Multiple sclerosis (MS) is a stealthy and unpredictable autoimmune disease that targets the central nervous system. MS disrupts the communication between the brain and the body. Most people with multiple sclerosis are diagnosed with the disease between the ages of 20 and 40, but MS could develop at any age. MS affects about a million Americans, with women two to three times more likely to develop MS than men. It’s easy to miss the early symptoms of MS, which can make it hard to detect and intervene early in order to manage symptoms and slow the disease’s progression.
MS is an inflammatory condition that damages myelin, the material that insulates the nerves. Without this insulation, the signals from the brain to the rest of the body are degraded, resulting in a number of health problems. It’s unknown what precisely causes MS, although it could be due to environmental or genetic factors. Research also suggests MS could be triggered by Epstein-Barr virus in certain individuals. There’s no cure for MS, but there are several treatment options for the disease.
Symptoms
It can be easy to overlook the first warning signs of multiple sclerosis, as its symptoms can be subtle and vague at first. Symptoms of MS can vary in type and severity from person to person, and may include:
- Bladder and bowel problems
- Fatigue
- Muscle weakness
- Numbness
- Pain
- Vision problems
- Trouble with balance and/or coordination
- Sexual dysfunction
Vision problems are frequently the first symptoms noticed. MS can cause damage to the optic nerve and difficulty controlling the eye muscles. This can lead to blurry vision, double vision, involuntary eye movement, optic neuritis (blind spots) and rarely, blindness.
Numbness and tingling is a common early symptom of multiple sclerosis. The sensations are most likely to occur in the arms, leg, and face, and may persist or be intermittent. These sensations are a result of damage to the nerves.
Trouble with balance and coordination can be another early sign of MS. The disease can cause weakness, tightness, or spasms of the muscles. MS can also cause dizziness and vertigo, increasing mobility difficulty.
MS can lead to bladder and bowel troubles, including incontinence and constipation. These problems may also be more severe. For bladder trouble, an increase in urgency and frequency of needing to urinate are the most common issues. Constipation is the most common bowel problem, and may be treated with dietary changes.
Diagnosis
Your doctor may order a number of tests to confirm you have multiple sclerosis. These tests may include magnetic resonance imaging (MRI), lumbar puncture (spinal tap), evoked potential tests, blood work, and other testing.
An MRI is typically the primary test by neurologists when determining an MS diagnosis. It would be used to give your physician a detailed view of the brain and spinal cord. These scans are able to see whether parts of the central nervous system have lesions or other damage indicative of MS.
A lumbar puncture, or spinal tap, could be used to collect cerebrospinal fluid from the spinal canal. This fluid would then be examined to determine whether it shows several markers that could indicate the presence of MS.
An evoked potential test measures electrical activity in the brain to determine how it responds to various stimuli, such as sight, sound, and touch. The most common of this type of test is the visual evoked potential, which is used to assess the optic nerve pathway.
Your doctor may also order blood tests. These are not usually done to diagnose MS, but to see if other conditions may be responsible for the symptoms. Several other diseases may present similar symptoms to MS.
Treatment
Unfortunately, there is no cure for multiple sclerosis. However, there are a number of treatments available which can slow the disease’s progression and reduce its attacks and manage its symptoms.
The most commonly-used treatments for multiple sclerosis are disease-modifying therapies (DMTs). If taken early enough in the disease, DMTs may help slow its progression and reduce the MS relapse rate. However, DMTs come with significant risk factors and must be tailored to individual patients to find the right balance. There are a variety of DMTs available in infusion, injection, and oral forms. Your doctor will work with you to help determine the best option for you.
Treatment for MS attacks could be done with either corticosteroids or plasma exchange. Corticosteroids are used to reduce inflammation of the nerves. These may be taken orally or intravenously. Plasma exchange, or plasmapheresis, is used for severe symptoms that do not respond to high doses of corticosteroids. Plasma exchange is the separation of blood plasma, the liquid part of the blood, from blood cells. A protein solution is then combined with the blood cells and returned to the body.
Your doctor may also set you up with a physical therapist to help with mobility. The exercises can help build muscle strength, as well as reduce pain, and improve balance. If necessary, the therapist may have you use mobility devices such as a cane or walker.
If you believe you have multiple sclerosis, or are looking for new ways to improve your condition, speak with one of Lexington Clinic’s board-certified neurologists. They offer the latest technology to diagnose even the most complex conditions that can develop in the intricate network of the brain, spine and nerves.
About Melissa P. Smith, DO
Dr. Melissa P. Smith is certified by the American Osteopathic Board of Neurology and Psychiatry. She is also affiliated with the American Academy of Neurology. She provides treatment of Parkinson’s disease, strokes, multiple sclerosis, headaches, spasticity, migraines, muscle diseases, epilepsy and seizures, neuropathy, and general neurological consultations. Dr. Smith has provided patients with excellent care since 2001.
Dr. Smith can be reached at (859) 258-4800. For help scheduling an appointment, or to find the location closest to you, call (859) 258-4362, or visit LexingtonClinic.com.
