In ms, the sheath that protects nerve fibers (myelin) is gradually damaged, leading to a breakdown in communication between brain cells and to a variety of symptoms. Because it is so unpredictable, ms can be hard to diagnose. It is also possible for other health problems to cause similar symptoms, so doctors must consider many factors when deciding whether someone has MS. To be diagnosed, a person must have 2 attacks that occur at least 1 month apart and must have more than one area of damage to the myelin sheath. Often, doctors will also carry out a series of tests to rule out other diseases that may look like ms or have similar causes. These may include a spinal tap to obtain a sample of the fluid that surrounds the central nervous system, which can be analyzed for proteins and inflammatory cells that are characteristic of the disease; magnetic resonance imaging (MRI) to check for areas of tissue damage; and tests such as evoked potentials, which use electrodes to measure nerve responses.
People with ms can experience different types of weakness, spasticity and pain. In some cases, these can be severe enough to limit walking or standing. In more advanced cases, they can lead to partial or complete paralysis. Other health issues that can occur in ms are changes to thinking and memory, called cognitive dysfunction; and depression, which can be caused by both stress and neurologic changes.
Fatigue is a common symptom of ms and can interfere with work, school and everyday activities. It can be related to muscle atrophy, inflammation and the loss of nerve function. It can also be triggered by hot weather, exercise or illness. It can be improved by varying tasks, addressing sleep issues and reducing fatigue-causing habits such as smoking or excess alcohol intake.
Other health issues that can occur in ms include slurred or incoherent speech (dysarthria), and swallowing difficulties, which are caused by damage to the complex nerve pathways involved in movement. In some people, tremors can develop in several parts of the body due to damage to these nerve pathways, and a quarter of those with ms will experience a decrease in taste. Seizures can occur in a small number of people with ms and are linked to abnormal electrical discharges in the brain.
People with ms who spend long periods of time sitting or lying down can develop pressure sores, which are areas of skin that become damaged by extended contact over an extended period of time. These can be prevented by moving around more frequently, using special mattresses and pillows, preventing heat exposure and keeping skin clean.
