Multiple sclerosis (MS) is an inflammatory disease that affects the central nervous system. It attacks the myelin sheaths that insulate nerve fibers that connect the brain and spinal cord to the rest of the body. This damage causes a variety of symptoms that can be mild to severe. These include vision problems, weakness, fatigue, numbness or tingling, and difficulty with walking and balance. The symptoms appear in different parts of the body and may come and go. They may be triggered by fever, hot baths, sun exposure, or stress. The attack usually lasts for days, weeks, or months, and is followed by a period of reduced or no symptoms.
A diagnosis of MS is based on the results of neurological tests and a series of laboratory tests. The tests can show reduced function in different areas of the brain and spinal cord. They also can show changes in reflexes and the speed at which information travels along nerve pathways. A magnetic resonance imaging (MRI) test can show the presence of lesions, or scars, caused by MS. A spinal tap (lumbar puncture) can also be used to check for abnormal antibodies that are linked to MS.
About 85% of people with MS are diagnosed with relapsing-remitting MS (RRMS). This is the most common subtype and is characterized by unpredictably occurring flare-ups, or attacks, and remissions. In RRMS, inflammation of myelin and nerve fibers causes the symptoms that generate in the CNS, which include visual impairments, weakness, fatigue, spasticity, bowel and bladder disorders, and cognitive dysfunction. Approximately 15% of people with MS develop primary progressive MS (PPMS). In PPMS, symptoms gradually worsen over time without any relapses or remissions and without new brain lesions. Almost half of those with RRMS eventually develop secondary progressive MS (SPMS). In SPMS, the symptoms that occur are muscle weakness, cognitive decline, depression and anxiety, urinary tract infections, and impaired bowel movements.
There is no cure for MS, but there are treatments to slow the progress of the disease and reduce relapses and other symptoms. Medications called disease modifying therapies (DMTs) can be taken as pills or given infusions in a clinic or hospital. Infusions are often given in conjunction with other treatment options. Ozanimod, which was approved in 2020, is a DMT that reduces inflammation to help control relapses and slow disease progression.
Maintaining a healthy diet and getting enough exercise can strengthen muscles and improve balance and coordination. A health care professional can recommend dietary supplements and exercise programs that are safe for people with MS. Managing stress can help ease symptoms. Some people find it helpful to join a support group for themselves or for family members. Support groups can help people cope with the emotional and physical challenges of living with a chronic illness and can provide a place to share experiences and resources with others in similar situations.
