What is multiple sclerosis (MS)?
MS is a chronic disease of the central nervous system. It is an unpredictable condition that can be relatively benign, disabling, or devastating. Some individuals with MS may be mildly affected, while others may lose their ability to write, speak, or walk when communication between the brain and other parts of the body becomes disrupted.
What causes MS?
There are many possible causes of MS, including viruses, autoimmune disorders, environmental factors, and genetic factors. All of the possible causes share the common feature that the body's immune system is prompted to attack its own nervous tissue. In particular, in MS, the immune system commonly attacks the layer of protein called myelin that surrounds the connecting fibers between parts of the central nervous system. This layer of protein normally provides insulation for the electrical signals that the nervous system uses to communicate. When this insulation is destroyed, communication becomes interrupted and ultimately parts of the nervous system are permanently destroyed.
What are the symptoms of MS?
Symptoms of MS are erratic. They may be mild or severe, and of long duration or short. They may appear in various combinations, depending on the area of the nervous system affected. Throughout the course of the illness, an individual may experience any or all of the following symptoms, to a varying degree:
- Muscle weakness in the extremities
- Difficulty with coordination. Impaired walking or standing may result and partial or complete paralysis is possible.
- Spasticity. An involuntary increased tone of muscles leading to stiffness and spasms.
- Fatigue. This may be triggered by physical activity, but may subside with rest, or may be constant, persistent fatigue.
- Loss of sensation
- Speech impediments
- Hearing loss
- Double vision
- Bowel and bladder dysfunction
- Sexual dysfunction
- Emotional changes
Many people with MS experience cognitive impairments related to their disease. The effects of these impairments may be mild, often detectable only after comprehensive testing, and may include difficulty with any or all of the following:
- Poor judgment
The symptoms of multiple sclerosis may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
How is MS diagnosed?
Diagnosis is made from multiple sources of information including an accurate clinical history, a detailed neurological exam and diagnostic testing such as magnetic resonance imaging (MRI) and cerebral spinal fluid (CSF) analysis obtained by performing a lumbar puncture. Certain criteria need to be met along with eliminating the possibility of another disease "mimicking" the symptoms common to MS.
How is MS managed?
Although there is not any cure yet for MS, relapses, rate of progression, and it's symptoms can be managed often successfully.
Relapses are new or worsening neurological symptoms that are present longer than 24 hours and typically evolve over a week and may be present for several weeks before beginning to improve. Treatment of these relapses are with high-dose intravenous (IV) steroids given for 3 to 5 days sometimes followed by oral steroids "taper" if felt necessary. It is believed that steroids do not have any long-term benefit on individuals with MS but can hasten the recovery from a relapse.