Multiple sclerosis is a disease that affects the central nervous system, which includes the brain, spinal cord, and optic nerves.
Although researchers have made a great deal of progress on understanding and treating the disease, there are still many questions and misconceptions about MS. Here are five important facts that people should know about the disease.
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1. Its cause is unknown
Although the exact cause of MS is unknown, it has been suggested that smoking may increase the risk of it developing.
MS is thought to be an autoimmune disease, a disease in which the body's immune system attacks its own healthy tissues.
With MS, the body attacks myelin, the fatty substance that acts as a protective cover to nerve fibers. This causes communication issues between the brain and body.
Doctors don't know why the body attacks the myelin, but they believe the following factors may increase the risk of MS developing:
- Having a family history of MS, other autoimmune diseases, or certain infections
- Being aged between 15 and 60
- Being Caucasian, particularly with Northern European descent
- Living in temperate climates
2. It can range in severity
With MS, the communication problems between brain and body can lead to major damage to the nerves. Symptoms of the disease can range from inconvenient and annoying to debilitating and even fatal.
It is important to note that life expectancy with MS has increased over the years, according to the National Multiple Sclerosis Society. This is due to emerging therapies and a better understanding of the disease. Some of the most common symptoms of MS include:
- Bladder problems
- Bowel problems
- Trouble with walking or balancing
- Sexual dysfunction
- Stiffness and numbness
- Muscle weakness
- Speech difficulties
- Swallowing problems
- Memory problems
- Problems with vision
Memory problems, depression, vision issues, and tiredness may indicate MS.
Some symptoms may not be noticeable in the early stages of MS. Others may cause a severe impact on a person's quality of life. If untreated, MS symptoms can worsen over time.
Paralysis is one of the most severe symptoms but only affects about one-third of people with the condition. Most people with MS maintain mobility although some may need assistive devices, such as canes or walkers.
David Bexfield told Medical News Today that it is important for people diagnosed with MS to pay attention to their bodies, and do what helps them feel good. Bexfield started a group called ActiveMSers after his diagnosis in 2006.
"Thankfully, I don't have many bad days," he said. "Daily exercise has helped keep my fatigue in check, one of the most debilitating symptoms of this disease."
"Few people understand how MS fatigue can be utterly pancaking. Imagine pulling an all-nighter, make that three of them in a row, and then running a marathon. Backwards. On stilts. While juggling chainsaws. Once you get that in your mind, realize that's not even close to what it feels like. When MS fatigue hits, everything is exhausting: reading, thinking, even listening. And lying down to take a nap doesn't help."
Bexfield's other piece of advice was to take help where people can get it:
"Check your ego at the door. Handicap parking placards, walking aids, protective undergarments - I've used them all. They've helped take me down the street, onto the hiking trail, and around the globe. Take advantage of the helpful tools available to you."
3. It can be difficult to diagnose
MS can be difficult to diagnose because many symptoms overlap with those of other diseases and conditions. Unfortunately, this means it can take time for doctors to make a diagnosis. They may order multiple tests to rule out other conditions first.
A doctor will review a person's medical history and do a physical examination. Then they may recommend the following tests:
- Blood tests
- Lumbar puncture
- Evoked potential tests
If a person displays more unusual symptoms or progressive disease, a doctor will order more exams. Relapsing-remitting MS is the most common form of the disease and although the diagnosis is easier in this particular type, MRI scans will usually confirm the diagnosis.
Experts say that with improving diagnostic methods, there is hope that better management will follow.
"Advances in MS management focus both on disease modification as well as symptomatic management," said CEO of The Consortium of Multiple Sclerosis Centers and nurse practitioner June Halper. "While treatment regimens have become more complex and more challenging to the person with MS, there is now a clear message of hope for the future."
4. It affects more women than men
Women aged between 20-40 may be the group most likely to develop MS.
For unknown reasons, MS is more common in women than in men. In fact, women are two to three times more likely to develop the disease than their male counterparts.
Additionally, people usually experience their first symptoms between the ages of 20 and 40, although older adults and children have been known to develop MS as well. For women in this age group, MS symptoms can cause complications to their reproductive health, especially during a pregnancy.
Medical student Jen Finelli described working with a female who had MS and her unique struggles while preparing to get pregnant:
"We had a sweet, sweet patient on one of my rotations who had MS attacks so severe she went blind, and she was concerned when she became pregnant, because she needed her medications to prevent these horrible attacks. She told us that she'd quit her medications to protect her baby if she had to!"
"Thankfully, [that patient] didn't have to make that sacrifice," she added, "but because of the autoimmune nature of the disease, patients must verify their medications with their ob-gyn and their MS specialist before becoming pregnant."
5. Vitamin D may help prevent and treat it
Although there are a number of FDA-approved pharmaceuticals available to treat some forms of MS, there is no cure for the disease. One main type of MS, which comprises periods of exacerbations and remissions and is known as a relapsing-remitting MS, does respond to drugs. Unfortunately, another main type of MS, known as primary-progressive MS, does not respond to medication.
Most of these drugs, called disease-modifying treatments (DMTs), have also been known to cause serious side effects.
"There are currently no highly effective and low risk DMTs available for people with MS," Dr. Robert Glanzman told MNT.
Dr. Glanzman, neurologist and Chief Medical Officer at GeNeuro, a clinical stage pharmaceutical company, explained that for more than a third of people with progressive MS, "none of the currently-available DMTs (with the exception of mitoxantrone, a chemotherapeutic agent) have been shown to be effective."
Vitamin D may help to treat and prevent MS.
Additional DMTs are currently in development and "have positive studies in people with progressive MS," he added. "However, in both of those studies, the therapeutic effect seems to have been largely limited to people with ongoing inflammation, as measured by brain MRI."
Research shows that additional vitamin D treatment is safe for people with MS and may be effective in helping both prevent it and treat it. In fact, people who have low levels of vitamin D may have an increased risk of developing MS.
People with MS "should strive to lead a healthful lifestyle, which includes no smoking, vitamin D supplementation, reducing sodium intake, sleeping well, moderate exercise, and maintaining an ideal weight or body mass index," said Dr. Ann Bass, clinical director at Neurology Center of San Antonio, TX.
"[They] should form a strong and lasting support network, which includes healthcare professionals, families, friends, support groups [...] that will assist them throughout their journey with this disease," she added. "They should establish, continually assess and share their goals and expectations for their lives as well as for their MS treatments throughout the disease course."