What is multiple sclerosis?
Multiple sclerosis (MS) is a disease of the central
nervous system (the brain and spinal cord). People who have
multiple sclerosis may lose coordination and muscle control.
However, many people with multiple sclerosis are only mildly
affected by the disease and continue to lead their lives
much as they did before their diagnosis.
There are two different patterns of MS symptoms. The more
common pattern is episodes of symptoms for days or weeks
followed by periods of no symptoms for weeks or months. This
type of MS is called relapsing-remitting disease.
The less common pattern is steady worsening of symptoms
from the first signs of illness. This is called primary
How does it occur?
The cause of multiple sclerosis is still unknown. For
reasons not yet understood, the fatty substance called
myelin, which covers nerve fibers, is damaged in random
areas. The myelin normally insulates entire nerve fibers. It
helps the conduction of nerve messages to and from the
brain. The areas of myelin that are damaged are called
plaques. The damage can prevent nerves from sending signals
to other body parts. The symptoms of multiple sclerosis
depend on where these plaques are in the central nervous
Currently, most scientists believe that the loss of
myelin is caused by an autoimmune process. This means the
body mistakenly reacts to some part of itself as foreign and
attacks it. In the case of MS, the body destroys areas of
its own myelin.
What are the symptoms?
Common first symptoms of MS are:
vague feelings of weakness, clumsiness, or
one or more areas of skin that feel numb or tingly.
Other possible symptoms include:
Usually the symptoms come and go unpredictably. The times
when you are having symptoms are called episodes. The
episodes may last a few days or weeks at a time. The times
between episodes, when you are not having symptoms, are
called remissions. Many people with MS are able to function
quite normally between episodes.
How is it diagnosed?
The best test for MS is MRI (magnetic resonance imaging).
MRI produces x-ray-like images that are better than other
methods for seeing certain areas of the central nervous
system. With MRI it is possible to see the places where
myelin has been damaged.
If the diagnosis is still uncertain after MRI, your
health care provider may do a test that measures how fast
your nerves conduct impulses. Also, a sample of fluid from
your spine may be analyzed for protein changes that are
often found in people who have MS.
More than one MRI may be done over time. Several MRIs may
show plaques appearing in different areas of the central
nervous system at different times. This confirms the
diagnosis of multiple sclerosis.
How is it treated?
There is not yet a cure for MS. However, treatment with
medicine can help shorten episodes of symptoms and increase
the time between episodes. For example, steroids may shorten
the time an episode of symptoms lasts.
The goal of long-term treatment is to help lengthen the
time between episodes of symptoms. Drugs that prevent the
immune system from attacking the myelin are used to prevent
The drugs most commonly used for this purpose are
the interferons, especially beta interferon.
A new drug, glatiramer acetate, is being prescribed
to decrease the relapsing rate.
New treatments currently under study range from
experimental drugs to bone marrow transplants.
Combinations of proven drugs, such as beta
interferon, with new treatments are also being tested.
There are also medicines that can help control specific
symptoms of MS, such as depression, fatigue, urinary
symptoms, and tremors or spasms. Ask your health care
provider about medicines to help with these symptoms.
Getting enough rest is an important factor in treating
MS. Always try to get plenty of rest, especially when you
are having symptoms.
How long do the effects last?
You may have many episodes and remissions. Some people
never have more than a few mild, infrequent symptoms.
However, with time, the episodes may become more frequent or
last longer. Some loss of function may continue between
episodes. In some cases the disease eventually results in
What kind of ongoing care do I need?
The most important aspect of care is emotional support.
You may feel anxiety, anger, and fear. A mental health
professional or other counselor may be able to help with the
depression that often comes with MS.
Caring for someone with active MS requires a team
approach. In addition to doctors (often including a
neurologist) nurses, and counselors, other members of your
health care team may be a physical therapist, occupational
therapist, or social worker. For example, a physical
therapist can help you develop strength, coordination,
balance, and stamina. The goal is to enable you to be as
independent as possible while helping you deal with the
intense emotional consequences of a disease that can become
What can be done to help prevent multiple sclerosis?
Because the cause of MS is not known, we do not yet know
how to prevent it. Some studies suggest Vitamin D intake may
For more information, call or write:
National Multiple Sclerosis Society
733 3rd Ave.
New York, NY 10017-3288
9 a.m. - 5 p.m., (caller's time), Monday - Friday
Educational materials, local chapters, referrals to doctors,
physical therapists, lending library, on-line information