Multiple sclerosis is an
MS; Demyelinating disease
Multiple sclerosis (MS) affects women more than men. The disorder is most commonly diagnosed between ages 20 and 40, but can be seen at any age.
MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve signals slow down or stop.
The nerve damage is caused by inflammation. Inflammation occurs when the body’s own immune cells attack the nervous system. This can occur along any area of the brain, optic nerve, and spinal cord.
It is unknown what exactly causes this to happen. The most common thought is that a virus or gene defect, or both, are to blame. Environmental factors may play a role.
You are slightly more likely to get this condition if you have a family history of MS or live in an part of the world where MS is more common.
Symptoms vary, because the location and severity of each attack can be different. Attacks can last for days, weeks, or months. Attacks are followed by periods of reduced or no symptoms (remissions). Fever, hot baths, sun exposure, and stress can trigger or worsen attacks.
It is common for the disease to return (relapse). However, the disease may continue to get worse without periods of remission.
Nerves in any part of the brain or spinal cord may be damaged. Because of this, MS symptoms can appear in many parts of the body.
Loss of balance
Numbnessor abnormal sensation in any area
- Problems moving arms or legs
coordinationand making small movements
Tremorin one or more arms or legs Weaknessin one or more arms or legs
Bowel and bladder symptoms:
Constipationand stool leakage
- Difficulty beginning to urinate
Frequent need to urinate
- Strong urge to urinate
- Urine leakage (
Uncontrollable rapid eye movements
Vision loss(usually affects one eye at a time)
Numbness, tingling, or pain:
Tingling, crawling, or burning feeling in the arms and legs
Other brain and nerve symptoms:
Decreased attention span, poor judgment, and memory loss
Difficulty reasoning and solving problems
Depressionor feelings of sadness
Dizzinessand balance problems Hearing loss
Problems with erections
Problems with vaginal lubrication
Speech and swallowing symptoms:
Slurred or difficult-to-understand speech
Trouble chewing and swallowing
Exams and Tests
Symptoms of MS may be mimic those of many other nervous system problems. MS is diagnosed by ruling out other conditions.
People who have a form of MS called relapsing-remitting may have a history of at least two attacks, separated by a period of reduced or no symptoms.
The doctor may suspect MS if there are decreases in the function of two different parts of the central nervous system (such as abnormal reflexes) at two different times.
An exam of the nervous system may show reduced nerve function in one area of the body. Or it may be spread over many parts of the body. This may include:
Abnormal nerve reflexes
Decreased ability to move a part of the body
Decreased or abnormal sensation
Other loss of nervous system functions
An eye examination may show:
Abnormal pupil responses
Changes in the
visual fieldsor eye movements
Decreased visual acuity
Problems with the inside parts of the eye
Rapid eye movements triggered when the eye moves
Tests to diagnose multiple sclerosis include:
- Blood tests to rule out other conditions similar to MS
Lumbar puncture(spinal tap) for cerebrospinal fluid tests, including CSF oligoclonal banding MRI scan of the brainand MRI scan of the spine are important to help diagnose and follow MS
- Nerve function study (evoked potential test, such as
brainstem auditory evoked response)
There is no known cure for multiple sclerosis at this time. But, there are treatments that may slow the disease. The goal of treatme
nt is to control symptoms and help you maintain a normal quality of life.
Medicines are often taken long-term. These include:
- Medicines to slow the disease
- Steroids may be used to decrease the severity of attacks
- Medicines to control symptoms such as muscle spasms, urinary problems, fatigue or mood problems
The following may also be
Assistive devices, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars
A planned exercise program early in the course of the disorder
A healthy lifestyle, with good nutrition and enough rest and relaxation
Avoiding fatigue, stress, temperature extremes, and illness
what you eat or drink if there are swallowing problems
Making changes around the home to
- Social workers or other counseling services to help you cope with the disorder and get assistance
- Vitamin D or other supplements (talk to your doctor first)
Living with MS may be a challenge. You can ease the stress of illness by joining an
Outcome varies, and is hard to predict. Although the disorder is
The following typically have the best outlook:
People who were young (less than 30 years) when the disease started
People with infrequent attacks
People with a relapsing-remitting pattern
People who have limited disease on imaging studies
The amount of disability and discomfort depends on:
How often and severe the attacks are
The part of the central nervous system that is affected by each attack
Most people return to normal or near-normal function between attacks. Slowly, there is greater loss of function with less improvement between attacks.
- Difficulty swallowing
- Difficulty thinking
- Less and less ability to care for self
- Need for
indwelling catheter Osteoporosisor thinning of the bones Pressure sores
- Side effects of medications used to treat the disorder
Urinary tract infections
When to Contact a Medical Professional
Call your health care provider if:
You develop any symptoms of MS
Symptoms get worse, even with treatment
The condition worsens to the point when home care is no longer possible
Related:Caring for muscle spasticity or spasms , Swallowing problems , Constipation – self-care, Multiple sclerosis – discharge, Daily bowel care program, Preventing pressure ulcers, Immune response, Urinary tract infection – adults