Disease: Multiple sclerosis

    Overview

    Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).

    In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged.

    Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.

    There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

    Find out why Mayo Clinic is the best place for your care.

    Source: http://www.mayoclinic.com

    Symptoms

    Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers. They may include:

    • Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or the legs and trunk
    • Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
    • Prolonged double vision
    • Tingling or pain in parts of your body
    • Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
    • Tremor, lack of coordination or unsteady gait
    • Slurred speech
    • Fatigue
    • Dizziness
    • Problems with bowel and bladder function

    When to see a doctor

    See a doctor if you experience any of the above symptoms for unknown reasons.

    Disease course

    Most people with MS have a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by quiet periods of disease remission that can last months or even years.

    Small increases in body temperature can temporarily worsen signs and symptoms of MS, but these aren't considered disease relapses.

    About 60 to 70 percent of people with relapsing-remitting MS eventually develop a steady progression of symptoms, with or without periods of remission, known as secondary-progressive MS.

    The worsening of symptoms usually includes problems with mobility and gait. The rate of disease progression varies greatly among people with secondary-progressive MS.

    Some people with MS experience a gradual onset and steady progression of signs and symptoms without any relapses. This is known as primary-progressive MS.

    Source: http://www.mayoclinic.com

    Causes

    The cause of multiple sclerosis is unknown. It's considered an autoimmune disease in which the body's immune system attacks its own tissues. In the case of MS, this immune system malfunction destroys myelin (the fatty substance that coats and protects nerve fibers in the brain and spinal cord).

    Myelin can be compared to the insulation coating on electrical wires. When the protective myelin is damaged and nerve fiber is exposed, the messages that travel along that nerve may be slowed or blocked. The nerve may also become damaged itself.

    It isn't clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible.

    Source: http://www.mayoclinic.com

    Diagnosis

    There are no specific tests for MS. Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis.

    Your doctor is likely to start with a thorough medical history and examination. Your doctor may then recommend:

    • Blood tests, to help rule out other diseases with symptoms similar to MS. Tests to check for specific biomarkers associated with MS are currently under development and may also aid in diagnosing the disease.
    • Lumbar puncture (spinal tap), in which a small sample of fluid is removed from your spinal canal for laboratory analysis. This sample can show abnormalities in antibodies that are associated with MS. Spinal tap can also help rule out infections and other conditions with symptoms similar to MS.
    • MRI, which can reveal areas of MS (lesions) on your brain and spinal cord. You may receive an intravenous injection of a contrast material to highlight lesions that indicate your disease is in an active phase.
    • Evoked potential tests, which record the electrical signals produced by your nervous system in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli, in which you watch a moving visual pattern, or short electrical impulses are applied to nerves in your legs or arms. Electrodes measure how quickly the information travels down your nerve pathways.

    In most people with relapsing-remitting MS, the diagnosis is fairly straightforward and based on a pattern of symptoms consistent with the disease and confirmed by brain imaging scans, such as MRI.

    Diagnosing MS can be more difficult in persons with unusual symptoms or progressive disease. In these cases, further testing with spinal fluid analysis, evoked potentials and additional imaging may be needed.

    Source: http://www.mayoclinic.com

    Complications

    People with multiple sclerosis also may develop:

    • Muscle stiffness or spasms
    • Paralysis, typically in the legs
    • Problems with bladder, bowel or sexual function
    • Mental changes, such as forgetfulness or mood swings
    • Depression
    • Epilepsy

    Source: http://www.mayoclinic.com

    Alternative medicine

    Many people with MS use a variety of alternative or complementary treatments or both to help manage their symptoms, such as fatigue and muscle pain.

    Activities such as exercise, meditation, yoga, massage, eating a healthier diet, acupuncture and relaxation techniques may help boost overall mental and physical well-being, but there are few studies to back up their use in managing symptoms of MS.

    Guidelines from the American Academy of Neurology recommend the use of oral cannabis extract for muscle spasticity and pain, but do not recommend cannabis in any other form for other MS symptoms due to a lack of evidence.

    The guidelines also do not recommend the use of herbal supplements such as Ginkgo biloba and bee venom or magnetic therapy for MS symptoms.

    Source: http://www.mayoclinic.com

    Lifestyle and home remedies

    To help relieve the signs and symptoms of MS, try to:

    • Get plenty of rest.
    • Exercise. If you have mild to moderate MS, regular exercise can help improve your strength, muscle tone, balance and coordination. Swimming or other water exercises are good options if you're bothered by heat. Other types of mild to moderate exercise recommended for people with MS include walking, stretching, low-impact aerobics, stationary bicycling, yoga and tai chi.
    • Cool down. MS symptoms often worsen when your body temperature rises. Avoiding exposure to heat and using devices such as cooling scarves or vests can be helpful.
    • Eat a balanced diet. Results of small studies suggest that a diet low in saturated fat but high in omega-3 fatty acids, such as those found in olive and fish oils, may be beneficial. But further research is needed. Studies also suggest that vitamin D may have potential benefit for people with MS.
    • Relieve stress. Stress may trigger or worsen your signs and symptoms. Yoga, tai chi, massage, meditation or deep breathing may help.

    Source: http://www.mayoclinic.com

    Coping and support

    Living with any chronic illness can be difficult. To manage the stress of living with MS, consider these suggestions:

    • Maintain normal daily activities as best you can.
    • Stay connected to friends and family.
    • Continue to pursue hobbies that you enjoy and are able to do.
    • Contact a support group, for yourself or for family members.
    • Discuss your feelings and concerns about living with MS with your doctor or a counselor.

    Source: http://www.mayoclinic.com

    Risk factors

    These factors may increase your risk of developing multiple sclerosis:

    • Age. MS can occur at any age, but most commonly affects people between the ages of 15 and 60.
    • Sex. Women are about twice as likely as men are to develop MS.
    • Family history. If one of your parents or siblings has had MS, you are at higher risk of developing the disease.
    • Certain infections. A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis.
    • Race. White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.
    • Climate. MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe.
    • Certain autoimmune diseases. You have a slightly higher risk of developing MS if you have thyroid disease, type 1 diabetes or inflammatory bowel disease.
    • Smoking. Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS.

    Source: http://www.mayoclinic.com

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