The Facts About Multiple Sclerosis

About 1 million Americans are living with multiple sclerosis (MS), a figure that has quadrupled since 1994. About 200 people are diagnosed with the disease each week, the majority being between the ages of 20 and 50. Females face a three times greater risk than males for developing MS, and the highest prevalence is among Black women.

A chronic condition that affects the central nervous system, multiple sclerosis has the potential to be severely debilitating. MS involves the immune system attacking myelin, the sheath that protects nerve fibers in the brain and spinal cord. This disrupts the brain's ability to communicate with the rest of the body and can cause permanent nerve damage.

Muscle control, balance, vision and other basic functions can be affected by multiple sclerosis, depending on what part of the brain and spinal cord is affected. However, the outcomes differ greatly. While some people experience only minor symptoms and do not need treatment, others might have trouble moving and performing everyday tasks.

Clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), primary progressive MS (PPMS) and secondary progressive MS (SPMS) are the four primary types of MS.

Clinically isolated syndrome is a single episode of neurological symptoms that lasts for at least 24 hours. The symptoms arise from demyelination or inflammation of the central nervous system.

The most prevalent form of multiple sclerosis is relapsing-remitting MS, which affects about 85 percent of individuals at diagnosis. Relapses, or flare-ups, of MS symptoms, followed by symptom-free intervals, are typical of this type.

Primary progressive MS affects approximately 10 percent to 15 percent of multiple sclerosis patients. PPMS patients often have increasingly more severe symptoms, rather than sudden attacks or relapses.

Most individuals get secondary progressive MS after having relapsing-remitting MS for a number of years. In this type, there are no relapses or remissions, and the symptoms get steadily worse. The transformation often occurs 10 to 20 years after someone receives a diagnosis of relapsing-remitting MS.

Common but nonspecific signs and symptoms of multiple sclerosis include:

• Abnormal feelings or pain
• Anxiety
• Bladder problems
• Blurred or double vision
• Bowel problems
• Depression
• Difficulty walking
• Fatigue
• Muscle spasms
• Muscle weakness
• Numbness and tingling
• Problems with thinking and learning
• Sexual health problems
• Swallowing difficulties
• Trouble speaking

One of the more common signs of MS is spasticity, which describes feelings of stiffness and uncontrollable muscle spasms. Spasticity can range from a minor sensation of tight muscles to severe, uncontrollable spasms. Spasticity can affect any limb, but it tends to affect the legs the most frequently.

The two most common forms of muscular spasticity are:

• Flexor spasticity. The limbs are bowed and difficult to straighten because the muscles are so tight.
• Extensor spasticity. The limbs don't bend easily and stay straight because the muscles are so tight.

Muscle stiffness (spasticity and spasms), muscle weakness, numbness or altered sensations in certain regions of the body, tremors, discomfort, visual issues and exhaustion are among the symptoms and effects of MS that can contribute to problems such as maintaining balance.

Communication breakdowns between the brain and the rest of the body can lead to balance issues. For example, you could fall if your brain signals motion but the signal never reaches your leg.

If your feet are overly sensitive or numb, you might not be able to sense if they are contacting the ground evenly, making you walk more slowly and carefully. When you become fatigued, your ability to maintain your balance may worsen because of tired muscles or mental exhaustion. MS can produce vertigo and dizziness, which can make it challenging to keep your balance when standing still.

The following risk factors may increase your chance of developing multiple sclerosis:

• Age. MS can develop at any age, but most people begin experiencing symptoms in early adulthood.
• Certain autoimmune diseases. You have a slightly higher risk if you have other autoimmune disorders, such as thyroid disease, psoriasis or type 1 diabetes.
• Family history. If one of your parents or siblings has multiple sclerosis, you are at greater risk of developing the disease.
• Race and ethnicity. The prevalence of MS is similarly high among white and Black people. People of Asian, Hispanic and Native American ancestry have a lower risk.
• Sex. Women are approximately three times more likely than men to have multiple sclerosis.
• Smoking. People who smoke have a greater risk of developing RRMS.
• Viral infections. Certain viruses, such as Epstein-Barr virus and human herpesvirus 6, increase the risk of developing MS. However, the exact mechanism of this association is not well known.
• Vitamin D: Some research suggests people with low vitamin D levels have a greater risk.

There is no known cause of MS. It's considered an autoimmune disease because the immune system is attacking its own tissues. Myelin, the fatty substance that covers and shields the nerve fibers in the brain and spinal cord, is destroyed by this immune system malfunction. The messages that go along the nerve fiber may be slowed down or inhibited when the myelin is broken and the nerve fiber is exposed.

