Multiple Sclerosis (MS) is a disease of the central nervous system (brain, optic nerves, and spinal cord) in which the insulation (myelin) surrounding the nerves, and sometimes the nerves themselves, are damaged. This causes the nerves to short-circuit, resulting in lost body function. There is no cure, but there are treatments that slow its progression and reduce its severity.
It is estimated that approximately 400,000 people in the United States have MS, of whom about 300,000 have been diagnosed.
Multiple Sclerosis Symptoms
Symptoms of multiple sclerosis vary from person to person. Some notice symptoms for a short time, and then are symptom-free for years. Others experience a steady progression of symptoms.
Common symptoms include:
- Fatigue, especially in the afternoon or related to warmth
- Vision problems
- Bladder and bowel problems
- Sexual dysfunction
- Slurred speech
- Leg stiffness
- Difficulty swallowing
- Chronic aches
- Mild memory and cognitive problems
Causes and Prevention
Multiple sclerosis is an autoimmune disease, in which white blood cells attack the body's own central nervous system, causing inflammation, which damages the myelin and, eventually, the nerves themselves. Areas of sclerotic (scar) tissue may form along the damaged myelin. From these, multiple sclerosis gets its name.
It seems that a combination of factors causes the disease. There is considerable evidence that exposure to common, slow-acting viruses, especially Epstein-Barr, may cause MS to develop later in genetically susceptible people. Researchers are also looking for a connection between MS and nutrition. It has been noted that people who live near the equator and get more sun and more vitamin D have a lower incidence of MS.
The first symptoms usually appear between ages 20 and 40. Whites are more than twice as likely as other races to develop MS.
There is no single test for Multiple Sclerosis. If your symptoms, medical history, and a neurological exam suggest MS, your WellStar neurologist will order further tests.
To diagnose MS, your neurologist must:
- Find evidence of damage in at least two separate areas of the central nervous system
- Find evidence that the areas of damage occurred at least one month apart
- Rule out other possible diagnoses
Imaging tests can find the central nervous system scar tissue resulting from MS. Magnetic resonance imaging (MRI) is a standard tool in diagnosing MS as well as monitoring treatment and progression. Magnetic resonance spectroscopy (MRS) investigates the brain's chemistry; low levels of N-acetyl aspartate indicate nerve damage.
Evoked potential (EP) tests record the nervous system's electrical responses to stimuli. Since myelin damage results in slower response time, EP tests can provide evidence of MS. Visual evoked potential (VEP) tests are considered the most useful in diagnosing MS.
Examination of the cerebrospinal fluid, taken through a spinal tap, can show abnormalities associated with MS, like increased white blood cells and protein, especially myelin basic protein.
The first long-term MS treatments became available in the 1990s under the brand names Avonex®, Betaseron®, and Copaxone®, and were called the A-B-C drugs. Since then, five more drugs have been approved for the treatment of MS. Generally, patients use only one drug at a time. Since effectiveness and side effects vary, your WellStar neurologist will work with you to find the best drug to slow the progression of your MS. There are now newer medications, with excellent efficacy, which can be given orally.