What is Multiple Sclerosis?

Multiple sclerosis (MS) is a disease of the central nervous system (CNS), which consists of the brain, optic nerves, and spinal cord. It is an unpredictable disorder that can cause a variety of symptoms. For many, the symptoms of MS can flare-up and then subside over the course of days, months, or even years.

With MS, areas of the CNS become inflamed, damaging the protective covering (known as “myelin”) that surrounds and insulates the nerves (known as “axons”). This damage disrupts the smooth flow of nerve impulses. As a result, messages from the brain and spinal cord going to other parts of the body may be delayed and have trouble reaching their destination – causing the symptoms of MS.

MS is not contagious and its causes are not yet fully understood. Researchers continue to search for answers on how MS is developed and what treatments will be the most effective. A number of long-term treatments, known as “disease-modifying therapies,” are available for the majority of individuals with MS. Although these treatments do not cure MS, they do work to slow disease activity and delay progression. Additional treatment options are also available to reduce the severity of a relapse as well as to address the various symptoms of MS.

Signs and Symptoms of MS

While multiple sclerosis has the potential to cause several different symptoms, the specific symptoms each person experiences vary greatly. Symptoms range from physical (bladder dysfunction and spasticity, for example), mental/emotional (such as cognitive changes and depression), and “invisible” symptoms (examples include visual disorders and numbness).

Medications, different types of therapies, and other strategies are available to treat nearly all MS symptoms. MS symptoms are often compounded by extreme fatigue, which may be worse in the afternoon, sometimes relating to a rise in body temperature. When a family member is diagnosed with MS, individuals may be affected in different ways, both physically and emotionally. Participating in some type of counseling program is often of benefit to everyone involved. Read More

Who Gets MS?

Nearly one million individuals are living with multiple sclerosis in the United States. Most people with MS experience their first symptoms and are diagnosed between the ages of 15 and 50, although individuals of any age may be diagnosed with MS. More women are diagnosed with MS than men, and the area where someone lives, as well as race and ethnic background, also helps to determine his or her risk of developing the disease.

While MS is not contagious or hereditary, MS susceptibility is increased if a family member has MS. In addition to genetic susceptibility, other factors linked to MS include Vitamin D and exposure to sunlight, cigarette smoking, and even cleaner environments lacking certain parasites. Please see the later section for more information on possible causes of MS. Read More

Types of MS

Initially, most people with multiple sclerosis experience symptom flare-ups, which are also known as relapses, exacerbations, or attacks. When someone experiences a relapse, he or she may be having new symptoms or an increase in existing symptoms. These usually persist for a short period of time followed by a remission. This type of MS is referred to as relapsing-remitting MS (RRMS). Over time, RRMS may advance to secondary-progressive MS (SPMS). This form of MS does not have the dramatic variations in symptoms that RRMS does, but rather has a slow, steady progression.

Individuals who are not initially diagnosed with RRMS may be experiencing a more steady progression of the disease from the onset. Approximately 10 percent of the MS population is diagnosed with primary-progressive MS (PPMS), where individuals experience a steady worsening of symptoms from the start, and do not have periodic relapses and remissions. Other types of MS exist, but these are less common and different terminology may be used.

Prior to an MS diagnosis, individuals with “possible MS” may often fall under the parameters of one of two syndromes: clinically isolated syndrome (CIS) and radiologically isolated syndrome (RIS). In such cases, an individual may show evidence of MS – either clinically or on magnetic resonance imaging (MRI), respectively – but a diagnosis cannot be confirmed at that time. Read More

Possible Causes

Researchers have studied a variety of possible causes for multiple sclerosis, and a combination of factors appears to be involved. A popular theory looks at commonly known slow-acting viruses, one that could remain dormant for many years. Examples include measles, herpes, human T-cell lymphoma, and Epstein-Barr. After being exposed to one of these viruses, some researchers theorize that MS may develop in genetically susceptible people.

Genes have some role in susceptibility to MS, but the exact mechanisms remain unclear. A connection between MS and nutritional factors, including fat intake, as well as deficiencies in fish oil and Vitamin D, may play an important role. In addition to food and supplements, Vitamin D is also derived from sunlight, which may be involved in the development of MS. Lack of parasites in cleaner environments is another possible risk factor in the development of MS, as well as cigarette smoking. Read More

Diagnosis and Tests

Diagnosing multiple sclerosis and evaluating disease activity is most reliably done by neurologists through a neurological history and examination. Lesions (areas of inflammation and myelin damage in the brain and/or spine) may be viewed on a magnetic resonance imaging (MRI) scan. This scan can confirm a diagnosis as well as evaluate ongoing disease activity.

A lumbar puncture, commonly known as a spinal tap, is sometimes used to help confirm a diagnosis. This procedure collects a small amount of cerebrospinal fluid (CSF), which is then evaluated for cellular and chemical abnormalities. Evoked potential (EP) tests may also be used to help diagnose MS, if further support is needed. These measure the speed of the brain’s response to visual, auditory (sound), or sensory (feeling) stimuli, using electrodes taped to the patient’s head. Delayed responses can indicate possible damage to the nerve pathways. Read More

Treatments and Care

Many effective medications and therapies are available for the treatment of multiple sclerosis in three different categories. The first area of treatment is to slow MS activity and progression; the second area is to reduce the severity and duration of a relapse; and the third area is to treat the symptoms of MS individually.

Long-term treatments to slow MS activity and progression are also referred to as disease-modifying therapies (DMTs). Presently, more than 20 brand medications and generics have been approved by the United States Food and Drug Administration (FDA) for relapsing forms of MS in adults, with at least one approved for use in pediatric MS. Some are also approved for clinically isolated syndrome as well as for certain types of progressive MS. Depending on the DMT selected, these are taken orally, via self-injection, or via intravenous (IV) infusion.

Treating relapses helps to control the sudden flare-up of symptoms, also referred to as exacerbations or attacks. Symptom management is another important area in the overall treatment of MS. In addition to medications prescribed for a specific symptom, other treatment therapies – such as rehabilitation, counseling, and exercise, for example – may be recommended by the healthcare team to increase the effectiveness of managing certain symptoms. Read More

Newly Diagnosed Information

For many, being newly diagnosed finally gives a name to having some unexplained symptoms. Often before a diagnosis of multiple sclerosis, a person might experience various symptoms, such as visual problems, numbness, or weakness, for example. Not knowing what is wrong and what might happen next is both worrisome and frightening. Once someone has been newly diagnosed with MS, he or she may actually feel a sense of relief in knowing the reason behind the different symptoms. From here, learning more about the disorder and its treatments will be of great help toward developing a positive plan for the future.

MSAA provides a wealth of information and support to assist individuals who are newly diagnosed as well as their family members, care partners, and friends. Resources include MSAA’s website, where extensive written information, a series of publications, as well as large collections of educational videos, webinars, and podcasts may be accessed. Other resources and online tools are also available.

In addition, MSAA’s toll-free Helpline provides critically needed support, consultation, and encouragement to individuals who are newly diagnosed. Our Helpline allows individuals with MS, family members, care partners, and friends to speak directly with one of MSAA’s experienced Client Services Specialists, all of whom have a social services or counseling background. Read More

MSAA’s Helpline may be reached several ways:

• Call (800) 532-7667, extension 154. Helpline hours are Monday through Friday, 8:30 am to 5:00 pm, EST; with extended Wednesday hours until 8 pm EST.
• Email MSquestions@mymsaa.org
• Chat live via your computer or mobile device through the online MS Chat feature.