Multiple Sclerosis

What is multiple sclerosis?

Multiple sclerosis (MS) is a disease that leads to inflammation and damage to parts of your central nervous system (CNS). The CNS includes your brain, spinal cord, and nerves. With MS, your immune system attacks and destroys the coating (myelin) that covers your nerves. This may cause problems with how you feel, move, and see.

What increases my risk of MS?

The cause of MS is unknown. MS is more common in women and young adults. The following may increase your risk for MS:

• Living somewhere with small amounts of sunlight
• A family history of MS
• Viral infections such as Epstein-Barr or herpes simplex virus
• Cigarette smoking

What are the signs and symptoms of MS?

The signs and symptoms of MS depend on where the damage is in the CNS. They may vary from person to person and from time to time in the same person. The most common signs and symptoms of MS include:

• Extreme tiredness even with plenty of rest (fatigue)
• Difficulty controlling your bladder or bowels
• Blurred or double vision or dizziness
• Depression, mood swings, or difficulty controlling emotions
• Muscle weakness, cramps, or spasms
• Numbness or tingling usually felt in the arms and legs
• Problems with sexual function such as difficulty having or maintaining an erection

What are the types of MS?

• Relapsing-remitting MS (RRMS) is the most common type of MS. It has quiet and active periods. The quiet periods are called remissions. During remissions you may have little or no symptoms. Remission may last for months or years. During an active period, or relapse of MS, your symptoms may get worse.
• Primary progressive MS (PPMS) is when you have a slow or steady worsening of symptoms. There are no periods of remission.
• Secondary progressive MS (SPMS) begins with few or no symptoms. It is then followed by a steadily worsening disease. Periods of remission become less frequent over time.
• Progressive-relapsing MS (PRMS) is when the disease gets worse from the start or onset of MS. You may have times when symptoms improve, but no remission periods.

How is MS diagnosed?

• There are no specific tests to diagnose MS. You may need an MRI to take pictures of your brain. You may be given contrast liquid to help the pictures show up better. Tell your healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell a healthcare provider if you have any metal in or on your body.
• You may need other tests to make sure that your symptoms are not caused by other illnesses. Tell your healthcare provider about when your symptoms started and if you have other family members with MS.

How is MS managed?

There is no cure for MS. You may need any of the following:

• Medicines: Medicines may be given to treat relapses, slow the progression of MS, or manage the symptoms.
• Rehabilitation: Rehabilitation may include physical therapy, occupational therapy, or speech therapy. These therapies may help manage symptoms of MS.

How can I manage my MS symptoms?

• Manage your stress: This will help decrease relapses. Do activities that help you relax. Ask your healthcare provider about counseling or therapies to help you manage stress.
• Exercise: Exercise may help decrease fatigue and depression. It may also improve bowel or bladder function, mobility, and stiffness. Ask your healthcare provider about an exercise program that is right for you.
• Get vaccinated: Vaccinations can help prevent illnesses that worsen MS symptoms. Talk to your healthcare provider about what vaccines you need.
• Take your medicines as directed. This will help prevent complications of MS and may reduce your number of relapses. Know the side effects of your medicines and when to report them to your healthcare provider.

Call 911 for any of the following:

• You have trouble breathing.
• You fall and hit your head.
• Your abdomen is painful and larger than usual.

When should I contact my healthcare provider?

• You have a fever.
• You feel you cannot cope with your illness.
• You have new or worsening symptoms.
• You have an open sore.
• You have burning when you urinate.
• You do not have a bowel movement for 3 days or more.
• You choke or cough during eating or drinking.
• You have questions or concerns about your condition or care.