Unless you have or know someone who has multiple sclerosis (MS), you probably don’t know much about it. However, according to the Multiple Sclerosis Society, over 2.3 million people worldwide have been diagnosed with this chronic, very individualized, uncurable illness that has been around since the 1800’s.
“MS is the most common immune condition of the central nervous system affecting young adults,” says Dr. Komal Naik, Chair of Neurology at Summit Health. “But some MS symptoms are not so obvious to an outsider, such as vision impairment, fatigue, tingling, or bladder dysfunction, and it’s that invisibility that contributes to lack of awareness for this potentially devastating disease.”
What is Multiple Sclerosis (MS)?
Multiple Sclerosis, or MS, is an autoimmune disease that is extremely unpredictable in nature. In MS, the body’s immune system mistakenly attacks the layer that protects brain and spinal cord nerve fibers. When that layer of protection is damaged, messages are unable to travel efficiently along the nerves, and this causes interruption between the brain and the rest of the body. In early stages of MS, the body can repair itself, but after time, this activity can lead to long-lasting damage.
What causes MS?
The exact cause of MS is unknown. However, increasing evidence suggests that genetics, lifestyle, and environmental factors may play a role. Some of the most common risk factors include:
- Age: Most people are diagnosed with MS in their 20s and 30s. While children can be diagnosed, the risk of developing MS increases with age.
- Gender: Women are twice as likely as men to develop MS.
- Race: MS is most common in people of Northern European descent.
- Genetics: Those with immediate relatives afflicted by the disease may be at an increased risk themselves.
- Smoking: Studies have shown that smokers are 1.5 times more likely to develop MS than nonsmokers. Smoking may also contribute to rapid disease progression.
- Obesity: Being extremely overweight increases risk of developing MS.
- Infections: Some viruses such as Epstein-Barr and herpes may contribute to MS development.
- Low levels of vitamin D: People who have low levels of vitamin D have a higher risk for MS and those with higher blood levels of vitamin D have been shown to have better outcomes over time.
What are the symptoms of MS?
“The signs and symptoms of MS differ greatly from individual to individual and from day to day,” says Dr. Naik. Damage is being done to the nerves that control body function, so a wide range of symptoms may result, including:
- Fatigue
- Skin numbness, burning, or tingling
- Eye issues
- Memory problems
- Leg weakness
- Muscle spasms
- Bowel or bladder problems
- Sexual dysfunction
The way the disease changes or progresses is different for everyone, but once identified, there are three courses the disease can take.”
- Relapsing-remitting MS (RRMS) - This most common type is characterized by temporary flare-ups of new symptoms. These attacks are followed by periods of partial or complete recovery.
- Secondary-progressive MS (SPMS) - This type is characterized by symptoms that worsen steadily over time with or without relapses or temporary recovery.
- Primary-progressive MS (PPMS) – This type is characterized by slowly worsening symptoms from onset with no recovery.
How is MS diagnosed?
There is no single test that can diagnose MS, and since many of the symptoms experienced with the disease can also crop up with other conditions, it can be a difficult diagnosis to confirm.
Magnetic resonance imaging (MRI) is the best tool for identifying brain and spinal cord lesions or swelling that may indicate MS. However, in order to rule all else out, doctors will start with a thorough review of medical history, a complete neurological exam, a spinal fluid analysis, and blood workups.
How is MS treated?
Treatments for MS vary depending on severity but may include over-the-counter pain relievers or stool softeners, or prescription treatments such as muscle relaxants and corticosteroids.
“MS is a complex disease that requires a comprehensive treatment plan that addresses both the physical and emotional aspects,” says Dr. Naik. “My teams’ goal is to diagnose early so we can begin disease-modifying therapies that will manage symptoms, slow disease progression, and improve quality of life. And sometimes that’s a combination of things.”
In addition to oral or infused medications given at the Summit Health Infusion Center, Summit Health offers a variety of ancillary services to support patients, including acupuncture, physical therapy, nutrition, behavioral health, massage therapy, occupational and speech therapy, ophthalmology, and urogynecology.
While MS is a lifelong condition, it’s not a terminal illness. “It’s not easy, but with enough experience, patients can function with the disease and live full lives,” says Dr. Naik.