March—National Multiple Sclerosis (MS) month—is all about understanding MS. According to the National MS Society (NMSS), almost one million Americans have MS, and yet much is still unknown about the disease. Recognizing symptoms and risk factors can be critical to receiving an early diagnosis and intervention, which can greatly improve quality of life.

What is MS?

MS is a disease of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves. It occurs when the body’s immune system erroneously attacks the CNS, causing damage to the nerves, which results in faulty communication between the spinal cord, brain and rest of the body.

Although historical records indicate that people have suffered from symptoms suggestive of MS since the 1200s, it wasn’t until 1868 that it was named, and not until the 1950s was the first effective treatment for symptoms created. Although there is still no cure, today, over 20 medications exist to treat MS symptoms. 

Risk Factors

Even though the cause of MS is still unknown, researchers believe that a combination of multiple factors cause the abnormal immune response, which, in turn, causes inflammation and damage. 

These factors include:

Environmental Factors — High rates of MS in certain geographic locations and time periods suggests that exposure to an unknown agent—like an infectious disease—may play a role in the development of MS.

Infectious Factors — Researchers have studied many different viruses and bacteria to see if they increase the likelihood of developing MS. Ultimately, many have been disregarded, although not all have been ruled out, including Epstein-Barr Virus. 

Genetic Factors — While it has been determined that MS cannot be inherited, scientists are still considering the possibility that genetic risk might be inherited.  

Symptoms

MS symptoms are unpredictable, making the disease difficult to recognize. Symptoms often differ in both presentation and severity, and the disease progresses differently for each person. However, some common symptoms that may present include:

• • Fatigue
• • Numbness or tingling in the face, body or extremities  
• • Muscle weakness, which can lead to difficulty walking
• • Dizziness and vertigo
• • Pain and itching 
• • Emotional changes, including depression, irritability and mood swings
• • Muscle spasms
• • Vision problems
• • Bladder and bowel problems
• • Cognitive issues

Someone with MS may develop symptoms over the course of a few days or weeks, only to have symptoms disappear completely for months or years. This progression of the disease is known as relapse-remission. Over time, symptoms displayed during relapses worsen, although the rate at which this occurs can vary wildly over a period of 10 to 20 years.

Diagnosis

Unpredictable symptoms can make diagnosing MS tricky, and a diagnosis usually requires eliminating other possible causes of neurological symptoms. While there is no one test that can lead to an MS diagnosis, doctors have developed strategies to identify MS. A lengthy medical history can often rule out other causes; a neurological exam can confirm nerve damage; and other tests, including MRIs and blood tests, can rule out other conditions. 

Once other conditions have been ruled out, doctors look for at least two spots of damage on the CNS that have occurred at different times to confirm diagnosis. 

Prognosis and Treatment

Because MS is not curable, treatment focuses on slowing the progression of the disease, treating relapses, managing symptoms and maintaining quality of life. A comprehensive care plan often includes many medical professionals, including a neurologist. 

Medications can be used to treat the course of MS, as well as mitigate the frequency of relapses and reduce damage-inflicting inflammation in the CNS during relapses. Rehabilitation specialists can implement a variety of therapies, including physical, occupational and speech therapy, to ease symptoms. Mental health professionals can assist with the emotional toll of the disease. 

Although MS is a chronic disease, many people continue to lead a long life, and some may not need treatment at all. Thanks to advances in treatments, the lifespan of a MS patient has increased over the past 25 years. The progression of the disease can be slowed down, thanks to development of treatments and therapies, allowing greater mobility for a longer time after onset of MS.

According to the National MS Society, those diagnosed with MS are still likely to die about 7 years earlier than the national average. However, those with MS rarely die from the disease itself—rather, they die from medical complications related to MS. Therefore, the more we understand about the illness, the more we can help loved ones get treatment and improve quality of life. 

Visit https://www.nationalmssociety.org/What-is-MS to learn more or to get involved with an MS walk in your area. 

Written by: Sarah Harder