
Blurred or impaired vision is another early sign often experienced by some people. Colors and contrast may not be clearly defined. It might also be painful to move the eyes.
Dizziness and Vertigo
A feeling of dizziness, lightheadedness or loss of balance are not uncommon. Occasionally, people might develop vertigo, and feel that either they or the world around them, is spinning.
Bladder Dysfunction
The interference of signals from the brain can lead to bladder dysfunction. A person might feel the need to urinate more often or not be able to empty their bladder fully. The need to urinate may be more urgent and they could experience incontinence.
Bowel Issues
Bowel function can be affected, and constipation, or loss of control of the bowels, could occur.
Pain
Pain can be felt throughout the body. It might be described as aching, burning, pins and needles or prickling sensations. The pain can be acute or chronic.
Neuropathic pain may feel like a squeezing or stabbing sensation. Spasticity can cause muscle cramps.
Pain which feels like an electric shock could be present the face. It can also travel down the spine from the head.
Cognitive Function
The ability to remember and learn new things can be impaired. The person might also find it difficult to problem solve, focus, organize and generally process information.
Emotional Issues
Changes in emotions are common in multiple sclerosis sufferers. They can become depressed or irritable and be subject to mood swings. They may experience instances when they either laugh or cry uncontrollably.
Clinical depression is often diagnosed among people with this condition.
Sexual Problems
Both emotional and neurological changes can affect the libido.They can also impair the ability to function sexually.
Less Common Symptoms
There are some symptoms which are less common. These include: slurred speech, difficulty swallowing, itching, headaches and hearing loss.
Uncontrollable shaking (tremors), seizures and breathing problems might also be experienced.
Secondary Symptoms
As a result of the main and less common symptoms of this condition, other complications can arise.
Bladder dysfunction can lead to an increased risk of frequent urinary tract infections.
Muscles might lose tone and become weak. Bones can become more fragile and standing upright may be difficult. Pressure sores can form as a result of immobility. (5)
Stages
There are four categories applied to multiple sclerosis; these are:
Relapsing-Remitting Multiple Sclerosis (MS)
This is characterized by a flare-up (exacerbation or relapse) of symptoms which then disappear or improve (remission). Approximately 85 percent of people with multiple sclerosis (MS) fall into this category.
The symptoms can occur for days, weeks or months and then gradually improve. Periods of remission may last for several years.
Secondary Progressive Multiple Sclerosis (MS)
This usually develops following the relapsing-remission stage. The symptoms of the disease become worse, sometimes accompanied by periods of remission.
The chances of neurological damage are increased and there is more likelihood of disability.
The symptoms may level off in their severity, reaching a plateau.
Primary Progressive Multiple Sclerosis (MS)
Affecting about 10 percent of people with multiple sclerosis (MS), this is indicated by symptoms which gradually get worse from the onset. Relapses and remissions will not be experienced. There might be occasional plateaus and stabilization in symptoms.
Progressive Relapsing Multiple Sclerosis (MS)
This type of multiple sclerosis is rare; it is thought to affect less than five percent of sufferers. The disease is progressive from onset, presenting with intermittent flare-ups. The symptoms become worse as the condition progresses and there will be no periods of remission. (6, 7)
Treatment
There is currently no cure for multiple sclerosis (MS). There are treatments available to deal with both the symptoms and progression of the disease in some cases.
Steroid drugs can be prescribed to help with symptoms such as inflammation.
There are drugs which are approved for use to treat some forms of multiple sclerosis (MS). They either delay progression, treat relapses or reduce the frequency and severity of attacks.
Many medications used to treat this disease have serious side effects. Therefore, they should only be taken under medical supervision.
Some of the drugs are taken orally, while others are administered intravenously or by infusion.
Beta interferon drugs might reduce the amount of relapses and slow down the progression of the condition.
Monoclonal drugs are antibodies which aim to change the body’s immune response in respect of inflammation.
Associated spasticity can be helped with muscle relaxants or tranquilizers.
Exercise and physical therapy can help keep people mobile.
Antidepressants might be effective in combating psychological symptoms, such as depression, fatigue and mood swings. (8)
FAQ
What is multiple sclerosis (MS)? Multiple sclerosis (MS) is an autoimmune disease which affects the central nervous system (CNS).
What are the signs of multiple sclerosis (MS)? There are many signs and symptoms associated with this condition. The common symptoms include fatigue, pain, muscle issues, bladder and bowel problems, cognitive and emotional issues.
How do you develop multiple sclerosis (MS)? The exact reason why people develop this condition is unknown, however genetics, environmental factors and infections are thought to play a part.
How are you diagnosed for multiple sclerosis (MS)? Diagnosis of this condition can be challenging for medical professionals. The symptoms can often be attributed to other conditions. There are a number of tests which can confirm diagnosis. These include MRI scan, lumbar puncture, neurological test and blood test. (9)
What is the best treatment for multiple sclerosis (MS)? There is no treatment for the condition itself. However, doctors can prescribe medication to help relieve various associated symptoms.
What are the long term complications of multiple sclerosis (MS)? For many the symptoms of this condition are not incapacitating. However, when severe it can affect a person’s ability to walk, talk and write.
Is multiple sclerosis (MS) considered a disability? This condition is considered a disability. (10)
Is there a cure for multiple sclerosis (MS)? There is no known cure for the condition at this time.
Is multiple sclerosis (MS) life threatening? This condition is not considered life-threatening. It might, however, lower a person’s naturally expected lifespan. (11)
Summary
Multiple sclerosis (MS) is an autoimmune disease which affects the central nervous system (CNS).
The symptoms are varied and in many cases the disease can be in remission for several years between flare-ups.
There is currently no cure for multiple sclerosis (MS). Diagnosis can be challenging for doctors, but there are tests which can confirm the presence of the disease.
The good news is many treatments are available to help people manage the condition and lead productive, full lives.