Nerve fibers are protected by a coating of a substance called myelin. In multiple sclerosis (MS), the myelin coating of nerve fibers in the brain and spinal cord is destroyed by the immune system. This process is called demyelination.
Myelin insulates and surrounds the core of a nerve fiber known as the axon. When the axon is damaged, it hinders the transmission of signals along nerves. Damage to the nerve itself can also occur and is often referred to as axonal injury.
- The presence of symptoms depends on the type of MS that a person has
- People with MS may not show any symptoms of the disease from time to time
- MS is not itself fatal, although patients can experience severe complications that are fatal
- The symptoms of MS can impact all aspects of life
- Reduced quality of life can lead to depression in people with MS
Impact of multiple sclerosis
People with MS can be symptom-free for many years. However, living with MS can be both physically and mentally overwhelming when symptoms are present.
Multiple sclerosis can leave people constantly feeling tired.
It is common for people with MS to feel constantly tired. This tiredness can impact all aspects of life, including the ability to go out and do things and the ability to use the brain effectively.
The symptoms of MS can give rise to constant discomfort and disability that limits the ability to do everyday things many people take for granted.
People with MS may have to attend lots of medical appointments. They must also live with the uncertainty of when the next attack of symptoms may happen.
Together, these reduce a person's quality of life. The ongoing frustration of such restrictions results in some people with MS developing depression.
There are many occupational therapy and relaxation programs that can help people with MS to manage their symptoms. These programs can help people with MS improve their performance of daily activities despite the limitations imposed by the condition. A range of patient groups is also available to offer support to people living with MS.
Recent research suggests that a protein-rich diet may improve the outlook for MS by reducing inflammation. MS is not itself fatal, but the mortality rate among people with MS is higher than in the general population. The increased number of deaths is due to complications of MS, such as infection, diseases affecting the lungs or heart, or suicide.
Symptoms of MS
The damage to myelin and nerves can occur in several different areas of the brain and spinal cord. This means that any part of the body can be affected by MS.
Typical symptoms of MS include:
- Muscle weakness and spasms
- Blurred or double vision
- Changes in mood
- Difficulty with thinking clearly
- Loss of control of bladder and bowel function
Muscle weakness and spasms can cause problems with speech, coordination, and balance.
Fortunately, most people with MS do not experience all of these symptoms. The actual symptoms that develop depend on how bad the damage to the nerves is and where in the body it occurs. As the amount of damage increases, the symptoms get worse.
Symptoms usually first develop between the ages of 15 and 45 years. MS is typically diagnosed when a person is in their late twenties or early thirties.
The most common type of MS is relapsing-remitting MS (RRMS). According to the National Multiple Sclerosis Society, around 85 percent of people with MS have this form of the disease.
In RRMS, there are times when symptoms are mild or even absent (remission) and other periods known as relapses when the symptoms become worse.
Over time, as the nerves become more damaged, there may be fewer periods of remission and more severe symptoms. When this happens, RRMS has progressed to secondary progressive MS (SPMS). About half of individuals with RRMS go on to develop SPMS.
The least common type of MS is primary progressive MS (PPMS). This form of MS occurs in about 15 percent of people with MS. PPMS is often more debilitating for patients as the symptoms get worse over time instead of occurring as sudden attacks separated by periods with few symptoms.
Experts do not know what causes the immune system to attack the nerve cells in MS.
Experts are still not sure exactly what causes MS. For some unknown reason, the immune system attacks the protective coating of nerve fibers as it does for bacteria or viruses.
Research into MS has shown that levels of the cells responsible for raising an immune response (T cells, B cells, and macrophages) are increased in areas affected by MS.
Other possible causes of MS such as viral infection have also been suggested, but a definitive answer is still to be found.
The risk of developing MS depends on which genes a person is born with and the things that they are exposed to during everyday life.
Women are more likely to develop MS than men. A study published in the BMJ found that average female-to-male ratio for MS was 2.4.
Having an immediate relative with MS may further increase the risk of developing MS. People who have another autoimmune disease such as type 1 diabetes may also be more likely to develop MS than people who do not.
Some studies have shown a link between exposure to the Epstein-Barr or zoster viruses and developing MS. It has even been suggested that exposure to these viruses early in life may protect against autoimmune diseases later in life. It is believed that early exposure to infection allows the body to build up protection against autoimmunity later in life.
The risk of developing MS may be increased by smoking tobacco. The risk may be lowered by exposure to sunlight and increased levels of vitamin D.
There are several treatments for MS, but currently there is no cure.
Medical treatments typically fall into three main categories:
- Drugs that slow down the rate at which the disease worsens and reduces symptom relapses
- Drugs that help to reduce specific MS symptoms
- Drugs that are used to manage the sudden attacks of severe symptoms
In addition, people with MS are often given physiotherapy in the form of exercises and massage to help improve how their muscles work and to relieve pain.
Since MS can affect many different parts of the body, treatment is usually provided by a range of specialist doctors. These specialists can involve neurologists, urologists, physiotherapists, occupational therapists, and psychologists.