Multiple Sclerosis (MS)
Multiple sclerosis (MS) is a disorder of the central nervous system: the brain, optic nerves and spinal cord. Plaque develops in these areas and causes demyelination (the destruction of the myelin sheath, the protective covering over nerves), which in turn impairs nerve signal transmission. Why this occurs is unknown, but it is thought to be an autoimmune disorder. There are several types of MS, but the most common are relapsing-remitting and chronic progressive. In the relapsing-remitting form, there are periods when MS worsens or exacerbates, followed by periods of improvement. The chronic progressive type slowly worsens over time.
Symptoms of MS
Symptoms of multiple sclerosis (MS) depend on the location of the plaque formation. Weakness, numbness or tingling and/or visual disturbances may be the first symptoms. When symptoms occur in a more acute manner, it is known as the first demyelinating event, and can be useful in making a definitive diagnosis.
Subsequent symptoms may include:
- Urinary retention
- Poor coordination and balance
- Difficulty walking
- Problems swallowing
- Sexual dysfunction
Diagnosing multiple sclerosis (MS) can be difficult and is often a lengthy process. Symptoms of weakness, numbness and/or tingling can indicate a wide variety of issues and alone are not a basis for a definitive diagnosis. A careful health history and neurological examination, along with other diagnostic testing, will help rule out other possibilities and give a definitive diagnosis of MS.
Additional diagnositic testing may include:
- Magnetic resonance imaging (MRI) of the brain and/or spinal cord.
- Lumbar puncture to analyze the spinal fluid.
- Lab tests to rule out other causes of the symptoms.
Treatment of multiple sclerosis (MS) may include disease-modifying first level medications (injectable interferon [e.g., Avonex®, Betaseron®, Rebif®] and glatiramer [e.g., Copaxone®, Glatopa®]) and then progressing as needed to oral medications (e.g., dimethyl fumarate [Tecfidera®], fingolimod [Gilenya®], teriflunomide [Aubagio®]) and monoclonal antibodies (e.g., alemtuzumab [Campath®, Lemtrada®], natalizumab [Tysabri®], ocrelizumab [Ocrevus®]). Steroids may be used during acute flares. Immune globulin therapy administered into the blood stream intravenously (IVIG) can be used when other MS disease modifiers are not effective and exacerbations or declines occur despite compliance with these medications, or if there are intolerable side effects. Another use is after childbirth. It is thought the hormones during pregnancy keep MS symptoms under control. Once the child is born, the risk of exacerbation increases. IVIG is also thought to be safe while mothers breastfeed. Addiitonally, IVIG is sometimes used during pregnancy while MS drugs that may cause fetal harm are discontinued.
- All About Multiple Sclerosis
- National Institute of Neurological Disorders and Stroke
- National Multiple Sclerosis Society
The information provided on this website is not medical advice, nor is it intended to be a substitute for medical advice, diagnosis, and treatment. Always seek the advice of a physician or other qualified health provider with questions concerning a medical condition. Never disregard professional medical advice, or delay seeking it based on information provided on this website.