What is multiple sclerosis (MS)?
Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (brain and spinal cord) that causes demyelination (destruction of myelin that insulates and protects the nerve cells) of the brain and spinal cord nerve cells. The cause of multiple sclerosis is not known.
4 Types of MS
There are four types of multiple sclerosis:
- Relapsing: Remitting multiple sclerosis (RRMS) is the most common form of MS. Remission may last for weeks to years.
- There are two subgroups in RRMS, a subgroup termed clinically isolated syndrome (CIS) consisting of a single episode of neurologic symptoms, and subgroup termed benign MS, consisting of MS with almost complete remission between relapses and little if any accumulation of physical disability over time.
- Secondary: In progressive multiple sclerosis (SPMS) exacerbations don’t fully resolve during remission.
- Primary: Progressive primary multiple sclerosis (PPMS) progresses over time without episodes of remission.
- Progressive: In relapsing multiple sclerosis (PRMS) patients experience increasing symptoms over time and intermittent episodes of remission.
Who gets multiple sclerosis, and how many people have it?
Onset of the disease occurs in younger people ages 15 to 30 but can be diagnosed in older and younger persons (rarely in a child). The incidence is about 400,000 patients in the US, with a ratio of 2 to 1 females to males.
Multiple sclerosis is not considered to be a fatal disease although rarely it may be fatal due to complications.
The lifespan in people with this form of sclerosis, especially if it is treated early, is about the same as in the general population.
What are the signs and symptoms of MS?
Signs and symptoms of multiple sclerosis are variable and depend on the area of the destruction of the myelin protecting brain and spinal cord nerves. Consequently, people with the disease may have some symptoms that other people may not have. In general, however, early signs and symptoms include visual problems such as double vision and/or vision loss. Other symptoms that may occur, depending upon the patient’s disease process, include:
- Tingling (paresthesias)
- Vision changes
- Vertigo (the person is susceptible to the risk of falls)
- Lack of coordination of limbs (disability to function normally, for example, the person has difficulty walking)
- Muscle spasms and/or involuntary muscle contractions that are painful
- Urinary incontinence
- Sexual dysfunction
- Heat intolerance
- Slurred speech
- Sharp, electrical like pain that occurs in the spine with neck flexion (Lhermitte sign)
- Mental status changes
Can you get MS from people who have it, and can it passed on to children?
There is no evidence that multiple sclerosis undergoes transmission person-to-person. Consequently, the disease is not considered to be contagious so other people cannot catch it from any person with MS they may come in contact with. It is not considered hereditary by many researchers; however, individuals that have a first degree relative (for example, a parent or sibling) that develops the disease increases the risk of developing the disease. Some new research suggests that if people inherit a genetic mutation on gene NR1H3, they may develop MS (rapidly progressive form). These findings are new, and they and other genetic factors are being investigated further.
Although lifestyle factors like diet, smoking, exercise influence the development of such diseases like cancer and diabetes, they are not risk factors in developing MS. There is much speculation about risk factors and/or causes for MS, and they range from vitamin D deficiency to viral infections such as Epstein-Barr infections, association with black mold, and even too much salt intake. None of these theories or speculations have been proven. However, a recent study at Harvard suggested that Epstein-Barr virus infection may be a trigger to set off MS in genetically susceptible individuals with vitamin D deficiency.
Quick GuideMultiple Sclerosis (MS) Symptoms and Treatment
Alternative Treatments for Multiple Sclerosis (MS)
A person with MS has many problematic challenges they face daily, even with symptomatic drug treatment. There are alternative and complementary treatments for MS that can be beneficial in addition to drug treatment protocols. For example, these CAM therapies have been shown to relieve fatigue:
- Exercise (swimming and walking)
- Magnet therapy
- Gingko biloba supplements
How will I know if I have MS, and when should I contact my doctor if I think I may have the condition?
If you develop any of the symptoms listed previously, you should contact your doctor or other health care professional as soon as possible. Your doctor will perform a physical exam and get a history of your symptoms. If multiple sclerosis is suspected, blood work will probably be ordered to exclude another disease or disorder such as Lyme disease, lupus, or HIV. A spinal tap may be done along with nerve studies (evoked potential testing). Imaging studies such as a MRI may be done. Your doctor will likely consult a neurologist to help make a diagnosis and for additional medical advice about multiple sclerosis treatment.
What treatments are available for MS and its symptoms?
Treatment of MS is often determined by the type and medical condition of the patient. Drugs, either rejected or taken orally are the main medical treatments, although drugs don’t cure MS. Drug therapy can limit and/or postpone nerve damage and reduce relapse occurrences.
This is a list of drugs that may be used by your doctors and other health care professionals to treat your type of MS:
- Beta interferons: relapsing-remitting MS
- Copaxone (glatiramer acetate): relapsing- remitting MS
- Gilenya (fingolimod): relapsing forms to reduce clinical exacerbations of MS
- Aubagio (teriflunomide): relapsing forms to reduce clinical exacerbations
- Tecfidera (dimethyl fumarate): relapsing forms of MS
- Novantrone (mitoxantrone): treats of worsening relapsing – remitting MS, progressive – relapsing or secondary: progressive MS and to reduce neurologic disability and clinical exacerbations
- Tysabri (natalizumab): rapidly progressing MS especially if other treatments fail
- Ocrevus (ocrelizumab): a brand-new drug, FDA approved in 2017 (March), to treat relapsing MS and primary progressive MS
Treatment of MS should be discussed with your doctor. Patients are urged to question their doctors or other health care professionals about their type of MS condition, drug treatment, and prognosis. For additional information please read our Multiple Sclerosis and Alternative Treatment for MS articles, or contact the Multiple Sclerosis Society.
Medically Reviewed on 10/11/2017
Luzzio, C. MD. "Multiple Sclerosis." Medscape. Updated: Mar 01, 2017.
National Institutes of Neurological Disorders and Stroke. "Multiple Sclerosis Information Page.
Roche.com. "FDA approves Roche's OCREVUS&tm; (ocrelizumab) for relapsing and primary progressive forms of multiple sclerosis." Mar 29, 2017.