Multiple sclerosis (MS) is a neurological disease that is unpredictable and affects people in different ways. Because of that, understanding the disease’s symptoms, how it is diagnosed, and available treatment options can be confusing. We asked Dr. Neha V. Safi, a Penn Medicine Lancaster General Health neurologist and MS expert, to answer some questions her patients commonly ask.
What is MS?
To understand MS, it’s important to first understand the central nervous system (CNS). The CNS is made up of the brain, spinal cord, and optic (eye) nerves. It controls everything we do by sending messages from the brain and spinal cord to the rest of the body. The CNS impacts how we think, move, and feel.
MS is an autoimmune disease. In people with MS, their immune cells mistakenly attack the CNS, damaging the neurons’ protective covering known as myelin. This damage disrupts the signals to and from the brain, which can cause various neurological symptoms.
What causes MS? Is the disease genetic?
While the exact cause of MS is not known, we do know that something triggers the immune system to attack the CNS. Researchers are looking at several possible causes, including viruses or environmental factors.
Having a first degree relative with MS can increase your risk of developing MS from less than 1 percent to about 3 percent. So it’s possible that MS is hereditary to a certain degree, but it’s not the main cause of MS.
Of note: Because some of the genes associated with MS are similar to those linked to other autoimmune diseases like type 1 diabetes, lupus, and rheumatoid arthritis, it’s important to let your doctor know if you suffer from any of these conditions.
There is also some evidence showing that people who grew up in areas farther from the equator may be more likely to get multiple sclerosis, as this may be related to vitamin D levels. The disease is most common in females, and symptoms generally start between the ages of 20 and 40 years; however, this doesn’t mean that the disease is only present in these populations.
What are some of the early symptoms of MS?
MS is different for each person, which makes it hard to predict. The disease can cause a wide range of symptoms that vary depending on the specific type of MS one has and the areas of damage it causes within the CNS. Symptoms may begin over a few days and go away quickly or develop gradually over many years:
- Numbness, tingling or pain in the arms, legs, trunk or face
- Loss of balance and dizziness
- Vision problems, including blurred or double vision, pain with eye movement, and rapid vision loss in one eye
- Muscle weakness and stiffness, accompanied by muscle spasms
- Bladder control problems
- Problems with memory and thinking
- Mood changes
Everyone’s experience with MS is different, and these losses may be temporary or long-lasting.
How is MS diagnosed?
Because the first symptoms of MS can be vague, and those symptoms can be caused by problems other than MS, diagnosing the disease can be challenging. Adding to the difficulty is the fact that doctors can’t diagnose MS unless you have had classic clinical symptoms of the disease with patches of damage, or lesions, in at least two different areas of your CNS.
To begin the diagnosis process, your doctor will ask questions about your symptoms, examine you, and order some tests. An MRI is often used to confirm the diagnosis because the lesions caused by MS attacks can be seen with this test. If these results are concerning, but not quite definitive, your doctor may also ask you to get an eye exam with a neuro-ophthalmologist and/or a lumbar puncture, or spinal tap.
What treatments are available to treat MS?
While there is no cure for MS, there are treatments and things you can do to help you maintain your quality of life.
- Self-care, including eating balanced meals, getting regular exercise and rest, and using your energy wisely
- Physical therapy, occupational therapy, and speech therapy to help with physical problems
- Steroids can help to improve your symptoms from an acute MS attack and potentially make the attacks shorter or less severe
- Various medications can be used to control specific symptoms due to prior MS attacks
- Disease modifying therapy can help to prevent MS attacks from occurring and slow or even stop disease progression
Living with the physical and emotional demands of MS isn’t easy, but encouraging progress is being made every day in the development of new treatment options to help reduce the disability related to MS. Talk with your doctor for the latest information and how to best deal with your symptoms.