Multiple sclerosis is a chronic disease that attacks the central nervous system. It affects the brain, spinal cord, and optic nerves.
Symptoms range widely. In milder cases, there may be numbness in the limbs. Severe cases may involve paralysis or vision loss.
It is not possible to predict how multiple sclerosis (MS) will progress in any individual.
It is two to three times more common in women than in men, and diagnosis usually occurs between the ages of 20 and 50 years.
Fast facts on multiple sclerosis
Here are some key points about multiple sclerosis. More detail is in the main article.
- Multiple sclerosis affects the central nervous system.
- Diagnosis usually happens between the ages of 20 and 50 years.
- It is impossible to predict how the disease will progress.
- Mild symptoms include tingling and numbness, but severe cases can involve vision loss and paralysis.
- There is no cure, but treatment can relieve symptoms and help the person manage their daily living.
MS affects the CNS, which controls all the actions in the body. When nerve fibers that carry messages to and from the brain are damaged, symptoms may occur in any part of the body.
For some patients, symptoms are so mild that they do not notice anything until later in the course of the disease. Others may be aware of their symptoms in the early stages.
The overall symptoms of MS are:
- muscle weakness
- visual disturbances
- difficulties with co-ordination and balance
- numbness and tingling, as in “pins-and-needles”
- problems with thinking and memory
The doctor will carry out a physical examination, ask about symptoms, and consider the patient’s medical history. No single test can confirm a diagnosis, so several strategies are needed when deciding whether a patient meets the criteria for a diagnosis.
There will be a neurologic exam, imaging scans, a test to measure the electrical activity of the brain, a spinal fluid analysis, and possibly other tests. These can help rule out other possible causes of the symptoms.
There is no cure for MS, so treatment focuses on suppressing the autoimmune response and managing symptoms.
Several disease-modifying drugs are approved for the relapsing forms of MS.
Corticosteroids: These are the most commonly prescribed drugs for MS. They reduce inflammation and suppress the immune system. They mostly treat an acute flare-up of symptoms in certain types of MS.
Interferon Beta 1a or 1b: These may slow down the progression of symptoms, but they must be used with care, as they can cause liver damage.
One study of data for 868 patients concluded that Interferon Beta was not helpful in preventing disability in the long term.
Copaxone (Glatiramer): This aims to stop the immune system from attacking myelin. It is injected once a day. Flushing and shortness of breath may occur after receiving the injection.
Tysabri (Natalizumab): This is used for patients who either cannot tolerate other treatments or have not benefitted from them. It increases the risk of developing multifocal leukoencephalopathy, a fatal brain infection.
Mitoxantrone (Novantrone): This immunosuppressant is normally used only in the later stages. It can damage the heart, but if symptoms are worsening rapidly, it can help slow down the progression of disability.
Cannabis extract: Studies have suggested that this may help relieve pain, muscles stiffness, and insomnia.
Aubagio (teriflunomide): This is a once-daily tablet for adults with relapsing forms of MS.
Rehabilitation aims to help patients improve or maintain their ability to perform effectively at home and at work.
Programs generally include:
Physical therapy: This aims to provide people with the skills to maintain and restore maximum movement and functional ability.
Occupational therapy: The therapeutic use of work, self-care, and play activities to increase development and prevent disability.
Speech and swallowing therapy: A speech and language therapist will carry out special training.
Cognitive rehabilitation: This helps people manage specific problems in thinking and perception.
Vocational rehabilitation: This helps people with disabilities make career plans, learn job skills, get and keep a job.