What Is Multiple Sclerosis? Key Facts a Neurologist Wants You to Know

There’s a lot of misconceptions about this autoimmune disease.

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The initial symptoms of multiple sclerosis (MS) can be subtle and wide-ranging. You may experience a “pins and needles” feeling in your fingers even though your arm hasn’t fallen asleep. Your wrists might feel weak after a long day of typing at work, almost like carpal tunnel, or you might struggle to text as fast as you used to. You might notice a change in how often you need to run to the bathroom. (It’s common to need to urinate less often; you might get through a whole night out for dinner or drinks without needing to go.) You might feel clumsier than usual, experiencing tripping or falling for no obvious reason.

Because the symptoms of MS can vary widely and easily be mistaken for other health issues, it can take some patients a long time to seek medical care or get the right diagnosis when they do.

MS is an autoimmune disease, which means the immune system (which normally works to fight against foreign pathogens) turns against itself. In the case of multiple sclerosis, it attacks the central nervous system. In the process, it damages the myelin, the insulation of the nerves in the brain, spinal cord, or optic nerve.

When your brain transmits messages to the rest of the body, myelin helps those messages travel faster. This allows you to answer the phone the nanosecond you decide not to ignore it, or shield your face the instant you see fallen leaves flying toward you. If your immune system breaks down that myelin, however, those messages get lost or take longer to get to your muscles, and your body will be unable to do what you intended.

Because the central nervous system can impact many different parts of your body, MS can cause a number of different symptoms. Here are the main symptoms patients with MS tend to experience, according to neurologist Michelle Fabian, MD, of The Mount Sinai Hospital in New York City.

  • Blurry or double vision

  • Numbness

  • Weakness

  • Dizziness

  • Trouble walking

There are two primary types of MS: relapsing-remitting MS and primary progressive MS.

With relapsing-remitting MS, symptoms occur in episodes called “attacks,” which can last days or weeks but then go away until the next flare up. Doctors define a relapse with MS as a new symptom localized somewhere on the body that lasts longer than 24 hours. Relapsing remitting MS is the most common type, affecting around 85 percent of patients at the time they are diagnosed.

With primary progressive MS, symptoms begin slowly and steadily progress and become worse over the course of months or years. Symptoms may eventually plateau, but they don't go away entirely.

MS treatments have changed dramatically over the last 30 years. Now medications can control the progression of disease, making relapses much less common. It’s a big misconception, according to Dr. Fabian, that MS will automatically have a dramatically negative impact on your quality of daily life.  “When I tell someone that they have a diagnosis with MS, I always give that message with a message of hope,” says Dr. Fabian. Treatment for MS has come a long way, and many patients can now expect a life that isn’t much different than what they had before their diagnosis.