Multiple sclerosis (MS) is a chronic disease of the central nervous system. It is an unpredictable condition that can be relatively benign, disabling, or devastating. Some individuals with MS may be mildly affected, while others may lose their ability to write, speak, or walk when communication between the brain and other parts of the body becomes disrupted.
What causes multiple sclerosis?
There are many possible causes of MS, including viruses, autoimmune disorders, environmental factors, and genetic factors. All of the possible causes share the common feature that the body’s immune system is prompted to attack its own nervous tissue. In particular, in MS, the immune system commonly attacks the layer of protein called myelin that surrounds the connecting fibers between parts of the central nervous system. This layer of protein normally provides insulation for the electrical signals that the nervous system uses to communicate. When this insulation is destroyed, communication becomes interrupted and ultimately parts of the nervous system are permanently destroyed
Symptoms of multiple sclerosis vary, depending on the location of affected nerve fibers. Multiple sclerosis symptoms may include:
- Numbness or weakness in one or more limbs
- Partial or complete loss of central vision, usually in one eye, often with pain during eye movement (optic neuritis)
- Double vision or blurring of vision
- Tingling or pain in parts of your body
- Electric-shock sensations that occur with certain head movements
- Tremor, lack of coordination or unsteady gait
- Slurred speech
Heat sensitivity is common in people with multiple sclerosis. Small increases in body temperature can trigger or worsen multiple sclerosis symptoms.
Most people with multiple sclerosis, particularly in the beginning stages of the disease, experience relapses of symptoms, which are followed by periods of complete or partial remission of symptoms.
Some people have a benign form of multiple sclerosis. In this form of the disease, the condition remains stable and often doesn’t progress to serious forms of MS after the initial attack.
Outcome varies, and is hard to predict. Although the disorder is chronic and incurable, life expectancy can be normal or almost normal. Most people with MS are active and function at work with little disability.
The following typically have the best outlook:
- People who were young (less than 30 years) when the disease started
- People with infrequent attacks
- People with a relapsing-remitting pattern
- People who have limited disease on imaging studies
The amount of disability and discomfort depends on:
- How often and severe the attacks are
- The part of the central nervous system that is affected by each attack
Most people return to normal or near-normal function between attacks. Slowly, there is greater loss of function with less improvement between attacks.
Despite the lack of a definitive remedy for central nervous system demyelination in multiple sclerosis, certain manifestations of the disease are treatable. Recognition and identification of specific impairments, disabilities, and handicaps faced by the patient afford the physician the best opportunity to provide effective intervention. Impairments are ameliorated with difficulty; however, when comprehensive methods of rehabilitation are applied to the associated disabilities and handicaps, meaningful improvements can be achieved. The goal of rehabilitation in multiple sclerosis is to maximize the patient’s physical, emotional, social, and vocational independence. Through the multidisciplinary efforts of numerous health-care workers in close cooperation with the patient and the family, this goal can be attained