Multiple Sclerosis

What is multiple sclerosis?

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Multiple sclerosis is an autoimmune condition. Known colloquially as MS, the condition causes the immune system to attack myelin, the protective covering around nerve fibers. The result is consistent and widespread inflammation, which can hinder mobility and cause pain. Most people with MS also experience extreme fatigue, vision disruption, and speech issues. Multiple sclerosis can occur in people of all ages, but diagnoses typically occur between ages 15 and 60.

While there is no known cure for multiple sclerosis, patients can manage symptoms with the help of a physician. If you are experiencing MS symptoms, contact your primary care physician or a neurologist as soon as possible. Additionally, if you have MS and are looking for a new provider, Premier Medical Group is ready and able to help you take control over your condition.

What causes multiple sclerosis?

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Multiple sclerosis occurs when the immune system mistakenly attacks the body. In the case of MS, the brain and nerves – the central nervous system – are the target of the attack. Specifically, the immune system targets myelin. Myelin is the fatty substance that protects the nerve fibers in the spinal cord and brain. If the myelin is damaged, signals from the brain can’t reach their destination. Without this protective sheath, the nerves become damaged. This, in turn, leads to bodily dysfunction, which can include both mobility and cognitive impairment.

Doctors don’t yet know the cause of multiple sclerosis. However, according to the National Multiple Sclerosis Society, women are four times more likely to develop the condition than men. The points to a potential genetic cause. Ongoing research also points to potential environmental factors, like location and air quality, as contributing to MS development. Additionally, certain experiences, like viral infection and emotional trauma, can cause MS symptoms to worsen. Symptoms can be managed with the help of a physician.

What are the symptoms of multiple sclerosis?

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Multiple sclerosis symptoms are often nebulous and wide-ranging. Because MS is an autoimmune and neurological disorder, its presentation can vary by person. Additionally, MS symptoms vary in severity depending on potential triggers and symptom management.

Still, some MS symptoms are experienced more widely than others. The most common symptoms associated with multiple sclerosis include:

  • Mobility impairment – Many people with multiple sclerosis have mobility issues, which lead to difficulty walking. Causes include difficulty balancing, foot and leg numbing, and spastic muscles. As a result, many people with MS walk with a cane.
  • Fatigue – The overwhelming majority of people with multiple sclerosis – around 80% – experience persistent fatigue. In many cases, this hinders a person’s ability to complete routine tasks, like cooking and cleaning.
  • Speech issues – Multiple sclerosis causes brain lesions, which can affect more than a person’s physical ability. Brain lesions can impair speech. Often, this includes slurred language, uncontrolled speech volume, and stuttering.
  • Vision impairment – Vision problems can include double vision, blindness, involuntary eye movement, and painful eyes. These symptoms are typically the first to appear. Vision impairment fluctuates over the course of years, sometimes getting worse, and sometimes resolving completely.

Other less common but widespread symptoms include muscle tremors, sleep disorders, brain fog, chronic or acute pain, bladder incontinence, and difficulty chewing and swallowing food.

Additionally, symptoms of multiple sclerosis can differ by sex. Females may experience menstrual problems, more severe symptoms after menopause, and various pregnancy-related symptoms. Note that MS is not shown to affect fertility.

What are the types of multiple sclerosis?

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Because multiple sclerosis can affect people differently, researchers have worked to define different types of MS that better characterize a specific patient experience.

  • Relapsing-Remitting Multiple Sclerosis – This is the most common type of MS, comprising around 90% of cases. Relapsing-Remitting MS is characterized by neurological symptoms, like numbness, tingling, fatigue, and blurred vision. Symptoms often occur for a short time – days or weeks – then disappear for a period. Sometimes, symptoms may disappear for years.
  • Clinically Isolated Syndrome – Known as CIS, is a pre-MS condition. It involves a single episode of symptoms that last for at least one day, or 24 hours. This experience is usually what encourages people to seek an MS diagnosis.
  • Primary Progressive Multiple Sclerosis – This is a more severe form of MS where neurological function worsens from the initial symptom onset. Like in RRMS, people with PPMS can sometimes experience periods of stability.
  • Secondary Progressive Multiple Sclerosis – If symptoms continue to the point where there are no identifiable remissions, a doctor may diagnose secondary progressive multiple sclerosis. While periods of stability are possible, overall symptoms are almost constant.
  • Benign Multiple Sclerosis – This type of MS is a mild form of the disease. It is exceedingly rare, occurring in only around 7% of patients. Often, Benign Multiple Sclerosis is diagnosed after an individual has had mild MS for at least 15 years.

