Symptoms
Multiple sclerosis (MS) is an unpredictable disease. MS can range from fairly mild to somewhat disabling to devastating. MS affects from 250,000 to 350,000 people in the United States and 2.5 million worldwide.
Many researchers believe that MS is an autoimmune disease — one in which the body's immune system launches a defensive attack against its own tissues. In the case of MS, it is the myelin that insulates the body's nerves that is attacked. Such attacks may be linked to an unknown environmental trigger, perhaps a virus.
Most people experience their first symptoms of MS between the ages of 20 and 40. The initial symptom of MS is often blurred or double vision, color distortion, or even blindness in one eye. Other symptoms can include tingling, numbness, muscle spasms, and bladder control problems. Many people with MS have muscle weakness in their legs and arms and difficulty with coordination and balance.
These symptoms may be severe enough to affect walking or even standing. In the worst cases, MS can produce partial or complete paralysis. Some may also have pain. Speech problems, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss.
About half of all people with MS experience problems with thinking, such as difficulties with concentration, attention, memory, and poor judgment. But such symptoms are usually mild and are often overlooked. Depression is another common feature of MS.
Click to enlarge image
In multiple sclerosis (MS), the myelin that covers nerve cells becomes inflamed,
swollen, and
detached. It is then destroyed, forming a scar over
the axons
(nerve fibers). Sclerosis means scar.
Illustration: Patient Education Institute
Diagnosis
MS can be difficult to diagnose in some cases, notes Joan Ohayon, R.N., M.S.N., a clinically registered nurse practitioner with the Neuroimmunology Branch of the National Institute of Neurological Disorders and Stroke (NINDS).
"One reason is that there's not one specific diagnostic test that tells you, yes, you have MS, or, no, you don't," says Ohayon. "Fortunately, MRI technology (magnetic resonance imaging) has revolutionized the way we diagnose and manage and treat MS."
While some people with MS have clear cut, textbook cases, other cases are less clear. A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms.
While some patients are mildly affected, in the worst cases MS can leave a person unable to write, speak, or walk. MS is a disease that may wax and wane. The types of MS include:
- relapsing-remitting, the most common type, in which symptoms appear for short periods, then seem to go away
- progressive MS, in which symptoms worsen.
- secondary-progressive, which begins with a relapsing-remitting course and is followed by a later primary-progressive course.
Treatment
There is no cure for MS, but there are drugs that slow the progression of the disease. As of now, there are eight drugs that have been approved by the Food and Drug Administration (FDA). A tremendous amount of progress has been made. Most of these drugs target only the early stage of the disease, not the progressive stages that are worse. Treatment often depends on which type of MS an individual has.
Questions to Ask Your Healthcare Provider
Good communications with your healthcare provider is very important in making sure you get the best, most accurate information about your health.
- Given my symptoms, could I have multiple sclerosis?
- What tests are needed to help diagnose whether or not I have MS?
- Does MS run in families?
- What other diseases might be causing my symptoms, other than MS?
- What stage of MS do I have, and will it get worse or better through treatment?
- Can diet and exercise affect my MS?
- Is there a chance my MS will ever go away?
Latest NIH Research
Scientists continue their extensive efforts to create new and better therapies for MS. At NIH, the National Institute of Neurological Disorders and Stroke (NINDS) conducts such research and funds additional research at major medical centers.
- Interferons: Beta interferon (a naturally occurring antiviral protein) has been shown to help prevent the disease from getting worse and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe.
- Idebenone: Clinical research is under way with this experimental drug originally developed for Alzheimer's disease. It is being tested on with people have the primary progressive form of MS.
- Rituximab: NINDS is conducting clinical research on this drug to evaluate the safety and effectiveness of using both intravenously and via an injection to treat secondary progressive MS.
- Daclizumab: NINDS researchers are exploring this drug as it relates to abnormal immune reactions in MS. The researchers are also discovering new keys to the basic biology of the immune system.
In addition, there is a number of other treatments under investigation that may curtail attacks or improve function. Over a dozen clinical trials testing potential therapies are under way, and additional new treatments are being devised and tested.
To Find Out More
- MS Information Page – National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/disorders/multiple_sclerosis - MedlinePlus – In the Search box, type in "MS"
http://www.nlm.nih.gov/medlineplus/ - NIH Clinical Trials – Click on "Search for Clinical Trials" link, then type "MS" in Basic Search box
http://clinicaltrials.gov/ - NIH Clinical Research Trials and You – Click on "Finding a Clinical Trial" link
http://nih.gov/health/clinicaltrials/