Multiple sclerosis is an autoimmune inflammatory disease that attacks the myelinated axons in the central nervous system, destroying the myelin and the axon (the projection of a nerve cell that conducts electrical impulses) to variable degrees, resulting in significant physical impairment. Myelin is the protective fatty coating covering nerve fibers in the brain and spinal cord. In multiple sclerosis, the myelin is damaged and depending on where the nerve damage occurs, the disorder may affect vision, sensation, coordination, movement, and bladder and bowel control. The demyelinating lesions of multiple sclerosis are called ‘plaques’ and appear as hardened tissue, hence the term ‘sclerosis’. Eventually, the disease may cause the nerves themselves to deteriorate and ultimately become permanently damaged.

Causes

The cause of multiple sclerosis is unknown

Potential risk factors:

Genetic and molecular factors

Viral infections (the Epstein-Barr virus has been linked to cases of multiple sclerosis)

Environmental factors

Thyroid disease, type 1 diabetes or inflammatory bowel disease may increase the risk of developing multiple sclerosis

Symptoms and signs

Most people with MS experience a relapse-remitting disease course

Periods of new symptoms or relapses alternate over days or weeks and usually improve partially or completely

The relapses are followed by periods of remission that can last for months or years

Eventually, a majority of people with MS develop a steady progression of symptoms, with or without periods of remission, known as secondary-progressive MS

Cases of a gradual onset of MS and steady progression of signs with or without any periods of relapsing is called primary-progressive MS

 

Usual symptoms of MS include:

Numbness or weakness in one or more limbs usually occurring on one side of the body at a time, or the legs and trunk

Partial or complete loss of vision, usually in one eye at a time

Double vision

Pain in different parts of the body

Electric shock sensations that occur with certain neck movements, especially when bending the neck forward

Tremor, lack of coordination and unsteady gait

Slurred speech

Fatigue

Dizziness

Issues with bowel and bladder control

Heat intolerance

Subjective cognitive difficulties: attention span, concentration, memory and judgment

Depression

Euphoria (less common than depression)

 

Other symptoms:

Seizures

Significant motor impairment

Advice

There is no cure for multiple sclerosis

Treatments are aimed at ameliorating symptoms:

Corticosteroids to reduce nerve inflammation

Plasma exchange if the symptoms are new, severe and have not responded to steroids treatment

No therapies have shown to slow down the progression of primary-progressive MS

Treatment options for relapsing-remitting MS include:

Beta-interferons for reducing the severity and frequency of relapses (medication injected under the skin or into muscle)

Glatiramer acetate to help block the immune system attacking the body’s myelin

Diemthyl fumarate for reducing the incidence of relapses

Fingolimod and an assortment of other drugs for reducing relapse rates

Physical therapy to improve muscle weakness and gait

Muscle relaxants

Medications for reducing fatigue

MISCONCEPTIONS
  • MS is a fatal condition

    There are no effective treatments of the disorder

    People with MS should not have children

    Everyone with MS ends up in a wheelchair (almost 7 out of 10 people diagnosed with MS have only moderate symptoms)

    Experiencing relapses means that treatment is not functional

Statistics

According to the National Multiple Sclerosis Society 400,000 individuals are diagnosed with MS (misdiagnosis is common however)

 

MS is more common in women

 

MS is usually diagnosed in people aged 15-45 years, though it can occur at any age

 

The average age of diagnosis in women is 29, and in men is 31

 

Worldwide, approximately 2.1 million people are affected by MS

 

White people, particularly those of Northern European descent are at highest risk of developing MS

 

People of Asian, African or Native American descent have the lowest risk

 

MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe

Did you know?

If left untreated, more than 30% of patients with MS will develop significant physical disability within 20-25 years after onset

 

Male patients with primary progressive MS have the worst prognosis

 

Less than 5-10% of patients have a clinically milder form of MS

 

Famous personalities diagnosed with MS: comedian Richard Pryor, Emmy-award winning talk show host Montel Williams, journalist Richard Cohen, Iron Maiden drummer Clive Burr, writer Joan Didion, Jack Osbourne

 

World MS Day is on the 25th of May