Multiple sclerosis (MS) is a life-long chronic disease of the central nervous system that can cause symptoms of varying degree.

MS occurs when myelin is lost in multiple areas in the central nervous system.

Myelin is a fatty tissue that surrounds and protects the nerve fibers. The loss of myelin forms scar tissue called sclerosis, also known as plaques or lesions. When damaged in this way, the nerves are unable to conduct electrical impulses to and from the brain. Communication between the brain and other parts of the body is disrupted.

Causes

There are many possible causes of MS, including viruses, autoimmune disorders, environmental factors, and genetic factors. MS affects mainly women between the ages of 20 and 50.

Diagnosis

With today's medicine, no definitive test is available to diagnose MS. But your doctor can make a probable diagnosis by following a careful process that demonstrates findings consistent with MS and that rule out other causes and diseases.

Multiple Sclerosis Symptoms

The symptoms of MS are unpredictable. Some people with MS may be mildly affected. Others may lose their ability to write, speak, or walk. Symptoms can be of long or short duration. They may appear in various combinations, depending on the area of the nervous system affected.

  • Sudden loss of vision; blurred or double vision
  • Slurred speech
  • Clumsiness, especially on one side
  • Unsteady gait
  • Loss of coordination
  • Trembling of a hand
  • A feeling of extreme tiredness
  • Facial symptoms including numbness, weakness or pain
  • Loss of bladder control (incontinence)
  • Inability to empty the bladder
  • Tingling, numbness or a feeling of constriction in the arms, legs or elsewhere
  • Weakness or a heavy feeling in the arms or legs

In diagnosing MS, doctors use two criteria:

  • There must have been two attacks at least one month apart. An attack is a sudden appearance of or worsening of any MS symptom or symptoms that lasts at least 24 hours.

  • There must be more than one area of damage to the central nervous system myelin that must have occurred at more than one point in time and was not caused by any other disease.

Evaluation and diagnosis of MS requires a variety of tools to rule out other possible disorders and a series of laboratory tests that, if positive, confirms the diagnosis. Your doctor will start with a complete medical history and a neurological exam. The following may also help in the diagnosis of MS:

  • Magnetic resonance imaging (MRI):  a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body to detect the presence of plaques or scarring caused by MS.

  • Evoked potentials: procedures that record the brain's electrical response to visual, auditory, and sensory stimuli to show if there is a slowing of messages in the various parts of the brain.

  • Cerebral spinal fluid analysis (also called spinal tap or lumbar puncture): a procedure used to make an evaluation or diagnosis by examining the fluid withdrawn from the spinal column to check for cellular and chemical abnormalities associated with MS.

  • Blood tests: to rule out other causes for various neurological symptoms.

Treatment

There is no cure yet for MS. But you can take steps to ease symptoms and improve function and mobility. Your doctor may recommend the following to treat the conditions associated with MS: medication, assistive technology, and rehabilitation activities. Rehabilitation varies depending on the range, severity, and progression of symptoms.

Medical Reviewer: [Akin, Louise RN, BSN, Bowers, Nancy A. RN, BSN, MPH, Foster, Sara M. RN, MPH, Gaskin, Kelley RN, MSN, CPNP, Jenkins, Lee, Pierce-Smith, Daphne RN, MSN, CCRC, FNP, Sweetwood, Jane RN, MN, CCRN, White, Vicki RN, MSN] Last Annual Review Date: 2009-09-19T00:00:00-06:00 Copyright: © 2000-2010 The StayWell Company, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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