Multiple sclerosis (MS) is a neurodegenerative disorder caused by the immune system mistakenly attacking the myelin sheath, or the protective protein coat around nerve fibers. This results in inflammation, which further damages the myelin sheath as well as the nerve cells themselves, and the cells that produce myelin.
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Symptoms
The immune system attack on myelin causes a disruption in electric signals traveling along the nerve fibers from the brain to the body and back. As a result, patients with MS experience many symptoms, including fatigue, numbness and tingling, muscle spasms, walking difficulties, pain, and bowel or bladder problems. Many patients also experience emotional changes, including depression, anxiety, and mood swings.
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Diagnosis
There is no single test to diagnose MS. Physicians diagnose the disease based on a series of physical and neurological examinations that can help eliminate other conditions. These tests include magnetic resonance imaging (MRI), blood and cerebrospinal fluid tests, and tests that measure electrical signals from the brain.
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Types of MS
Patients with MS are broadly classified into four groups based on disease progression.
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Clinically isolated syndrome
Clinically isolated syndrome (CIS) represents a single event, the first episode of neurological symptoms. On its own, it is not indicative of MS, unless MRI scans show lesions in the brain.
Relapsing-remitting multiple sclerosis
Relapsing-remitting multiple sclerosis (RRMS) is the most common type of MS. Patients experience attacks of increasing neurological symptoms, called exacerbations or relapses, followed by periods of partial or complete recovery. At various times, patients may have active, not active, or worsening neurological symptoms.
Secondary progressive multiple sclerosis
Secondary progressive multiple sclerosis (SPMS) is the secondary stage of MS that follows RRMS. Patients may have relapsing-remitting episodes initially but then experience a steady worsening of neurological symptoms.
Primary progressive multiple sclerosis
Primary progressive multiple sclerosis (PPMS) affects about 15 percent of MS patients. Patients experience a steady decline in neurological function without relapses from the onset of symptoms.
Treatments
There are many treatments available for MS, and many more experimental treatments are being developed. Most therapies aim to suppress the immune system to reduce inflammation and help protect the myelin sheath.
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Prognosis
With improving treatments, life expectancy for patients with MS has increased over the years and most patients with MS now live to age 65 or older.
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