“A couple years ago my eyesight became blurred for a few days then got better. Now, I’m having double vision, and I can’t walk straight. Do I have MS?”
Multiple sclerosis (MS) is an autoimmune disease of the brain and spinal cord that affects 1 million Americans. MS affects young people more than old people and women more than men. Similar to other autoimmune diseases, MS occurs when your immune system attacks your nerve cells, particularly the “wires” connecting these cells.
What are the symptoms and signs of Multiple Sclerosis?
Because MS can affect so many parts of your nervous system, MS can cause many symptoms. Chief among these symptoms are
- Weakness and paralysis
- Numbness and tingling
- Vision loss
- Double vision
- Difficulty speaking
- Trouble walking
Common syndromes that can be the first attack of MS include optic neuritis and transverse myelitis.
Patients with MS often suffer attacks (flares or relapses) with different symptoms. These attacks last days or weeks and can get better. Management of MS is focused on the prevention, treatment, and recovery from attacks.
How do you diagnose MS?
Your doctor will review your history and MRI and CAT scans to find evidence of MS. MS is a disease that occurs in different parts of your brain and spinal cord and at different times in your life. In some cases, your doctor may recommend lab tests, a spinal tap (lumbar puncture), a visual evoked potential, or even a biopsy to verify the diagnosis of MS.
How do you treat MS?
MS is treated with medications that modulate the immune response (immunomodulators).
To treat MS attacks, large steroid (methylprednisolone) doses are given for 3-5 days. In rare cases, plasma exchange may be recommended to filter the blood of autoantibodies.
To prevent MS attacks, many different immunomodulators can be used. Older medications are injected under the skin. Newer medications are taken by mouth. Other agents are infusions of monoclonal antibody that target specific parts of the immune system.
In addition to immunomodulators, exercise (including physical and occupational therapy) and symptom-focused treatments (stimulants, antidepressants, muscle relaxants) can also boost your independence and quality of life.
Is MS inherited, or contagious to others?
MS is not contagious, you cannot transmit it, or get it from other people. While MS isn’t directly inherited from parents, those with first degree family members (parents, grandparents) have a higher incidence than those without any family history.
Will MS disable or kill me?
MS is a serious condition that can cause disability. This disability often improves greatly after each attack, but residual disability may accumulate over time and cause permanent impairment. The best chance to reduce disability is to diagnose and treat MS early!
In most cases, MS has a relapsing-remitting course over decades. In very rare cases, MS can progress rapidly and prove fatal.
Can I have something other than MS?
“The doctors said I have MS. I’ve been taking Betaseron but I keep getting worse. What else can I take, and can it be anything else?”
Yes, there are many other problems that might resemble MS and are important to diagnose as their therapies are often very different. In some cases, strokes, infections, tumors, or toxins can mimic MS. In other cases, there is a non-MS autoimmune disorder that will not respond to immunomodulators for MS.
Neuromyelitis optica (NMO or Devic’s disease) is an autoimmune disease that mostly affects the eyes and spinal cord. NMO is much more common in non-white patients (particularly African Americans). Attacks of NMO can be much more severe than for MS, and NMO can get worse if it is treated with medications for MS.