How do you get multiple sclerosis?
Multiple sclerosis (MS) is an inflammatory, neurodegenerative, and autoimmune disease that affects the brain and spinal cord of the central nervous system (CNS).
Within the CNS, the immune system attacks and damages the fatty substance that surrounds, insulates and protects the nerve cell (myelin sheath). This damage to nerve cells is known as demyelination. This results in the inability of the brain and its electrical impulses to perform normally, causing various nerve-related symptoms of MS. The damaged areas develop multiple areas of scarring of the brain and spinal cord, which gives the disease its name.
MS is one of the most common causes of non-injurious disability in young and middle-aged adults.
The exact cause of the disease is unknown; however, scientists believe that a combination of the following factors triggers MS:
- Genetic factors
- Family history of MS
- Viral infection due to Epstein-Barr virus
- Low levels of vitamin D due to low sunlight exposure
- Age between 15 and 45 years
- A high-risk ethnic group such as Eskimos
- Hepatitis B vaccine
- Women are more affected than men
- Obesity
- Cigarette smoking
What are the very first signs of multiple sclerosis?
The presentation of MS varies from individual to individual. Sensory loss, vision loss, double vision, blurred vision, and painful eye movement are early signs of MS
Some people have a predominance of changes in thinking, while others develop muscle cramping with spasticity; bladder, bowel, and sexual dysfunction; depression; or visual symptoms.
The prominent feature of MS is what is called an “attack” wherein symptoms occur and then resolve (remit) and may appear again (relapse) sometimes months or years apart affecting different organs. The following are the most common symptoms:
- Sensory loss
- Fatigue (occurs in nearly 80% of patients)
- Walking difficulties
- Numbness of the face, arms, and legs
- Muscle spasms in the leg
- Deterioration of unused muscle leading to muscle weakness
- Dizziness and lightheadedness are commonly seen in patients with MS
- Sexual problems
- Constipation
- Loss of bowel control
- Loss of bladder control
- Chronic pain and itching (noted in 55% of patients)
- Memory loss
- Analytical and problem-solving ability starts diminishing
- Significant depression, mood swings, irritability, and other emotional changes
Less common symptoms include the following:
- Slurring speech (dysarthria) and loss of volume (dysphonia)
- Difficulty in swallowing (dysphagia)
- Vigorous shaking (tremor)
- Sudden uncontrollable vigorous jerking (seizures)
- Breathing difficulty
- Hearing loss or impaired hearing
Secondary symptoms that occur as a complication of the above symptoms are as follows:
- Loss of bladder control leads to urinary tract infection
- Physical inactivity or immobility leads to bedsores, muscle weakness, and poor posture
SLIDESHOW
What Is Multiple Sclerosis? MS Symptoms, Causes, Diagnosis See SlideshowWhat are the different types of multiple sclerosis?
There are four types of MS, based on the relapse rate and time to disease progression:
- Relapsing-remitting multiple sclerosis (RRMS): A recurrent attack is the characteristic of relapsing-remitting multiple sclerosis RRMS (which resolves completely on treatment). The relapse period may last for weeks to years.
- Secondary progressive MS (SPMS): Secondary progressive MS (SPMS) occurs when patients with RRMS develop a rapid worsening of the disease. It does not respond to the currently available treatment.
- Primary progressive MS (PPMS): Primary progressive MS accounts for approximately 10% of patients with MS in which the function diminishes gradually without relapses.
- Progressive-relapsing MS (PRMS): In progressive-relapsing MS (PRMS) bouts of symptoms overlay the progressing disease. It accounts for 5% of the total MS cases.
What tests help in diagnosing multiple sclerosis?
Currently, there are no specific symptoms, physical findings, or laboratory tests that are used to diagnose MS. However, approaches for diagnosing MS include
- taking a medical history;
- a nerve-related examination;
- various imaging tests, particularly magnetic resonance imaging (MRI);
- spinal fluid analysis; and
- blood tests to rule out any underlying conditions.
A spinal tap involves the collection of spinal fluid, using a needle and syringe, in order to confirm the presence of any inflammation and other substances.
Medically Reviewed on 7/26/2022
References
Hersh, Carrie M., and Robert J. Fox. "Multiple Sclerosis." April 2018. <http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/multiple_sclerosis/>.
Luzzio, C. "Multiple Sclerosis." Jan. 3, 2022. Medscape.com. <https://emedicine.medscape.com/article/1146199-overview#a7>.
"Managing Relapses." National Multiple Sclerosis Society. <https://www.nationalmssociety.org/Treating-MS/Managing-Relapses>.
Luzzio, C. "Multiple Sclerosis." Jan. 3, 2022. Medscape.com. <https://emedicine.medscape.com/article/1146199-overview#a7>.
"Managing Relapses." National Multiple Sclerosis Society. <https://www.nationalmssociety.org/Treating-MS/Managing-Relapses>.
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MS (Multiple Sclerosis) vs. ALS (Amyotrophic Lateral Sclerosis)
ALS (amyotrophic lateral sclerosis, Lou Gehrig's disease) and MS (multiple sclerosis) are both diseases of the nervous system (neurodegenerative). ALS is a disease in which the nerve cells in the body are attacked by the immune system, although it's not considered an autoimmune disease by some scientists. MS is an autoimmune disease in which the insulated covering of the nerves (myelin sheath) in the CNS (central nervous system) degenerate, or deteriorate.
Scientists don't know the exact cause of either problem. However, they have discovered that mutations in the gene that produces the SOD1 enzyme were associated with some cases of familial ALS. Scientists also theorize that multiple sclerosis may be caused by infection or vitamin D deficiency. ALS occurs between 50-70 years of age (the average age of occurrence ALS is 55), and mostly affects men. While MS occurs between 20-60 years of age, and mostly affects women. About 30,000 people in the US have ALS, and an average of 5,000 new diagnoses per year (that's about 15 new cases per week). Worldwide, MS affects more than 2.3 million people, with about 10,000 new cases diagnosed each year (that's about 200 new diagnoses per week).
Some of the signs and symptoms of both diseases include muscle weakness, muscle spasms, problems walking, fatigue, slurred speech, and problems swallowing. ALS signs and symptoms that are different from MS include problems holding the head upright, clumsiness, muscle cramps and twitches, problems holding objects, and uncontrollable periods of laughing or crying. MS signs and symptoms that are different from ALS include vision problems, vertigo and balance problems, sexual problems, memory problems, depression, mood swings, and digestive problems.There is no cure for either disease, however the prognosis and life expectancy are different. Multiple sclerosis is not a fatal condition, while ALS progresses rapidly and leads to death.
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