What is Multiple Sclerosis?
Multiple sclerosis (MS) begins when a person’s immune system starts attacking the myelin coating around the nerve fibers in the central nervous system and damaging the nerve fibers themselves. This interrupts the communication of nerve signals among the brain, the spinal cord, and the rest of the body.
Multiple sclerosis is the leading cause of disability in young adults ages 20 to 40. Nearly a million Americans are living with the disease, according to the National Multiple Sclerosis Society.
What Are the Types of Multiple Sclerosis?
The most common type is relapsing remitting MS (RRMS). RRMS is more prevalent in women and typically causes neurological symptoms such as vision loss, numbness, weakness, memory issues, and fatigue. If untreated, many RRMS patients become increasingly disabled over a 10- to 20-year period and may eventually require walking aids or a wheelchair.
Some patients have a progressive form of MS from the beginning. These patients often lose their independence and are unable to continue working.
What Causes MS?
No one knows what causes MS. The current belief is that something in the environment triggers the immune system in patients who may have a genetic predisposition. However, multiple sclerosis is not considered a hereditary disease.
A recent study showed that multiple sclerosis is three times more common in women than in men, indicating that hormones may play a significant role in determining susceptibility. Other factors that might increase the risk of MS include smoking, vitamin D deficiency, and Epstein-Barr virus.
What Are the Symptoms of Multiple Sclerosis?
In its initial stages, MS is a silent disease. Newly diagnosed patients may recover completely from their initial episode. However, if left untreated, multiple sclerosis can continue to cause new scarring on the brain, which can lead to inflammation and an increase in the rate of brain shrinkage.
Signs and symptoms of multiple sclerosis are variable and unpredictable in progression from patient to patient, but the most common are fatigue, blurred or double vision, numbness and tingling, weakness, poor coordination and balance, pain, depression, and problems with memory and concentration. Less common symptoms are tremor, paralysis, and blindness.
How Is Multiple Sclerosis Diagnosed?
Doctors diagnose MS by conducting a detailed neurological history and examination. A diagnostic imaging test called magnetic resonance imaging (MRI) of the brain and spinal cord reveals lesions that are the hallmark of the condition. A spinal tap may be recommended to check the spinal fluid for abnormalities.
How Is Multiple Sclerosis Treated?
Today’s treatments for multiple sclerosis have significantly improved our patients’ quality of life.
There is no cure for MS, though the last two decades have seen a revolution in its treatment, offering hope to thousands of MS sufferers around the world. These treatments, called disease modifying therapies, work with the body’s immune system to limit damage and scarring of the brain and spinal cord.
While the treatments have become increasingly effective, there may be a higher risk of certain side effects. Some of the latest treatments are a class of drugs called monoclonal antibodies. These target specific pathways in the immune system and have a more defined risk of side effects.
Stem cell-based treatments currently being researched show very promising results.
Findings from numerous clinical trials suggest treatments are more effective when begun soon after diagnosis. Early and effective treatment minimizes the risk of further brain scarring and may prevent or slow progression of the disease.