Multiple Sclerosis

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June 13, 2022

Multiple sclerosis (MS) is a disables the brain and spinal cord (central nervous system). The immune system attacks the protective sheath (myelin) covering nerve fibres and it disturbs the communication between your brain and the rest of your body. The disease may lead to permanent damage or weakening of the nerves.

The MS signs and symptoms are different, depending on the amount of nerve damage and the type of nerves that are affected. People facing severe MS may lose their walking ability while some may experience remission for long periods without any new symptoms.

Multiple sclerosis is non-curable but treatments can help in faster recovery from attacks, modifying the course of the disease and manage symptoms.

Types of Multiple Sclerosis

There are four types of MS:

Clinically Isolated Syndrome (CIS): This is just one and first type in which symptoms last for at least 24 hours. In another episode occurs at a later date, a doctor might diagnose relapse-remitting MS.

Relapse-remitting MS (RRMS): It is the most common type of MS. There are about 85% of people that are initially diagnosed with RRMS. In RRMS episodes of new or increasing symptoms occur, followed by remission periods, during which symptoms wipe out partially or totally.

Primary progressive MS (PPMS): As the disease progresses, symptoms get worse without early relapses or remissions. When symptoms worsen, some people may experience times of stability and then get better. PPMS is faced by around 15% of people with MS.

Secondary progressive MS (SPMS): Initially, people will experience relapse and remission episodes, but then the disease may start progressing steadily.

Causes of Multiple Sclerosis

The cause of multiple sclerosis is still unknown by experts. Below are some factors that may trigger MS:

Exposure to specific viruses or bacteria: As per some research, being exposed to certain infections (such as Epstein-Barr virus) can lead to MS later in life.

Your living location: The environment you live in is also responsible for developing MS. There are certain parts of the world that have significantly higher rates of the disease as compared to others. Locations that are far from the equator have higher rates of MS may be due to less intense sun. People who are less exposed to sunlight have lower levels of vitamin D and it is a risk factor for MS.

Immune system’s functionality: Being an autoimmune disease, when it occurs some people’s immune cells mistakenly attack healthy cells.

Gene mutations: If you have any family member with MS it increases your risk of the disease. But it isn’t yet clear exactly how and which genes are responsible for causing multiple sclerosis.

Symptoms of Multiple Sclerosis

MS affects the CNS that controls all our body actions and so, symptoms can affect any body part.
Below are the most common symptoms of MS:

• Muscle weakness due to lack of use or stimulation due to nerve damage.
• Numbness and tingling in face, body, or arms and legs.
• Lhermitte’s sign, a sensation like an electric shock when moving the neck.
• Bladder problems such as difficulty emptying the bladder or frequent urination or suddenly, known as urge incontinence.
• Bowel problems such as fecal impaction, leading to bowel incontinence.
• Fatigue.
• Dizziness and vertigo.
• Sexual dysfunction in male and female.
• Spasticity and muscle spasms.
• Tremor.
• Vision problems.
• Gait and mobility changes.
• Emotional changes and depression.
• Learning and memory problems.
• Pain.

Less common symptoms include:

• Headache.
• Hearing loss.
• Itching.
• Respiratory or breathing problems.
• Seizures.
• Speech disorders.
• Swallowing problems.

Multiple Sclerosis

Overview

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).

In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerves.

Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.

There’s no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

Symptoms

MS-related nervous system damage
Myelin damage and the nervous systemOpen pop-up dialog box
Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers. Symptoms often affect movement, such as:

Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or your legs and trunk
Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
Tremor, lack of coordination or unsteady gait

Vision problems are also common, including:

Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
Prolonged double vision
Blurry vision

Multiple sclerosis symptoms may also include:

Slurred speech
Fatigue
Dizziness
Tingling or pain in parts of your body
Problems with sexual, bowel and bladder function

When to see a doctor

See a doctor if you experience any of the above symptoms for unknown reasons.

Disease course

Most people with MS have a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by quiet periods of disease remission that can last months or even years.

Small increases in body temperature can temporarily worsen signs and symptoms of MS, but these aren’t considered true disease relapses.

At least 50% of those with relapsing-remitting MS eventually develop a steady progression of symptoms, with or without periods of remission, within 10 to 20 years from disease onset. This is known as secondary-progressive MS.

The worsening of symptoms usually includes problems with mobility and gait. The rate of disease progression varies greatly among people with secondary-progressive MS.

Some people with MS experience a gradual onset and steady progression of signs and symptoms without any relapses, known as primary-progressive MS.

Causes

The cause of multiple sclerosis is unknown. It’s considered an autoimmune disease in which the body’s immune system attacks its own tissues. In the case of MS, this immune system malfunction destroys the fatty substance that coats and protects nerve fibers in the brain and spinal cord (myelin).

Myelin can be compared to the insulation coating on electrical wires. When the protective myelin is damaged and the nerve fiber is exposed, the messages that travel along that nerve fiber may be slowed or blocked.

It isn’t clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible.

Risk factors

These factors may increase your risk of developing multiple sclerosis:

Age. MS can occur at any age, but onset usually occurs around 20 and 40 years of age. However, younger and older people can be affected.
Sex. Women are more than two to three times as likely as men are to have relapsing-remitting MS.
Family history. If one of your parents or siblings has had MS, you are at higher risk of developing the disease.
Certain infections. A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis.
Race. 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.
Climate. MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe.
Vitamin D. Having low levels of vitamin D and low exposure to sunlight is associated with a greater risk of MS.
Certain autoimmune diseases. You have a slightly higher risk of developing MS if you have other autoimmune disorders such as thyroid disease, pernicious anemia, psoriasis, type 1 diabetes or inflammatory bowel disease.
Smoking. Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS.

Complications
People with multiple sclerosis may also develop:

Muscle stiffness or spasms
Paralysis, typically in the legs
Problems with bladder, bowel or sexual function
Mental changes, such as forgetfulness or mood swings
Depression
Epilepsy

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