Multiple sclerosis (MS) is an unpredictable disease of the central nervous system in which nerve damage disrupts communication between the brain and the body. This can cause a wide range of symptoms that may include pain, fatigue, weakness, impaired coordination, loss of the ability to see, speak or walk, cognitive (thinking) problems and digestive issues.
These symptoms, as well as their severity and how long they last, can vary from person to person. Some people may be symptom free for most of their lives, while others can have debilitating symptoms that are chronic (long-lasting). Still others have periodic flare-ups—episodes when their symptoms get worse, then improve.
MS is considered an autoimmune disorder, which means it occurs when the body mistakenly attacks itself. In MS, the immune system destroys myelin, the fatty tissue that surrounds and protects nerve fibers in the brain and spinal cord. When myelin is destroyed, it forms scar tissue called sclerosis. Doctors also refer to these areas as plaques or lesions. When this damage occurs, the nerves can’t conduct electrical signals to and from the brain and spinal cord and the rest of the body.
There are four types of multiple sclerosis:
- Relapsing-Remitting MS (RRMS): The most common form of multiple sclerosis; about 85% of people with MS are initially diagnosed with RRMS. With RRMS, people have temporary periods called relapses, flare-ups or exacerbations, when new symptoms appear
- Secondary-Progressive MS (SPMS): With SPMS, symptoms steadily worsen over time, with or without periods of relapses and remissions. Most people diagnosed with RRMS will eventually transition to SPMS.
- Primary-Progressive MS (PPMS): This type of MS occurs in about 10% of people with MS. It’s characterized by slowly worsening symptoms from the beginning, with no relapses or remissions.
- Progressive-Relapsing MS (PRMS): A rare form of MS, PRMS is characterized by a steadily worsening disease state from the beginning, with acute relapses but no remissions.
MS affects about 400,000 people in the United States, and about 2.5 million worldwide. The disease affects women two to three times as often as men. It’s usually diagnosed in people between the ages of 20 and 50, with the average age of onset approximately 34.
While there currently is no cure for multiple sclerosis, today there are newer drugs that suppress the immune system and can help lessen symptoms and reduce flare-ups. Physical therapy can also help with coordination problems and muscle weakness.
Early diagnosis of multiple sclerosis is important because there’s growing evidence that early intervention with these newer disease-modulating drugs can also slow progression of the disease.
Because the early symptoms of MS can be vague and look like other conditions, it’s important to see a neurologist who specializes in MS in order to obtain a timely, accurate diagnosis and start treatment right away.
Why Choose Cooper to Diagnose and Treat Multiple Sclerosis
Cooper University Health Care has a comprehensive neurology program that is on the forefront of care for multiple sclerosis. Our team of fellowship-trained neurologists offers a full range of today’s most advanced diagnostic and treatment services, delivered in a caring, attentive manner:
- Sophisticated diagnostic resources: There is no single, specific test to diagnose MS, but our specialists can make a diagnosis by undertaking a careful process to rule out other causes. Diagnostic tests may include:
- MRI: Imaging to detect plaques or scarring caused by MS
- Evoked potentials: A test to record the brain’s electrical response to sensory stimuli; it shows if there’s a slowing of messages in different parts of the brain
- Cerebral spinal fluid analysis: Also called a spinal tap or lumbar puncture, this test looks for abnormalities in spinal fluid seen with MS
- Blood tests: To rule out other causes for certain neurological symptoms
- Multidisciplinary expertise: MS is a complex neurological disease that can affect many different body systems. As the region’s only academic health system, Cooper is home to experts in more than 75 specialties, giving you access to all the expertise you need, all in one place.
- Access to clinical trials: Research is an important component of our mission as an academic health system; our patients may have the opportunity to participate in clinical trials with novel treatments that are unavailable anyplace else in the area
Causes and Risk Factors for Multiple Sclerosis
Scientists don’t yet know what causes MS. It's considered an autoimmune disease in which the body's immune system mistakenly attacks its own tissues. In MS, this malfunction destroys myelin, the fatty substance that coats and protects nerve fibers in the brain and spinal cord.
There are, however, certain factors that increase the risk of developing MS. They include:
- Age: While MS can occur at any age, it usually affects people between the ages of 20 and 50
- Gender: Women are two to three times as likely as men to have RRMS
- Race: White people, particularly those of Northern European descent, are at highest risk of developing MS; people of Asian, African or Native American descent have the lowest risk
- Climate: MS is much more common in countries with temperate climates (located in the middle latitudes between the tropics and the polar regions); these include Canada, the northern U.S., New Zealand, southeastern Australia and Europe
- Family history: If a parent or sibling has MS, you are at higher risk of developing it
- Viral infections: Certain viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis
- Low vitamin D levels: Low levels of vitamin D and low exposure to sunlight are linked to a greater risk of MS
- Certain autoimmune diseases: People with thyroid disease, type 1 diabetes or inflammatory bowel disease (IBS) have a slightly higher risk of developing MS
- Smoking: Smokers and people who are exposed to secondhand smoke have a higher risk of developing MS
Symptoms of Multiple Sclerosis
Multiple sclerosis symptoms are wide-ranging and often unpredictable. They can be mild or severe, short-term or chronic (long-lasting). They can appear in different combinations, depending on the part of the nervous system affected. These are the most common symptoms of MS—but they can vary from person to person:
- Blurred or double vision
- Red-green color distortion
- Pain and loss of vision due to swelling of the optic nerve (optic neuritis)
- Difficulty walking
- An abnormal feeling or pain, such as numbness, prickling, or pins and needles
- Muscle weakness in the arms and legs
- Trouble with coordination (this may cause problems with walking or standing, or cause partial or complete paralysis)
- Spasticity (involuntary contraction of muscles leading to stiffness and spasms)
- Fatigue (this may be triggered by physical activity and ease with rest, but some people have constant tiredness that doesn't go away)
- Loss of sensation
- Speech problems
- Hearing loss
- Bowel and bladder problems
- Changes in sexual function
- Cognitive issues such as trouble concentrating, memory problems, poor judgment
Treating Multiple Sclerosis
While there is no cure yet for multiple sclerosis, there are things you can do to slow its progression, treat flare-ups, manage symptoms, and improve your mobility and ability to function. These options include:
- Medications: There is a wide variety of oral and injectible medications available today to reduce relapse rates and help prevent the disease from progressing; your doctor will prescribe these based on the type of MS you have and the severity of your disease
- Rehabilitation/physical therapy: A specialized exercise program can help you build muscle strength, endurance and control, regain motor skills, and remain as independent as possible
- Assistive devices: Equipment such as canes, braces or walkers can help you remain mobile
- Home adaptations: Changing the way your home is set up can help you safely move about as easily as possible and remain independent
- Psychological support: Living with a chronic condition like MS can contribute to depression; talking with a qualified professional can help you and your loved ones deal with these feelings