Multiple sclerosis (MS) is a chronic disease of the Central Nervous System (CNS). It is believed to be an autoimmune disease in which the body’s own defense system attacks myelin, leading to demyelination. Myelin is a soft white, fatty substance that surrounds and shields the nerve fibers in the central nervous system. Scar tissue is formed by damaged myelin (sclerosis), which gives the disease its name. Destruction of myelin leads to interference with the communication between your brain and the rest of your body. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing the variety of symptoms. Almost any neurological symptom can appear with the disease, and it often progresses to physical, cognitive and neuropsychiatric disorders. Coping with MS has become easier today and most people find it easier to lead productive, satisfying lives.

Although multiple sclerosis can occur at any age, it most often begins in people between the ages of 20 and 40. Women are more likely to develop multiple sclerosis than are men.

Multiple Sclerosis Symptoms:

The Symptoms of Multiple sclerosis can vary between people, and can range from mild to severe. Early symptoms can be very mild.

 

Some of the more common early symptoms of MS are:

• Numbness
• Tingling
• Weakness in one or more limbs
• Visual disturbances - optic neuritis, diplopia, nystagmus

As the disease progresses, other symptoms may include:
(Some symptoms listed below may occur early on)

• Cognitive difficulties
• Depression
• Unstable mood   
• Slurred speech
• Sudden onset of paralysis
• Lack of coordination
• Fatigue
• Heat sensitivity
• Bowel –incontinence, diarrhea constipation
• Urinary –incontinence, frequency or retention
• Abnormal sensations
• Speech and swallowing problems
• Tremors

Different Types, or Courses of Multiple Sclerosis (MS):

Some experts suggest that there are three types of MS, others including the national multiple sclerosis society recognize a fourth course of MS. Here are the four recognized forms of MS.*

 

1. Relapsing-remitting Multiple Sclerosis (RRMS) - Relapsing-remitting is the most common form of MS, affecting approximately 85 percent of MS patients. It is most commonly characterized by acute episodes of decreased neurologic function. These episodes, also called relapses, are essentially flare ups, or exacerbations of the illness. This is usually followed by partial or complete recovery periods, also known as remissions, during which time there is usually no marked progression of MS.

 

2. Primary-progressive Multiple Sclerosis (PPMS) – This form of MS affects approximately 10 percent of those newly diagnosed with the disease. This type of MS is characterized by a gradual decrease in neurologic function, which progressively becomes worse over time, with no period of remission. It can level out over time, or may continue to get progressively worse for many years.

 

3. Secondary-progressive Multiple Sclerosis (SPMS) – approximately 55% of people with relapse – remitting type of MS will develop SPMS within ten years of their original diagnosis. It is characterized by steady progression of the disease which may or may not include periods of relapse and remissions.

 

4. Progressive-relapsing Multiple Sclerosis (PRMS) – The rarest form of MS, it affects about five percent of MS patients. PRMS is characterized by a steady worsening of the disease from the onset or original diagnosis; it may also include marked attacks of decreased neurological functions throughout the course of the illness. Unlike other forms of MS, these patients may not experience any remissions from the relapses.

*Reference:

National Multiple Sclerosis Society. What is Multiple Sclerosis?

Available at: the MS Socciety 

Accessed December 28, 2009.

Multiple Sclerosis Diagnoses and Testing

Symptoms of MS can have similar characteristics of other nervous system disorders. The disease is often diagnosed by ruling out other conditions.

People who have relapsing-remitting form of MS may have a history of at least two attacks, separated by a period of reduced or no symptoms. The health care provider may suspect MS if there are decreases in the function of two different parts of the central nervous system at two different times.

A neurological exam may show reduced nerve function in one area of the body, or spread over many parts of the body. This may include:

• Abnormal nerve reflexes
• Decreased ability to move a part of the body
• Decreased or abnormal sensation
• Other loss of nervous system functions

Tests to diagnose multiple sclerosis include:

• Head and Spine MRI scan
• Cerebrospinal fluid tests, including CSF oligoclonal banding
• Lumbar puncture (spinal tap)
• Nerve function study (evoked potential test) 
  

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