Multiple sclerosis (MS) is a progressive, lifelong illness that affects nerve cells in the brain and spinal cord. Normally, myelin protects nerve cells. Myelin is a fatty substance that acts like electrical wire insulation. Myelin helps signals move along nerves. In MS, myelin becomes damaged or inflamed, interrupts nerve signals, and causes symptoms. People can have only one mild symptom, very few symptoms, or many symptoms with severe disability.
MS is more common in women than men and in temperate climates more than the tropics.
The cause is unknown, but MS is thought to be an autoimmune illness. That is, the body’s own immune system attacks itself. In MS, it attacks the myelin covering.
Symptoms improve (during remissions) and then can worsen. Symptoms depend on whether the brain or spinal cord is affected and which areas are involved. Symptoms of brain involvement may include sudden vision loss or blurry vision, clumsiness, slurred speech, tiredness, muscle weakness, and trouble walking. Loss of bladder control and numbness, tingling, weakness, or heavy feelings in arms or legs mean spinal cord involvement.
The health care provider may think of MS because of age, symptoms, and physical and neurological examinations. No specific test proves the diagnosis. The health care provider will suggest seeing a neurologist (specialist in nervous system diseases). Magnetic resonance imaging (MRI), spinal tap, and visual-evoked response may be done. MRI shows areas where myelin is inflamed or destroyed. In a spinal tap, the health care provider takes a sample of fluid from the spinal cord for study.
MS cannot be cured, but many treatments are available to control the symptoms and slow the progression of the disease. Both the disease and complications (e.g., spastic movements, fatigue, pain, thinking problems, and bladder and bowel problems) are treated.
Corticosteroid drugs are the main treatment to control symptoms. Medicines such as interferon beta-1a and -1b, glatiramer, fingolimod, natalizumab, and several newer medications slow MS progress and reduce the number of relapses.
Medicines used for complications include amantadine, baclofen, gabapentin, oxybutynin, propantheline, stool softeners, psyllium, fiber, nonsteroidal antiinflammatory drugs (NSAIDs), and acetaminophen.
Maintaining a healthy lifestyle, getting enough rest and exercise, and keeping to a normal weight are important.
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