Multiple Sclerosis (MS)

The symptoms of MS vary from person to person. Which symptoms you have will depend on which parts of the brain or spinal cord (central nervous system) are damaged. The loss of myelin and scarring caused by MS can affect any part of the central nervous system. Myelin is the insulating coating around a nerve.

Symptoms may come and go or become more or less severe from day to day or, in rare cases, from hour to hour. Symptoms may get worse with increased body temperature or after a viral infection.

Early symptoms

Common early symptoms of MS include:

• Muscle or motor symptoms.
  • These include weakness, leg dragging, stiffness, a tendency to drop things, a feeling of heaviness, clumsiness, and a lack of coordination (ataxia).
• Visual symptoms.
  • These include blurred, foggy, or hazy vision, eyeball pain (especially when you move your eyes), blindness, or double vision. Optic neuritis—sudden loss of vision that is often painful—is a fairly common first symptom.
• Sensory symptoms.
  • These include tingling, a pins-and-needles sensation, numbness, a band of tightness around the trunk or legs, and electrical sensations moving down the back and legs.

Advanced symptoms

As MS progresses, symptoms may become more severe. They may include:

• Worse muscle problems, and stiff, mechanical movements (spasticity) or uncontrollable shaking (tremor). These problems may make it hard to walk. A wheelchair may be needed some or all of the time.
• Pain and other sensory symptoms.
• Bladder symptoms, such as loss of bladder sensation or not being able to hold urine (urinary incontinence) or to completely empty the bladder.
• Constipation and other bowel disorders.
• Male erectile dysfunction (impotence) and female sexual dysfunction.
• Cognitive and emotional problems, such as problem-solving and depression. These are common in people who have had MS for some time.
• Feeling very tired (fatigue). This can be worse if symptoms such as pain, spasticity, bladder problems, anxiety, or depression make it hard to sleep.

The exact cause isn't known, but most experts believe that MS is an autoimmune disease. In this kind of disease, the body's defenses, called the immune system, mistakenly attack normal tissues. In MS, the immune system attacks the central nervous system—the brain and spinal cord.

Diagnosing MS isn't always easy. The first symptoms may be vague. And many of the symptoms can be caused by problems other than MS.

The doctor will examine you and ask you questions about your symptoms. And some tests will be done. MS isn't diagnosed unless a doctor can be sure that you've had at least two attacks that affect at least two different areas of your central nervous system. These areas are usually the brain, the spinal cord, or the nerves to the eye.

An MRI is often used to confirm the diagnosis. That's because the patches of damage (lesions) caused by MS attacks can be seen with this test.

But abnormal MRI results don't always mean that you have MS. The diagnosis is made based on your symptoms, your neurological exam, and the results from an MRI and other tests.

Treatment can make living with MS easier. Your type of treatment will depend on how severe your symptoms are and whether your disease is active or in remission. You and your doctor will set up a schedule of appointments to watch and treat your symptoms. These checkups help your doctor find out if you may need to try a different treatment.

Different medicines are used to treat MS. Medicines called disease-modifying drugs may be used over a long period of time. They help to keep down the number of attacks and how severe they are and to slow the progress of the disease. Other medicines may be used during a relapse or to control certain symptoms.

Physical therapy, occupational therapy, and speech therapy can help you manage some physical problems caused by MS. There are also things you can do to help yourself. You can eat balanced meals, get regular exercise and rest, and learn to use your energy wisely.

In some cases, surgery may be done if you have severe tremor (shakiness) that affects movement. Or it may be done to implant a catheter or pump in the lower spinal area to deliver a constant flow of medicine to help treat severe muscle stiffness (spasticity).

Some complementary medicine treatments may help relieve symptoms of MS. For example, gingko biloba or magnetic therapy may help relieve fatigue. Talk to your doctor if you are interested in trying any of these treatments.

Dealing with the physical and emotional demands of MS isn't easy. If you feel overwhelmed, talk to your doctor. You may be depressed, which can be treated. Finding a support group where you can talk to other people who have MS can be very helpful.