Multiple Sclerosis (MS)

WHAT IS MS?

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system.

A combination of factors appears to be involved in the development and progression of multiple sclerosis (MS), the most common form of autoimmune disease, according to a new study from the University of California, San Diego School of Medicine. A new analysis of data from more than 1,000 MS patients, used by researchers to investigate the effects of various factors on the progression and development of MS, such as age and gender, suggests that it is primarily a result of a complex set of genetic and environmental factors, rather than a single cause.

The most common form is relapse – MS, which affects about 85% of people with MS. There are two types of relapses: progressive relapsed MS (remitted MS) and progressive remittances, and there are several different forms of relapse and remitting MS in the US, but the most common is the relaxed relapsed form, which affects about 1.5% to 3% more people than the progressive form and is responsible for about 10-15%, according to the Centers for Disease Control and Prevention.

The next most common form is primary progressive MS, which affects about 1.5 to 3% of people with MS in the US. Multiple sclerosis is rarely fatal, and the average life expectancy of the population is 93 percent.

If you know that you have fallen back into a form of multiple sclerosis, you will have a better understanding of how to design your therapy in a way that fits into your life. It can disrupt your lifestyle in many ways and will never go away, but it can cause a lot of pain and suffering.

Multiple sclerosis can occur differently from person to person depending on the location of the affected nerve fibers. As MS can damage nerves in parts of the brain and spinal cord, you may have symptoms at different times in your life.

To diagnose MS, your healthcare provider must find evidence of the disease at various times and periods that matches the symptoms of multiple sclerosis (MS), such as headaches, dizziness, fatigue and nausea. A definitive diagnosis of MS requires at least two separate seizures and lesions in the brain or spinal cord that point to previous seizures. If you have had two different attacks on the same nerve fibers, or even two separate attacks at different times, then your doctor may suspect MS. Diagnosis of MS requires that demyelination has taken place at two or more different points in your life (e.g. during the first seizure and the second).

At UCSF Children’s Hospital, the Centre for Pediatric Multiple Sclerosis is dedicated to improving the quality of life of children with multiple sclerosis and their families. It is the only center of its kind on the West Coast and has been designated by the National Multiple Sclerosis Society as the National Centre of Excellence for the Prevention and Treatment of Multiple Sclerosis. Penn’s Comprehensive MS Center also works to ensure the long-term health and well-being of people with MS in the U.S. and abroad. Ultimately, our goal is to accelerate the development of new treatments for multiple sclerosis such as MS and to better serve the community with science.

People diagnosed with CIS may have brain lesions consistent with MS and exhibit symptoms such as headaches, dizziness, nausea, fatigue, muscle spasms and muscle pain. People with multiple sclerosis may also feel tingling in their hands, feet or other parts of the body. Sexual arousal can also be a problem for people with MS, as it can start at any time with varying intensity over time. Symptoms of multiple sclerosis range from mild to severe; symptoms can persist or worsen in varying degrees and intensities.

In multiple sclerosis, the protective layer of nerve fibers, the myelin, is damaged or may eventually be destroyed. Myelin is a protective layer of nerve cells in the brain and spinal cord and is damaged in MS when it attacks by a process called demyelination. Myeline is destroyed, nerve and cell spots are exposed and then scarred in sclerosis. A person with MS has a number of symptoms, each occurring at different times, so other possible diagnoses must be ruled out.

Common MS symptoms may include:

Cognitive difficulties

Many people with MS have problems with cognition. Symptoms may include memory loss, attention and concentration issues, difficulty processing information, trouble planning and prioritizing, and verbal fluency issues (like word recall).

Vision problems

People with MS may experience problems with their eyes. This happens because the optic nerve can become inflamed, or other related nerves can be damaged, resulting in potential blurred vision, loss of normal color vision, blindness in one eye, a dark spot in the field of vision, double vision, and uncontrolled eye movements or “jumping vision.”

Fatigue

People with MS may become more easily worn out after physical activity than usual. In addition to experiencing physical fatigue from doing simple things, people with MS may also experience mental fatigue from depression. There is also a type of fatigue called “lassitude” or “MS fatigue” that many believe to be unique to people with MS, which is generally more severe than normal fatigue. This type of fatigue may happen almost every day and could start early in the morning after a good night’s sleep. Lassitude also often worsens with heat and humidity.

Heat sensitivity

High temperatures make it harder than it already is for demyelinated nerve cells to conduct electrical signals. Because of this, many people with MS may experience a temporary worsening of MS symptoms when exposed to heat or dealing with a fever. Symptoms caused by heat are typically temporary and do not cause further damage to the nerves. Once the temperature cools, even by a small amount, the symptoms usually subside.

Bowel and bladder problems

Problems with your bowel and bladder can happen because MS lesions may block or delay nerve signals in parts of the central nervous system that control the bowel, bladder and urinary muscles. Symptoms of bladder dysfunction may include incontinence; having to urinate frequently, urgently, or at night (nocturia); and the inability to empty your bladder completely. Bowel problems may include constipation and diarrhea.

Sexual issues

The nerve damage caused by MS may lead to issues with sexual function. This means sexual response—including arousal and orgasm—can be directly affected. Men may experience difficulty achieving or maintaining an erection, and reduced sensation or difficulty achieving ejaculation. Women may experience reduced sensation, painfully heightened sensation, or vaginal dryness. Sexual issues may also stem from other MS symptoms such as fatigue or spasticity, as well as from psychological factors relating to self-esteem and mood changes.

Pain

People with MS may feel things like sharp stabbing facial pain. Burning, aching, and tingling “pins and needles” are also common around the body. Chronic back and musculoskeletal pain may be experienced as a result of walking problems and/or muscle spasticity. If you’re experiencing pain, it’s important to identify its source with the help of your healthcare provider. Read more about other types of MS pain.

Motor problems

Because MS can damage the nerves in the spinal cord and brain, your muscles may become weak and ineffective. Stiff muscles and spasms, or sudden involuntary movements, also known as spasticity, are common. Trouble with walking is also common in people with MS. Many people with MS may also experience some degree of tremor, or uncontrollable shaking, which can occur in various parts of the body. Always talk to your healthcare provider if you are experiencing any pain or motor problems.

What are the main types of MS treatments?

Pills

Pills, also known as oral medications, can come in tablet or capsule form.

Infusions

Infusion treatments are administered intravenously (IV), usually through a needle in the arm. They may be given less frequently than self-administered therapies and are typically administered by a healthcare professional in a hospital, infusion center, or doctor’s office.

Injections

Injectable therapies are another way to treat MS. Your doctor can show you, or your care partner, how to use a needle or autoinjector to inject the medication under your skin or into your muscle tissue.

Be sure to discuss your symptoms and treatment options with your doctor. Together, you can decide which treatment may be best to help with your MS.

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