Multiple Sclerosis (MS)
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Neurological Institute MDA/Neuromuscular Clinic
Symptoms can vary, depending on where the damaged nerves are and what stage of the disease you are in. You may experience numbness or weakness, pain and tingling, an electric shock feeling in your neck, partial or complete loss of vision with some pain during eye movement, double or blurred vision, slurred speech, tremors, unsteady gait and loss of coordination, dizziness, fatigue, and loss of bowel and bladder control.
For most people with multiple sclerosis, the path the disease follows is that new symptoms develop over days or weeks (these typically improve partially or completely), then you experience a remission period that can last months or years; this is called relapsing-remitting MS. Up to 70 percent of people who follow this pattern eventually reach a point of steady progression of the disease without remission periods. S ome people experience a steady progression of the disease from the start; this is called primary-progressive MS.
The cause of this condition is unknown , although it is thought to be an autoimmune disease. It commonly appears between the ages 15‒60 and is twice as likely to affect women as men. Other factors that put you at a higher risk of developing multiple sclerosis:
- A parent or sibling has the condition
- Having experienced a virus-like infectious mononucleosis
- Being of Northern European descent
- Having an autoimmune disease like diabetes
- Being a smoker
Diagnosing MS is a complex task since no symptoms or test results can determine if someone has the condition. Our team will perform a medical history, neurological examination and various lab tests to exclude other potential causes for your symptoms.
To make a diagnosis of MS, three elements need to be confirmed.
- You must have damage in a minimum of two separate areas of the central nervous system (that can be your brain, spinal cord or optic nerves).
- We must find evidence that these damages occurred at least a month apart.
- All other potential diagnoses must be eliminated.
- Blood tests will help us rule out other infectious and inflammatory diseases with similar symptoms.
- A spinal tap (lumbar puncture) will show abnormalities in white blood cells or antibodies that are associated with MS. It may also help us eliminate other viral infections as the cause.
- The MRI scan will show us if there are MS lesions on your brain or spinal cord.
- Evoked potential tests will demonstrate if the electrical signals that occur in response to stimuli are slower than they should be due to demyelination; this test can help us discover nerve damage associated with MS even if the damage is too subtle to appear in examination.
There is no cure for MS, so our team will treat you to help speed your recovery from attacks, slow the course of the disease and manage your symptoms.
To help recover from attacks, we may recommend corticosteroids to reduce nerve inflammation and, if your symptoms have not responded to steroids, plasmapheresis (plasma exchange) in which the liquid portion of your blood is replaced.
To help slow the progression of the relapsing-remitting form of MS by lessening the relapse rate and reducing formation of new lesions, we may recommend certain medications.
At present, no therapies are known to slow the progression of the primary-progressive form of MS.
To help treat symptoms of MS, our team may suggest a combination of therapy and medications:
- Physical or occupation therapy can help you strengthen muscles and learn to use devices that make it easier to perform daily tasks
- Medications can help relax stiff and uncontrollable muscles, reduce fatigue and address other minor medical problems associated with MS