Information on Multiple Sclerosis (MS)

Multiple sclerosis is an autoimmune disease. It affects the central nervous system. With MS, the immune system attacks the body. Specifically it goes after the protective covering, called myelin, of the nerve fibers found in your brain and spinal cord. As a result, your nervous system has difficulty sending messages out to the rest of your body. After a while, the disease may cause permanent nerve damage.

Indicators of MS vary depend on which nerves are affected and how severely they’re damaged. Some people experience mild symptoms that do not require treatment, while others eventually lose their ability to do day-to-day tasks.

There is no cure for MS, though treatment can slow the progress of the disease, increase recovery time after an attack, and manage symptoms.

Early Symptoms of MS

The first signs of multiple sclerosis tend to appear between people aged 20 to 40. In most cases, the symptoms appear, then clear up, then return. Specific symptoms may last, while others come and go.

No two people who have MS experience the same set of symptoms. Symptoms depend on the area of the brain under attack, though some common first symptoms can include:

• Complete or partial loss of vision or blurred vision
• Double vision that doesn’t go away
• Tingling or numbness
• Pain
• Tremors
• Lack of physical coordination
• Feeling unsteady on your feet
• Slurred speech
• Dizziness
• Fatigue
• Problems with bladder and bowel control
• Depression
• Difficulty focusing or remembering
• Muscle weakness
• Sexual problems

If you notice symptoms, it’s important to keep track of them so that your doctor can monitor the course of the illness. This can make it easier for your doctor to prescribe effective treatment.

You should see a doctor if you experience any of these symptoms.

What Causes MS?

The exact cause of multiple sclerosis is unknown. Research has identified environmental and genetic factors that play a role in the development of the disease. But recent data also suggests that a possible virus may contribute to the development of MS. 
It's good to know that there are some interesting trends regarding the prevalence of MS. The disease is more common in countries with temperate climates, with prevalence increasing the further you are from the equator. MS is especially common in northern Europe, Scotland, and Scandinavia. These statistics, along with documented MS outbreaks—for instance the one that occurred after WWII to a group of people living off the coast of Denmark—suggest that there is an environmental factor at play, which effectively triggers the disease. In the United States, MS more commonly affects Caucasians than other ethnic groups.

Research also suggests that MS runs in families. First, second, and third degree relatives of individuals who have been diagnosed with MS are at an increased risk of also developing MS. Having a sibling who has MS means that you have a 2 to 5% chance of developing the disease as well.

Risk Factors

The following factors may increase your risk of developing multiple sclerosis:

• Sex. Women are twice as likely to develop MS compared to men. 
• Age. People between the ages of 15 and 60 are most likely to develop the disease, though MS can occur at any age.
• Race. White people are more likely to develop MS, particularly those who can trace their origins to Northern Europe. Native Americans, Asian Americans, and African Americans have the lowest risk.
• Family history. Having a parent or sibling who has MS can put you at an increased risk of developing MS.
• Climate. It's been found that MS is even more common in temperate regions, including northern U.S., Canada, Europe, Scandinavia, New Zealand, and southeastern Australia.
• Infections. Some viruses, such as Epstein-Barr (mononucleosis), have been linked to MS. 
• Other autoimmune diseases. There are several other autoimmune diseases which can increase the risk factor. The first is type 1 diabetes. There's also the potential for people with thyroid disease. Finally, those people with inflammatory bowel disease are at a higher risk of gaining MS.
• Smoking. After you experience an initial bout of symptoms, symptoms are more likely to reappear if you’re a smoker. 

How Does MS Progress?

In the majority of cases, MS is relapsing-remitting. People who suffer from the relapsing-remitting version experience periods where new symptoms occur or previous symptoms reappear. These symptoms usually improve, either partly or totally. These periods without symptoms, also known as remission, can last months or even years.

Of those diagnosed, 60% to 70% of people who have relapsing remitting MS will eventually experience steady symptoms with or without remission. This scenario is referred to as secondary progressive MS.

When symptoms worsen, they tend to affect your ability to walk. The rate of progression varies greatly from person to person.   

People who do not experience intermittent periods of remission have primary-progressive MS. Instead, their symptoms come on gradually and appear to progress without remission.  

Treatment

Multiple sclerosis has no known cure, but treatment can greatly improve the quality of life for people suffering from MS. The goal of treatment is to quicken recovery time after an attack, delaying the progression of the disease, and help manage symptoms. In some cases, no treatment is necessary.

Quickening Recovery Time

• Plasma exchange. This form of treatment involves removing plasma, a part of your blood, from your body. Your plasma is mixed with a protein solution called albumin and then returned to your body. This option is often used for people who don’t respond to other treatments.

Delaying Progression

There are currently no known treatments to delay the progression of primary-progressive MS.

For relapsing-remitting, aggressive treatment in the early stages of the disease is most effective. However, treatments that modify the course of MS come with significant health risks. Choosing the right therapy can depend on a number of factors, including your previous history of treatment and whether or not you want to have children.

Beta interferons are one of the most common medications used to treat MS, and are often effective in reducing the frequency of relapses. It can also reduce the intensity of relapses. They are injected into the muscle or under the skin. Side effects include flu-like symptoms.

Managing Symptoms

• Physical therapy. Physical and occupational therapists can help MS patients to learn stretching and strengthening exercises that can make it easier to perform day-to-day tasks.
• Muscle relaxants. Medication can help to treat muscle stiffness or painful spasms.
• Other medication. Medications may be prescribed to help reduce symptoms such as fatigue, depression, sexual problems, and bladder or bowel control issues.

Alternative medicine. Alternative medicine is frequently used to complement medical treatment and help MS patients manage symptoms such as pain and fatigue—though there is a lack of existing research to support the use of such techniques. Common activities include massage, dietary changes, yoga, meditation, exercise, and acupuncture. Always consult your primary care physician before starting alternative therapy.