“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 one 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.
Because MS can affect so many parts of your nervous system, MS can cause
many symptoms. Among these symptoms are:
Weakness and paralysis
Numbness and tingling
Vision loss
Double vision
Difficulty speaking
Imbalance
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.
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.
MS is treated with medications that modulate the immune response (immunomodulators).
To treat MS attacks, large steroid (methylprednisolone) doses are given
for three to five 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.
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.
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.
“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.