Why some people develop MS and others do not is unclear. Many researchers believe a combination of hereditary and environmental variables is to blame.

It makes sense to speculate that multiple sclerosis may be linked to an increased risk of cancer because of the associated immune system response.

The research on this question is both conflicting and inconclusive. While some studies have linked MS to an increased risk of cancer, other studies have not. According to some research, multiple sclerosis patients have a lower risk of developing cancer.

Multiple sclerosis can have a direct impact on sexual health because sexual arousal begins in areas of the central nervous system. A lesion refers to an area of scarring in the central nervous system caused by multiple sclerosis. MS lesions can affect the region of the brain and spinal cord responsible for sending and receiving the signals associated with arousal. This impediment can lead to sexual health dysfunctions, including arousal problems, erectile dysfunction (ED) and difficulty achieving an orgasm.

The symptoms of multiple sclerosis may cause trouble with the act of sex itself. Common symptoms—such as fatigue, spasticity, pain and bladder dysfunction—can all be detrimental to a person's sex life. Someone with numbness, for example, may not feel pleasurable sexual sensations, and someone with chronic pain may find sex very uncomfortable. If bladder and bowel dysfunction is a symptom, the patient might be worried about having an accident during sex, making them unable to relax enough for arousal.

In men with MS, erectile dysfunction (ED)is one of the most common sexual symptoms. Multiple sclerosis is a disease characterized by the progressive damage of nerves, and nerves associated with erectile response can be affected. ED can occur, leading to impaired stimulation and arousal.

The causes and signs of erectile dysfunction can differ depending on where the demyelination takes place. For instance, some men are able to get an erection in reaction to physical but not erotic stimulation, while the opposite is true for other men. This circumstance appears to be particularly applicable to younger males with MS who do not have other established risk factors for ED such as diabetes and high blood pressure.

Having multiple sclerosis can be challenging. Since the symptoms can disappear and reappear, the disease is unpredictable. Daily functioning may be hampered by the fatigue, pain and coordination issues that come with MS.

Multiple sclerosis can have a wide variety of effects on different individuals. The majority of MS sufferers can have fulfilling lives, especially with the help of doctors, loved ones and caregivers. However, a person with multiple sclerosis might need to make significant changes to their lifestyle.

In addition to physical challenges, MS can cause emotional and mental changes, including depression, anxiety, distress, anger and frustration, according to the National Multiple Sclerosis Society. The uncertainty of the disease, loss of functions and altered life circumstances can contribute to the anxiety. Professional counseling and support groups can be helpful to MS patients, though medication may be necessary to treat severe anxiety.

Although there is no known treatment for MS, you can control the condition with medication and lifestyle modifications. The course of the illness and the patient's particular symptoms determine the course of treatment, generally focusing on symptom management and reducing the disease's progression.

Different forms of multiple sclerosis can affect people differently, and the disease's course and symptoms vary substantially between individuals. Each person's treatment strategy is unique for both of these reasons.

More than 20 drugs have been approved by the Food and Drug Administration for the treatment of multiple sclerosis. Some of the most common medications are baclofen, dalfampridine and dexamethasone.

Multiple sclerosis medications can be grouped according to three main uses:

1. Treatment of acute relapses
2. Management of symptoms
3. Prevention of future disease activity

MS treatment may be handled by a team of healthcare providers working together. This team may include a neurologist, physiotherapist, primary care provider, neuropsychologist and/or speech and language therapist.

How does a person get multiple sclerosis?

Although the exact cause of MS is unknown, it may be a result of both hereditary and environmental factors. Researchers think it's a combination of external triggers and genes passed down from family members. Genetics, a lack of vitamin D, smoking, viral infections, teenage obesity and gender are some of the factors that have been reported to contribute to the development of multiple sclerosis. Women are about three times more likely than men to have MS.

Where does MS usually start?

There are several early signs of multiple sclerosis, but two stand out as occurring more frequently than others:

• Optic neuritis. This is a condition where the optic nerve is inflamed. You could have headaches, eye pain and blurry vision. It frequently affects one side and eventually results in partial or complete vision loss.
• Partial transverse myelitis. Also known as inflammation of the spinal cord. You can feel numb, tingly and weak in the arms and legs, and have bladder issues or trouble walking.

What is the life expectancy for a person with MS?

In a study from 2015 that was published in the journal Neurology, researchers compared 5,797 MS patients with 28,807 control subjects who did not have MS. According to the study, those with MS typically lived to be 75.9 years old, compared to people without MS who lived to be 83.4 years old.