Neurology Insights

The Nature of Multiple Sclerosis

Ribbon for Multiple Sclerosis

Around 1 million Americans are currently living with Multiple Sclerosis (also known as “MS”). And a growing body of evidence suggests that these statistics may be underrepresented due to the difficulty in diagnosing this unique autoimmune condition.

Living with MS

Those living with MS will often tell you that symptoms are unpredictable, difficult to explain and vary day by day. And that description alone highlights the difficulty in diagnosing this condition and assuming proper care.

Multiple Sclerosis is an autoimmune disorder that causes the body to attack its own perfectly healthy cell tissue located in the central nervous system (this consists of the brain and spinal cord).

This healthy cell tissue that is being attacked by the immune system is called “Myelin.” Myelin is the protective layer surrounding the nerves that communicate signals all across the body. When this protective layer is damaged, it results in dysfunctional communication between the nervous system. When the myelin is interrupted, the nerve signal slows down, and the result is a dysfunction in the area supplied by that nerve; for example, if the eye nerve is attacked, then vision is affected. If a sensory nerve is inflamed, then numbness or tingling, or distorted sensation occurs in the area supplied by that nerve.

Symptoms of Multiple Sclerosis

This unfortunate damage done to the central nervous system results in pain symptoms, sensory distortions, and disruptions in overall physical and mental ability.

Patients who live with MS often describe a wide range of symptoms, such as;

  • Extreme weakness
  • Blurred vision
  • Pain & numbness
  • Fatigue
  • Muscle spasms and tingling

Some patients describe days where simple movement such as walking or getting out of bed becomes nearly impossible. And this autoimmune “attack” can occur in any section of the central nervous system‚ which is why no MS patient is the same.

Diagnosis & Treatment

MS is often difficult to diagnose because pain symptoms can mirror other diseases and conditions.  Many times, patients will undergo a series of tests before coming to a proper diagnosis. This amount of testing can cause a great deal of stress to the patient.

An MRI brain scan and MRI of the spinal cord is currently the most effective way to diagnose MS, along with spinal fluid evaluation. Through a brain scan, your doctor will see the amount of white matter (myelin) in the brain and recognize the signs of MS through myelin plaque formations. In the spinal cord, signal changes representing inflammation and damage can be seen that can be indicative of MS.

It is advised that if you are experiencing any sudden changes in physical or mental ability that mirror MS symptoms, schedule a consultation with your doctor, as time is of the essence when working to reduce cellular damage.

In the early stages of MS, cellular repair is possible, and the more your team of doctors can work with you to reduce inflammation, the less damage is projected to occur over time. In more progressive forms of MS, the damage may be too advanced to repair.

Treatment Options

Medications that have been proven to be effective consist of;

  • Corticosteroids
  • Cyclophosphamide
  • Intravenous immunoglobin
  • Immunosuppressants and more.

It is important to note that these treatments are not as effective in treating the more progressive forms of MS.

Instead, these treatment options aim to manage specific symptoms like pain and weakness to improve one’s day-by-day ability.

Other complementary treatment options include increased Vitamin D intake, physical therapy, and counseling. Daily exercise, adequate hydration, and a healthy lifestyle are also important in preventing disease progression.

FAQs About Multiple Sclerosis

What causes MS?

While no direct cause of MS has been found yet, current research suggests a correlation between vitamin D deficiency and the development of MS. Environmental factors such as living further away from the equator have shown to manifest higher MS rates in the US populations. Another theory is a genetic predisposition to this disease, combined with an environmental or viral insult that may trigger the immune system to respond.

Is there just one type of MS?

There are four types of Multiple Sclerosis. The progressive nature of the autoimmune categorizes these types of responses.

Relapsing-Remitting RRMS: This is when periods of “immune attack” are followed by periods of repair (aka remyelination). This can occur for months and years. This form of MS is the most common form among populations

Secondary Progressive SPMS: This type of progression often begins like RRMS, but overtime lacks the period of repair, so instead, flare-ups are more present, and down periods are less frequent. This causes a steady progression of the disorder without periods of healing.

Primary Progressive PPMS: This type of autoimmune attack is steady, and attacks increase simultaneously without a reparative healing period.

Progressive – Relapsing Multiple Sclerosis PRMS: This type of attack is similar to the first (relapsing-remitting); however, flare-ups are more severe and damaging with this condition. Disability is also more evident in this condition and less likely to be repaired.

Is MS (Multiple Sclerosis) like ALS (Amyotrophic Lateral Sclerosis)?

Often MS will be compared to ALS because, in both conditions, the central nervous system (brain and spinal cord) is affected.

However, the key critical difference between MS and ALS is that MS is an autoimmune disease. This means that the body’s immune system is attacking perfectly healthy nerve cells for an unknown reason.

In ALS, the nervous system itself is deteriorating. And the cells that affect the nervous system in the body are damaged and breaking down progressively.   For more on ALS, visit our article here.

Is MS an older adult’s disease?

No. Multiple Sclerosis is most prevalent among the age group of 2050 years.

Also; Studies also show a gender disparity in this disease as women tend to develop MS at 2-3 times the rate of men. And although MS is common in most ethnic groups, it is shown to be most common in those of Northern European descent

Is MS contagious or deadly?

There is no evidence to suggest that MS is contagious as it is an autoimmune disease that affects the protective layer of the cells in the nervous system. And although MS can progress to a point where it does become debilitating, this result is unlikely if symptoms are recognized soon and managed adequately.

Is there a cure for MS?

Currently, there is no definitive cure for this autoimmune condition. However, the latest progressions in medicine have shown to be promising. Better treatment options are now underway to improve quality of life and minimize progression.

“As I have told my patients for years, MS is a disease of multiple lesions in the nervous system over time and space.  This means that if someone has numbness in one area over and over and over, that is unlikely to represent Multiple Sclerosis. However, if someone has vision changes, and months later has numbness and tingling in a limb, and then a series of weeks later has balance and ambulation issues, that may represent multiple lesions in the central nervous system over different periods. This would be worrisome for multiple Sclerosis, and diagnostic testing as listed above should be performed.” – Dr. Joseph Kandel

Therapies exist that can positively impact the disease process, and therapies are improving all the time. The vast majority of patients with Multiple Sclerosis lead healthy, relatively unencumbered lives, which is the takeaway message to understand.

If you have any questions about MS or would like to schedule an appointment, please contact the Neurology Office for more help. 

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“To Cure Sometimes, To Heal Often, To Comfort Always”

Neurology Office, Joseph Kandel M.D. and Associates

Concierge medicine without the concierge price”

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