What Is Multiple Sclerosis (MS)? How Do You Get MS?
Multiple sclerosis (MS) is a chronic disease that affects different parts of the central nervous system (CNS) at different points in time. The central nervous system is made up of the brain and spinal cord. The brain controls bodily activities, such as movements and thoughts. The spinal cord serves as a pathway for messages between the brain and various parts of the body. These messages participate in most bodily actions. Because multiple sclerosis affects different parts of the central nervous system, it can affect the functioning of many parts of the body.
Many researchers consider multiple sclerosis an autoimmune disease of the (CNS). In an autoimmune disease that affects the brain or spinal cord, the body's immune system (its defense system against infection and disease) treats normal CNS tissues as foreign and attacks them. Moreover, in MS, the body’s immune system attacks the fatty substance that surrounds and insulates nerve fibers or myelin sheath, and the nerve fibers themselves called demyelination. The myelin forms scar tissue (sclerosis), which is the basis for the name of for multiple sclerosis. When the immune system attacks tissues in the (CNS), as in multiple sclerosis, the messages the brain sends are interrupted.
Who Has Multiple Sclerosis? Is MS Genetic (Inherited)?
- The onset of MS typically occurs between the ages of 20-50 years. MS is the most common, disabling neurologic disorder in young adults.
- Women are about 2 times more likely than men to develop MS.
- The disease is more common in people who live farther from the equator, although the strength of this association has recently been questioned.
- MS occurs more frequently in whites with northern European ancestry. People living in North America, Europe, and Australia are more likely to develop MS than those living in Asia.
- Genetic factors play a role in MS. If a parent or a sibling has MS, the risk of developing MS is 3%. If an identical twin has MS, the risk of the other twin is 25-40%.
- Endocrine factors are also thought to play a role in MS. For instance, there is a decrease in the number of MS attacks during pregnancy. Within the 3 months that follow pregnancy, the chance of new MS attacks is higher. This fluctuation in disease severity is thought to be a response to hormonal changes that occur during the pregnancy and the postpartum period.
What Are the Early Warning Signs and Symptoms of Multiple Sclerosis?
Symptoms of multiple sclerosis that appear in adults, teens, and children (pediatric MS) depend upon the part of the central nervous system affected and the function of the damaged nerve. Early signs and symptoms of MS may appear for days or weeks, and then disappear. Symptoms can be mild, moderate, or severe, and include:
- Vision changes, including blurred, patchy or hazy vision, and loss of color perception, which may be accompanied by eye pain (Double vision may occur if the nerve pathways in charge of eye movements are affected.)
- Fatigue, tiredness, and lack of energy
- Muscle tightness or spasticity
- Imbalance and incoordination
- Bladder and bowel problems
- Facial pain
- Slurred speech
- Difficulty with walking and fine motor skills
- Mood swings
- Memory loss
People with multiple sclerosis may have worsening of symptoms after taking a hot shower or bath, or being outside in hot weather for prolonged periods.
When MS symptoms that are active, they are referred to as attacks or relapses. When there are no symptoms of multiple sclerosis, they are referred to as remissions.
Most people with MS have days or weeks of relapses followed by months or years of remissions, called relapsing-remitting MS.
Other conditions related to MS that may have similar symptoms include acute disseminated encephalomyelitis (ADEM), Balo’s disease, HTLV-I associated myelopathy (HAM), neuromyelitis optica (NMO), Schilder's disease, and transverse myelitis.
What Is the Prognosis for Multiple Sclerosis?
The progress of MS and a person's prognosis cannot be predicted at the early stages with great accuracy. People with multiple sclerosis are advised at the early stages to try to lead a normal life, exercise frequently, and follow healthy diets. However, no particular diet for MS has been shown to adversely affect the course illness.) If you have MS, monitor symptoms that appear during exercise to adjust and learn to moderate your level of effort accordingly.
MS Relapses, Remissions, and Complications
- Most people with MS relapses and remissions will eventually need assistance to walk within 15-20 years. The disease tends to become progressive, and many of these people will eventually need canes, walkers, scooters, or wheelchairs to deal with the disability caused by the disease. Some choose to use a scooter early on to help conserve their energy.
- A small percentage of people with MS have a very mild form of the illness with little or no disability and few symptoms, although in many, the disease may progress to a more moderate form within 25 years. Although these individuals appear to have few neurologic deficits, a detailed neurologic examination in some may reveal substantial cognitive impairment.
- A large percentage of people have relapsing-remitting MS (RRMS), with intermittent worsening of neurologic symptoms that usually last several weeks. After years of relapses, MS patients with relapsing-remitting MS may switch to a steadily progressive form of the disease known as secondary-progressive (SPMS).
- Some people with MS have a relapsing-progressive form of the disease from the onset, and do not return to their normal state of health after a relapse. These individuals may accumulate disability with and between each attack.
- A lower percentage of people have a progressive form of the MS, termed primary-progressive MS (PPMS) in which problems with the nervous system progress every year despite the absence of clear exacerbations.
- Avoid exposure to excessive heat since it may exacerbate latent symptoms of MS, such as visual blurring, tingling, and numbness, or fatigue.
Complications of MS (usually seen in patients in the advanced stages of the disease) include medical conditions such as:
- Pressure sores caused by immobility and long periods of time in a wheelchair or bed
- Osteoporosis caused by lack of weight-bearing exercise and side effects of corticosteroid treatment
- Severe bladder or kidney dysfunction due to chronic urinary dysfunction
- Aspiration pneumonia caused by problems swallowing
What Is the Life Expectancy for Multiple Sclerosis? Can You Die from MS?
Multiple Sclerosis cannot be cured, and you cannot die from it (it is not fatal). People with MS can die from the complications of advanced MS. However, the life expectancy for a person with MS is similar to general population. People with MS can be treated with medications that speed the recovery of relapses, relieve symptoms, or are prevention.
How to Adjust to Living with Multiple Sclerosis
If you or a loved one has been diagnosed with multiple sclerosis, you may find support and encouragement from:
- The National Multiple Sclerosis Society or its local chapters
- Multiple Sclerosis Foundation
- Multiple Sclerosis Association of America
Several MS Centers or clinics have available support groups for patients with MS and their families.
1. Adams R, Victor M, Ropper A. Multiple Sclerosis and Allied Demyelinative Diseases. In: Principles of Neurology. 6th ed. NY: McGraw-Hill; 1997:902-927.
2. Dangond F. Multiple Sclerosis: A Prototypical Human Demyelinating Disease. In: Dangond F. Disorders of Myelin in the Central and Peripheral Nervous Systems. Butterworth-Heinemann; 2002:103-138.
3. Dangond F. Repair and Neuroprotective Strategies in MS. In: Olek MJ. Multiple Sclerosis. Etiology, Diagnosis, and New Treatment Strategies. Totowa NJ: Human Press; 2004:193-207.