Multiple sclerosis (MS) is a condition that can affect the brain and spinal cord, causing a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance.
It is a lifelong condition that can sometimes cause serious disability, although it can occasionally be mild. In many cases, it is possible to treat the symptoms.
MS is most commonly diagnosed in people in their 20s, 30s and 40s, although it can develop at any age. It’s about two to three times more common in women than men and is one of the most common causes of disability in younger adults.
What causes MS?
MS is an autoimmune condition. This is when something goes wrong with the immune system, and it mistakenly attacks a healthy part of the body – in this case, the brain or spinal cord or central nervous system.
In MS, the immune system attacks the layer that surrounds and protects the nerves called the myelin sheath. This damages and scars the sheath and potentially the underlying nerves, meaning that messages travelling along the nerves become slowed or disrupted.
Exactly what causes the immune system to act in this way is unclear, but most experts think a combination of genetic and environmental factors is involved.
Types of MS
MS starts in one of two general ways: with individual relapses (attacks or exacerbations) or with gradual progression.
The main types of MS are as follows.
1. Relapsing remitting MS
About 85% of people with MS are diagnosed with the relapsing remitting type. These people will have episodes of new or worsening symptoms, known as relapses. Relapses typically worsen over a few days, last for days to weeks to months, then slowly improve over a similar time period.
Relapses often occur without warning but are sometimes associated with a period of illness or stress. The symptoms of a relapse may disappear altogether, with or without treatment, although some symptoms often persist, with repeated attacks happening over several years.
Periods between attacks are known as periods of remission and can last for years at a time.
2. Secondary progressive MS
In this type of MS, symptoms gradually worsen over time without obvious attacks. Some people continue to have infrequent relapses during this stage. About two-thirds of people with relapsing remitting MS will develop secondary progressive MS.
3. Primary progressive MS
10-15% of people with the condition start their MS with a gradual worsening of symptoms. In primary progressive MS, symptoms gradually worsen and accumulate over several years and there are no periods of remission. However, people often have periods where their condition appears to stabilise.
MS Symptoms
The symptoms of MS vary widely from person to person and can affect any part of the body.
Depending on the type of MS you have, your symptoms may come and go in phases or get steadily worse over time. The symptoms often have many other causes, so they’re not necessarily a sign of MS.
Speak to your GP if you are concerned and let them know about the specific pattern of symptoms you’re experiencing. If they think you could have MS, you will be referred to a neurologist, who may suggest tests such as an MRI scan to check for features of MS.
The main symptoms include:
- Fatigue;
- Difficulty walking;
- Vision problems, such as blurred vision;
- Problems controlling the bladder;
- Numbness or tingling in different parts of the body;
- Muscle stiffness and spasms;
- Problems with balance and co-ordination;
- Problems with thinking, learning and planning.
Treatments for and living with MS
There is currently no cure for MS, but a number of treatments can help control the condition and ease symptoms.
The treatment you need will depend on the specific symptoms and difficulties you have and may include:
- Treating relapses with short courses of steroid medicine to speed up recovery;
- Specific treatments for individual MS symptoms;
- Treatment to reduce the number of relapses using medicines called disease-modifying therapies.
Disease-modifying therapies may also help to slow or reduce the overall worsening of disability in people with relapsing remitting MS, and in some people with primary and secondary progressive MS, who have relapses.
Unfortunately, there’s currently no treatment that can slow the progress of primary progressive MS or secondary progressive MS, where there are no relapses. Many therapies aiming to treat progressive MS are currently being researched.
MS can be a challenging condition to live with, but new treatments over the past 20 years have considerably improved the quality of life of people with the condition.
The condition itself is rarely fatal, but complications may arise from severe MS, such as chest or bladder infections, or swallowing difficulties. The average life expectancy for people with MS is around five to ten years lower than average but this gap appears to be getting smaller all the time.
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