What is multiple sclerosis (MS)?

Multiple sclerosis (MS) is a chronic disease of the central nervous system. It is thought to be an autoimmune disorder. It is an unpredictable condition that can be relatively benign, disabling, or devastating. Some individuals with MS may be mildly affected while others may lose their ability to see clearly, write, speak, or walk when communication between the brain and other parts of the body becomes disrupted.

Myelin is a fatty tissue that surrounds and protects the nerve fibers. Myelin is lost in multiple areas with MS. This loss of myelin forms scar tissue called sclerosis. These areas are also called plaques or lesions. When damaged in this way, the nerves are unable to conduct electrical impulses to and from the brain.

What causes multiple sclerosis?

There are many possible causes of MS, including the following:

  • Viruses

  • Autoimmune disorders

  • Environmental factors

  • Genetic factors

However, not enough is known about the role these factors play to definitively describe why a particular patient develops MS.

What are the symptoms of MS?

The symptoms of MS are erratic. They may be mild or severe, of long duration or short. They may appear in various combinations, depending on the area of the nervous system affected. The following are the most common symptoms of MS. However, each individual may experience symptoms differently. Symptoms may include:

  • Initial symptoms of MS:

    The following are often initial symptoms of MS:

    • Burred or double vision

    • Red-green color distortion

    • Pain and loss of vision due to optic neuritis, an inflammation of the optic nerve

    • Difficulty walking

    • Paresthesia - abnormal sensation, or pain, such as numbness, prickling, or "pins and needles."

  • Other symptoms of multiple sclerosis:

    Throughout the course of the illness, an individual may experience any/all of the following symptoms, to a varying degree:

    • Muscle weakness in the extremities

    • Difficulty with coordination (impaired walking or standing may result; partial or complete paralysis is possible)

    • Spasticity - the involuntary increased tone of muscles leading to stiffness and spasms.

    • Fatigue (this may be triggered by physical activity, but may subside with rest; constant, persistent fatigue is possible)

    • Loss of sensation

    • Speech impediments

    • Tremor

    • Dizziness

    • Hearing loss

    • Bowel and bladder disturbances

    • Depression

    • Changes in sexual function

    Approximately 50 percent of all people with MS experience cognitive impairments related to their disease. The effects of these impairments may be mild, often detectable only after comprehensive testing, and may include difficulty with any/all of the following:

    • Concentration

    • Attention

    • Memory

    • Poor judgment

Symptom categories of MS:

Primary symptoms - a direct result of demyelination, the destruction of myelin (the fatty sheath that surrounds and insulates nerve fibers in the central nervous system) may result in the following:

  • Weakness

  • Numbness

  • Tremor

  • Loss of vision

  • Pain

  • Paralysis

  • Loss of balance

  • Bladder and bowel dysfunction

Secondary symptoms - complications that arise as a result of the primary symptoms, for example:

  • Paralysis can lead to bedsores

  • Bladder dysfunction may cause repeated urinary tract infections

  • Inactivity can result in weakness, poor postural alignment and trunk control, muscle imbalances, decreased bone density, and/or shallow, inefficient breathing

  • Becoming less mobile because of weakness and difficulty swallowing can lead to an increased risk of pneumonia

Tertiary symptoms - the social, vocational, and psychological complications of the primary and secondary symptoms, for example:

  • A person who becomes unable to walk or drive may lose his/her livelihood

  • Strain of dealing with a chronic neurological illness may disrupt personal relationships

  • Depression is often seen among people with MS

The symptoms of MS may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is multiple sclerosis diagnosed?

With today's medicine, there is no definitive test available to diagnose multiple sclerosis. However, a probable diagnosis can be made by following a careful process which demonstrates findings that are consistent with MS, that also rule out other causes and diseases.

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Which of these age groups is more likely to experience initial symptoms of multiple sclerosis?