Multiple sclerosis (MS)

What is multiple sclerosis?

Multiple sclerosis (MS) is a lifelong condition of the brain and spinal cord, where the coating of your nerves (myelin) is damaged.

Myelin plays a vital role in protecting the nerve fibres that help messages travel between the brain and the rest of the body. If you have MS, your immune system attacks and damages myelin, making it harder for these messages to travel along the nerve fibres.

MS can cause difficulties with movement, vision, balance and the way you think and feel.

What causes MS?

Scientists don’t know exactly why the immune system attacks myelin in this way, but it’s thought to be affected by:

• Genes – Your chances of getting MS are higher if you have a close relative with the condition

• Lack of sunlight and vitamin D – Countries further from the equator have higher rates of MS

• Gender – Women are more likely to develop MS

• Smoking

• Being obese as a teenager

• Certain viruses, like glandular fever

MS symptoms

MS has a wide range of symptoms, affecting all body areas, and it’s different for everyone. Some of the more common symptoms include:

• Tiredness

• Problems with vision

• Numbness and tingling

• Feeling dizzy and off-balance

• Muscle spasms, stiffness and weakness

• Pain

• Bladder and bowel problems

• Thinking, learning and memory problems

The symptoms can come and go – known as relapses and remissions, or they can build up steadily over some time.

MS diagnosis

It can be hard to diagnose MS as many of the symptoms are similar to other conditions. Talk to a doctor if you experience any of the signs.

Some of the symptoms can be quite vague, so try to remember as much detail as you can. It might help to write down when the symptoms tend to happen, how they affect you, and any patterns you’ve noticed.

If the doctor thinks it could be MS, they’ll refer you to a neurologist who specialises in conditions of the nervous system.

There’s no single test to diagnose MS. The neurologist may do several tests to help rule out other possible conditions.

Tests for MS can include:

• Examination – An assessment of your vision, strength, balance, coordination, reflexes and speech

• MRI – A scan to look for damage to the myelin sheath in your brain or spinal cord

• Evoked potential test – Monitoring your brainwaves to check how well your eyes are working

• Lumbar puncture – Taking a sample of your spinal fluid with a needle and testing it for specific immune cells and antibodies

• Blood tests – To help rule out other conditions

Types of MS

The type of MS you have will determine how you experience symptoms:

• Relapsing-remitting MS – The most common form of MS typically involves periods where symptoms worsen for a few days and then last for weeks or months until they start to improve. A period of remission in between relapses can last for years, but some people can go on to develop secondary progressive MS.

• Primary progressive MS – It’s less common for MS to start with primary progressive MS. This is when there are no periods of remission, and symptoms develop gradually and slowly over time.

Multiple sclerosis treatment

As MS affects everyone differently, treatment can vary, depending on your symptoms. In general, treatment is used for:

• Specific symptoms – for example, physiotherapy to treat muscle spasms and stiffness or support from an occupational therapist to help with the day-to-day impact of mobility problems

• MS relapses – Short courses of steroid medicine may help speed up recovery during relapses

• Reducing the number of relapses – Medicines called disease-modifying therapies can help to reduce the number and severity of relapses by lowering the level of damage to the myelin sheath

MS outlook and complications

MS can lower life expectancy by around five to 10 years. It can also cause a range of health complications, including bladder and chest infections.

But advances in treatments for MS in recent years mean that many people with the condition can reduce their symptoms and enjoy a good quality of life.

It can be a challenge living with an ongoing health condition like MS. But there’s lots of support available to help you come to terms with the diagnosis and cope with the disease.

Self-help groups are safe, private places where you can share your thoughts and feelings without judgement and get reassurance and advice. Talk to a doctor or contact the MS Society to find out what’s available in your area.