Multiple Sclerosis (MS)

What is multiple sclerosis?

Multiple sclerosis, often called MS, is a disease that affects the central nervous system—the brain and spinal cord. It can cause problems with muscle control and strength, vision, balance, feeling, and thinking.

Your nerve cells have a protective covering called myelin. Without myelin, the brain and spinal cord can’t communicate with the nerves in the rest of the body. MS gradually destroys myelin in patches throughout the brain and spinal cord, causing muscle weakness and other symptoms. These patches of damage are called lesions.

MS is different for each person. You may go through life with only minor problems. Or you may become seriously disabled. Most people are somewhere in between. Generally, MS follows one of four courses:

• Relapsing-remitting, where symptoms fade and then return off and on for many years.
• Secondary progressive, which at first follows a relapsing-remitting course and then becomes progressive. “Progressive” means it steadily gets worse.
• Primary progressive, where the disease is progressive from the start.
• Progressive relapsing, where the symptoms are progressive at first and are relapsing later.

What causes MS?

The exact cause is unknown, but most experts believe that MS is an autoimmune disease. In this kind of disease, the body’s defenses, called the immune system, mistakenly attack normal tissues. In MS, the immune system attacks the central nervous system—the brain and spinal cord.

Experts don’t know why MS happens to some people but not others. There may be a genetic link, because the disease seems to run in families. Where you grew up may also play a role. MS is more common in those who grew up in colder regions that are farther away from the equator.

What are the symptoms?

Symptoms depend on which parts of the brain and spinal cord are damaged and how bad the damage is. Early symptoms may include:

• Muscle problems. You may feel weak and stiff, and your limbs may feel heavy. You may drag your leg when you walk.
• Vision problems. Your vision may be blurred or hazy. You may have eyeball pain (especially when you move your eyes), blindness, or double vision.
• Sensory problems. You may feel tingling, a pins-and-needles sensation, or numbness. You may feel a band of tightness around your trunk or limbs.
• Balance problems. You may feel lightheaded or dizzy or feel like you’re spinning.

How is MS diagnosed?

Diagnosing MS isn’t always easy. The first symptoms may be vague. And many of the symptoms can be caused by problems other than MS.

MS is not diagnosed unless a doctor can be sure that you have had at least two attacks affecting at least two different areas of your central nervous system. The doctor will examine you, ask you questions about your symptoms, and do some tests. An MRI is often used to confirm the diagnosis, because the patches of damage (lesions) caused by MS attacks can be seen with this test.

How is it treated?

Medicines are used to treat MS:

• During a relapse, to make the attack shorter and less severe.
• Over a long period of time, to keep down the number of attacks and how severe they are and to slow the progression of the disease. (This is called disease-modifying therapy.)
• To control specific symptoms.

You may find it hard to decide when to start taking the drugs that slow the progression of MS. The drugs may not work for everyone, and they often have side effects. You and your doctor will decide together when you should start any of these drugs.

How do you live with MS?

There is no cure for MS. Treatment and self-care can help you maintain your quality of life.

Physical therapy, occupational therapy, and speech therapy can help you manage some physical problems caused by MS. You can also help yourself at home by eating balanced meals, getting regular exercise and rest, and learning to use your energy wisely.

Dealing with the physical and emotional demands of MS isn’t easy. If you feel overwhelmed, talk to your doctor. You may be depressed, which can be treated. And finding a support group where you can talk to other people who have MS can be very helpful.

Frequently Asked Questions