How is multiple sclerosis diagnosed?

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If you suspect you may have multiple sclerosis, your doctor will begin the diagnosis process. They will most likely refer you to a neurologist, who will provide a routine neurological exam. Then, the doctor will choose one or more of the following screening tools to provide a formal diagnosis.

  • Blood tests – Blood tests can help doctors rule out conditions that have similar symptoms, like Lyme disease.
  • MRI scan – An MRI can illustrate potential lesions forming on the brain and spinal cord. This is one of the most common tools used in diagnosing multiple sclerosis.
  • Lumbar puncture – Also known as a spinal tap, this test is designed to check for abnormalities in spinal fluid.
  • Optical coherence tomography – Also called OCT, this test produces a photo of the nerve layers behind the eye. Thinning of the optic nerve can be a symptom of MS.

While multiple sclerosis is not wholly diagnosed by ruling out other conditions, certain diseases have overlapping symptoms. This includes lupus, Sjögren’s syndrome, and Lyme disease. Often, a doctor will do tests to check for these conditions before providing a definitive MS diagnosis.

Is there treatment for multiple sclerosis?

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While there is no cure for multiple sclerosis, doctors can prescript treatments to ease symptoms. This, in turn, will improve a patient’s quality of life. Common multiple sclerosis treatments include various disease-modifying therapies, or DMTs. These injectable treatments can decrease relapses and slow the progression of MS in an individual. Doctors may also prescribe oral or intravenous medications to treat symptoms of multiple sclerosis. Corticosteroids can be used to treat relapses, but they are not intended for long-term use.

Keep in mind that MS is a deeply individualized condition, so not all treatments are suitable for all patients. Building a relationship with your neurologist is key to understanding which medications will work for you long-term.

Can multiple sclerosis go into remission?

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Yes, multiple sclerosis can go into remission. Symptoms often come and go over time. For some patients, symptoms may last for weeks or months. For others, they may only last a couple of hours or days. Remember that being in remission does not mean that you no longer MS; there is no cure for the condition. However, it can reduce the likelihood of a patient developing new degenerative symptoms, which can improve life expectancy and quality of life.

What is the outlook for a person living with multiple sclerosis?

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People with multiple sclerosis can lead fulfilling lives. For some, flares are uncommon, only affecting the patient a few weeks out of the year. For others, flares are consistent and can hinder the person’s ability to complete day-to-day tasks. While personal experience with multiple sclerosis will vary, here are some things to expect after diagnosis.

  • Regular visits to the doctor
  • Prescription medication management
  • Frequent physical self-assessment

Diet and exercise are important for people with multiple sclerosis. Many doctors encourage MS patients to try low-impact forms of exercise, like swimming and yoga. Additionally, consuming a well-rounded diet can help to manage overall health.

Multiple sclerosis may affect life expectancy. According to a recent study, the median life expectancy for MS patients was 74.7, which is compared to the 81.8 years expected in the general population. However, this life expectancy gap has become smaller with the invention of new treatments. Early

diagnosis and management can also allow patients to proactively manage the condition. Keep an eye out for early signs of MS, like double vision, weak legs, and numb or tingling limbs.

In general, people with multiple sclerosis can expect to lead long, fulfilling lives. Managing symptoms with the help of a neurologist can help prolong that life and make it more enjoyable to live. If you believe you may be experiencing symptoms of MS, schedule an appointment as soon as possible.