Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disease. With these conditions, your immune system mistakenly attacks healthy cells. In people with MS, the immune system attacks cells in the myelin, the protective sheath that surrounds nerves in the brain and spinal cord.

Causes #

Exposure to certain viruses or bacteria #

Some research suggests that being exposed to certain infections (such as Epstein-Barr virus) can trigger MS later in life.

Your habitat #

Your environment may play a role in your risk for developing MS. Certain parts of the world have significantly higher rates of the disease than others. Areas farther from the equator have higher rates of MS. That may be because these regions receive less intense sun. People who get less sun have lower levels of vitamin D, a risk factor for developing MS.

How your immune system functions #

Multiple sclerosis is an autoimmune disease. Researchers are working to figure out what causes some people’s immune cells to mistakenly attack healthy cells.

Gene mutations #

Having a family member with MS does increase your risk of the disease. But it’s still unclear exactly how and which genes play a role in triggering multiple sclerosis.

Types #

Clinically isolated syndrome (CIS) #

When someone has a first episode of MS symptoms, healthcare providers often categorize it as CIS. Not everyone who has CIS goes on to develop multiple sclerosis.

Relapsing-remitting MS (RRMS) #

This is the most common form of multiple sclerosis. People with RRMS have flare-ups also called relapse or exacerbation of new or worsening symptoms. Periods of remission follow (when symptoms stabilize or go away).

Primary progressive MS (PPMS) #

People diagnosed with PPMS have symptoms that slowly and gradually worsen without any periods of relapse or remission.

Secondary progressive MS (SPMS) #

In many cases, people originally diagnosed with RRMS eventually progress to SPMS. With secondary-progressive multiple sclerosis, you continue to accumulate nerve damage. Your symptoms progressively worsen. While you may still experience some relapses or flares (when symptoms increase), you no longer have periods of remission afterward (when symptoms stabilize or go away).

Symptoms #

• Changes in gait.

• Fatigue.

• Loss of balance or coordination.

• Muscle spasms.

• Muscle weakness.

• Tingling or numbness, especially in your legs or arms.

Diagnosis #

• No one test can provide a definitive MS diagnosis.

• To understand what’s causing symptoms, your healthcare provider will do a physical exam.

• You may also have blood tests and imaging tests, such as MRI.

• An MRI looks for evidence of lesions (areas of damage) in the brain or spinal cord that indicate multiple sclerosis.

• Lesions develop as a result of damage to the myelin sheath surrounding the nerves.

• A spinal tap (lumbar puncture) may also need to be done.

• If these tests don’t provide a clear answer, your neurologist may recommend an evoked potentials test.

• This test checks your nerve function by measuring electrical activity in the brain and spinal cord.

Prevention #

Eating a healthy diet #

There is no magic MS diet. Experts recommend a balanced diet that includes lots of fruit and vegetables, whole grains, healthy fats and lean protein. You should also limit your intake of added sugars, unhealthy fats and processed foods.

Getting regular exercise #

Multiple sclerosis can cause muscle weakness, loss of balance and difficulty walking. Aerobic exercise, flexibility and strength training are essential to help keep muscles strong and maintain physical function.

Managing stress #

Stress can take a physical and emotional toll. It can also interfere with sleep, which can worsen MS-related fatigue. It’s important to find ways to manage stress such as yoga, meditation, exercise, and working with a mental health provider.

Not smoking and limiting alcohol intake #

Smoking and alcohol are linked to worsening MS symptoms and could speed the disease’s progression. Quitting smoking will support your health.

Treatment #

Disease-modifying therapies (DMTs) #

Several medications have FDA approval for long-term MS treatment. These drugs help reduce relapses (also called flare-ups or attacks). They slow down the disease’s progression. And they can prevent new lesions from forming on the brain and spinal cord.

Relapse management medications #

If you have a severe attack, your neurologist may recommend a high dose of corticosteroids. The medication can quickly reduce inflammation. They slow damage to the myelin sheath surrounding your nerve cells.

Physical rehabilitation #

Multiple sclerosis can affect your physical function. Staying physically fit and strong will help you maintain your mobility.

Mental health counseling #

Coping with a chronic condition can be emotionally challenging. And MS can sometimes affect your mood and memory. Working with a neuropsychologist or getting other emotional support is an essential part of managing the disease.