There’s a lot of misconceptions about this autoimmune disease.
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
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.
Dr. Fabian is the assistant professor of neurology at The Mount Sinai Hospital in New York City.
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Multiple sclerosis is a disease
of the central nervous system.
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It is an autoimmune condition, and so
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that means the immune system
is activated against itself.
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The immune system is the system that we
have in our body to protect against virus,
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bacteria, any sort of infection.
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And instead of doing that, for some reason
in multiple sclerosis, it turns inward.
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And the immune system attacks the parts
of the central nervous system,
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the brain, the spinal cord and
the optic nerve,
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which is the connection
from the eye to the brain.
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We have these nerve cells in our brain,
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they send out these projections
that are called axons.
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That's the highways that
the message travels along, and
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it is insulated by
something called myelin.
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So myelin makes that message run quickly.
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So that when we think of doing something
like moving our arm, we move it quickly.
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And the immune system
attacks the myelin primarily.
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When it does that,
the message either travels slower or
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it kind of gets confused.
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And so that the patient has
trouble doing what they wanna do,
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because the message is
getting lost a little bit.
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So if we think about
the parts of the body,
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MS can affect most of them,
the way the nervous system does.
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So ee can think about the vision.
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People can have blurry vision
in one eye or the other.
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They also can have double vision,
that's another symptom people can have.
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They can have numbness.
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They can have numbness on their face.
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They can have numbness on their body.
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They can have weakness in their body.
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They can have dizziness.
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And because of the weakness,
sometimes they will have trouble walking.
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The two main sorts of MS
are relapsing-remitting MS, and
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primary progressive MS.
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Relapsing-remitting MS is
the most common form of MS.
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85% of people are diagnosed
with it at onset.
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In MS relapse is a patient that has a new
symptom that is somewhere on their body,
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localized on their body, and
it lasts longer than 24 hours.
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And it comes on usually over
the course of days to weeks, and
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then it goes away over days to weeks.
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The other sort of MS is progressive MS.
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Instead of a new symptom that
comes on over days to weeks,
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it's a slow thing that
happens over months to years.
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So it's more of a gradual symptom,
and then it doesn't typically go away.
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It might kind of plateau,
flatten out, but it doesn't go away.
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When I tell somebody that
they have a diagnosis of MS,
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I always give that message with
a message of hope as well.
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Because we have really good treatments for
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And so, it's a very different diagnosis
than it was 30 years ago when we
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didn't have treatments.
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So now what I tell patients is,
we've listened to your story.
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We've looked at your MRI's, and they are
consistent with having multiple sclerosis.
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But this is a treatable condition and
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I expect that you're gonna
continue to live your life.
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And it might not actually change much from
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how it was before you knew
you had the diagnosis.
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Patient education: multiple sclerosis in adults (the basics). Waltham, MA: UpToDate, 2017. (Accessed on December 15, 2017 at https://www.uptodate.com/contents/multiple-sclerosis-in-adults-the-basics.)
MS symptoms. New York, NY: National Multiple Sclerosis Society. (Accessed on December 15, 2017 at https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms.)
Types of MS. New York, NY: National Multiple Sclerosis Society. (Accessed on December 15, 2017 at https://www.nationalmssociety.org/What-is-MS/Types-of-MS.)
What is multiple sclerosis? New York, NY: Mount Sinai Hospital. (Accessed on December 15, 2017 at http://www.mountsinai.org/patient-care/service-areas/neurology/areas-of-care/corinne-goldsmith-dickinson-center-for-ms/symptoms-and-treatment.)