Multiple sclerosis (MS) is a chronic disease that affects the central nervous system, including the brain, spinal cord and optic nerves. Experts believe MS is an autoimmune disease caused by the immune system attacking and damaging the nervous system. It generally progresses gradually, with alternating periods of remission, good health and disabling flare-ups.
About 400,000 Americans, mostly young adults, suffer from MS. It occurs almost twice as frequently among women than men.
The exact cause of MS is not known, but factors such as disease, poisons and drug or alcohol abuse can damage the myelin sheath in children and adults. Heredity may contribute to the development of MS. About 5 percent of patients have a sister or brother who has the disease and about 15 percent have a close relative with MS.
MS damages the outer covering of nerve cells, called myelin, a fatty tissue that protects nerve cells in the same way that insulation protects electrical wiring in a house. Myelin helps nerve fibers conduct electrical impulses to and from the brain. Scar tissue, called sclerosis, accumulates when multiple areas of myelin are damaged. These damaged areas are known as plaques or lesions.
When MS damages the protective myelin sheath of nerve cells, the sheath sometimes repairs itself and nerves work correctly again. In other cases, the myelin is so damaged that the underlying nerve can’t be repaired and dies.
The symptoms of multiple sclerosis (MS) depend on which particular pathway of nerve fiber is damaged. Tingling, numbness, sensations of tightness or weakness may result when myelin in the spinal cord is damaged. If nerve fibers to the bladder are affected, urinary incontinence may occur. Likewise, damage to the cerebellum portion of the brain may result in imbalance or a lack of coordination. MS patients can have a wide range of symptoms, depending on where the damage occurs in the central nervous system.
Because MS can cause a wide variety of symptoms in different people, doctors frequently struggle to diagnose the disease. Some common symptoms are:
- Changes in sensation
- Clumsiness or weakness
- Difficulty walking or maintaining balance
- Dizziness or vertigo
- Eye problems such as double vision or uncontrolled eye movements
- Fatigue
- Muscle spasms
- Problems with bladder or bowel control
- Stiffness
- Tremors
- Tingling or numbness
- Depression or emotional changes
- Mild intellectual change such as memory problems
- Sexual problems such as difficulty reaching orgasm, lack of vaginal sensation or erectile dysfunction
Symptoms usually appear in people between 20 and 40 years of age.
Although there is no cure, most MS patients lead active lives for many years after their diagnosis and have a normal life span. The primary aims of therapy are returning function after an attack, preventing new attacks, and preventing disability. Several medications are modestly effective at decreasing the number of attacks in relapsing-remitting MS. Both drug therapy and neurorehabilitation have shown to ease the burden of some symptoms, though neither influences disease progression.
Some patients also turn to alternative treatments, including dietary regimens, herbal medicine, including the use of medical cannabis, hyperbaric oxygenation, and self-infection with hookworm.
MS can be tiring and requires schedule and lifestyle adjustments. A regular exercise program that includes walking, swimming, stretching or riding a stationary bike can reduce some symptoms.