What is multiple sclerosis?

Published: Tuesday, March 12, 2024
Neurology

While you may have heard of MS and may even know of a celebrity or someone in your life living with MS, there is a lot about the condition you may not know. For example, did you know that almost one million Americans have MS? And, while MS is the most common disabling neurological condition among young adults, many people with MS live normal lives and there has been significant progress in treatment over the last few decades. Keep reading to learn more about the condition, including how it’s treated.

An autoimmune condition

When the body is functioning optimally, a person’s immune system fends off germs and other potential hazards to the body. When a person has an autoimmune condition like MS, the immune system is too active and some of the cells that are usually responsible for fighting off viruses and bacteria mistakenly attack the body.

In MS, these cells attack myelin, which is a substance that forms the sheath surrounding nerve fibers in the body. Over time, this damages the sheath and can slow down or even prevent messages from traveling between the body and the brain. This is similar to a damaged charging cable that has the wires exposed from damage to the coating – the cable may still charge your device, but it may take longer.

The symptoms of multiple sclerosis

A variety of symptoms can result from this disruption in signaling, depending on which part of the nervous system is affected.  

There are two main patterns that new symptoms can take. In a relapse, new symptoms develop and worsen over the course of hours to days and improve at least partially over the course of days to weeks. In progression, symptoms develop and worsen over the course of months to years without sustained improvement. Often, both occur in the same individual over the course of their life. Symptoms of a prior relapse can also come back when the body is otherwise stressed; for example, by an infection, lack of sleep, stress, overheating, etc. This is termed a pseudo-relapse because it is often mistaken for a relapse.

Symptoms of a relapse can include blurry vision with pain behind the eyes when looking around, double vision, dizziness, muscle weakness, numbness and/or tingling, clumsiness, a lack of balance when walking or bladder control problems.

Additional symptoms can develop over time, and each relapse or attack may cause symptoms affecting different parts of the body. These symptoms can include extreme fatigue, involuntary muscle contractions and stiffness, a feeling of squeezing around the torso (sometimes called an “MS hug”), sexual dysfunction, bowel problems, pain and itching and emotional, mental and cognitive changes.

There are three different types of MS, named after the way their symptoms change over time:

  • Relapsing-remitting MS. In most individuals with MS, the first symptoms that are clearly from MS are in the form of a relapse. Early on, most people with MS have periods without experiencing any new symptoms, which is known as remission. This pattern is known as relapsing-remitting MS.
  • Secondary-progressive MS. When an individual with relapsing-remitting MS begins to have progression independent of relapse activity, this is termed secondary-progressive MS. It is often difficult to determine when this change happens.
  • Primary-progressive MS. This type of multiple sclerosis is relatively uncommon. It is marked by symptoms that appear and progressively worsen with no noticeable periods of remission.

Multiple sclerosis can affect anyone, but it’s most diagnosed among those between ages 20 and 40. With improvements in treatment, the average age of someone living with MS in the US is between 55 and 64. It’s more common among women than men. In the US, it is equally as likely in individuals who are Black and White and somewhat less common among individuals of other socially defined races.

Diagnosing & treating multiple sclerosis

If you’re experiencing any of the symptoms of multiple sclerosis outlined above, your first step is to check in with your primary care provider. Many of those symptoms can also be signs of less serious, or even fleeting, medical conditions.

Your primary care provider can do a full examination and help you determine next steps, which may include referral to a neurologist. Diagnosing multiple sclerosis is a complex process that often includes multiple tests, such as MRI scans of the brain and spinal cord, lumbar puncture (otherwise known as a spinal tap), blood tests and specialized eye exams.

If a multiple sclerosis diagnosis is confirmed, a neurologist and other care providers can work with you to put together a personalized treatment plan based on your specific symptoms, needs and preferences. While there is currently no cure for the disease, there are many different treatment options available, with additional treatments being researched and developed.

Treatment for multiple sclerosis has multiple purposes. Because damage from MS is typically not reversible, the first goal of treatment is to decrease the number of attacks and slow progression. This can be done with infused, injected or oral treatment known as disease modifying therapy. Treatment is also used to control symptoms and maintain quality of life. Medications are often used long-term, in combination with other treatments and assistive therapies. Those with MS may benefit from:

  • Lifestyle changes, including a healthy diet and stress management
  • Occupational, physical or speech therapy
  • Prescribed and supervised exercise
  • Energy management techniques
  • Complementary therapies, such as acupuncture
  • Vitamin supplements
  • Fall prevention techniques
  • Assistive devices to help with mobility or other challenges

The best type of treatment will vary from patient to patient, depending on the type of MS being experienced and the symptoms it causes. If you are diagnosed with the condition, working with a neurologist who specializes in multiple sclerosis can help you find the right combination of medications and other therapies to ease your symptoms and slow the progress of the condition.

Learn more

Northeast Georgia Physicians Group Neurology treats a wide range of neurological conditions, including multiple sclerosis. Call 770-219-6520 or click here for more information.