What is Multiple Sclerosis?

Multiple sclerosis (MS) is a nervous system disease that affects the brain and spinal cord. In MS, the immune system attacks the myelin sheath, which surrounds and protects nerve cells, leading to communication problems between the brain and the body. MS can range from mild to disabling and may be progressive or occur as isolated attacks followed by remission.

Baptist Health is known for advanced, superior care in diagnosing and treating multiple sclerosis. Our 24/7 inpatient neurology, neurosurgery and outpatient and Home Health physical, occupational, cognitive and speech therapy services are available to help treat people with multiple sclerosis. In addition, we have the region’s only advanced 3Tesla MRI, MRI spectroscopy and functional MRI, MRI angiography, CT angiography and conventional cerebral angiography technology to accurately diagnose all manner of neurologic disease, including multiple sclerosis.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Multiple sclerosis symptoms may include:

• Dizziness
• Double vision
• Electric shock sensations occurring with certain neck movements
• Fatigue
• Lack of coordination or balance problems
• Numbness or weakness in one or more limbs
• Numbness or weakness in the legs and trunk
• Partial or complete loss of vision, often in one eye
• Problems with bowel or bladder function
• Thinking and memory problems
• Tingling or pain in parts of the body
• Tremor
• Slurred speech
• Unsteady gait

Diagnosis

To determine if someone has multiple sclerosis, we conduct a thorough physical examination and ask questions about a person’s medical history. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Blood tests: These can help a physician rule out other diseases with symptoms that can mimic MS.

Evoked potential tests: These tests record electrical signals produced by the nervous system in response to stimuli. In some cases, patients watch a moving visual pattern and, in others, short electrical impulses are applied to nerves in a patient’s legs or arms. Electrodes measure how quickly signals travel down the nerve pathways.

Lumbar puncture: During this test, also known as a spinal tap, a physician uses a needle to remove a small sample of fluid from the spinal canal to be analyzed in the lab for abnormal antibodies associated with MS or signs of infection that can cause MS-like symptoms.

Magnetic resonance imaging (MRI): This scan, in which a large magnet, radio waves and a computer are used to produce detailed pictures of the brain and spine, can reveal areas of MS damage (lesions) on the brain and spinal cord.

Causes

The cause of multiple sclerosis is unknown, but researchers believe it’s an autoimmune disease. A combination of genetics and environmental factors may trigger its onset. Smoking may slightly increase the risk of developing MS.

Risk Factors

Risk factors that may contribute to multiple sclerosis include:

Age: Most people diagnosed with MS are between the ages of 15 and 60, and it most commonly begins between the ages of 20 and 40.

Autoimmune diseases: A person with another autoimmune disease – like thyroid disease, type 1 diabetes or inflammatory bowel disease – is slightly more likely to develop MS.

Climate: MS is more common in temperate climates, such as in Canada, the northern United States, New Zealand and southeastern Australia and Europe.

Ethnicity: Caucasians, especially those of Northern European descent, are at the highest risk of developing MS.

Family history: If a parent or sibling has MS, a person is more likely to develop the disease.

Gender: Women are twice as likely to develop MS as men.

Infections: Certain viruses – including Epstein-Barr, which causes mononucleosis – have been linked to MS.

Prevention

There is no known way to prevent multiple sclerosis, but some studies have found that higher levels of vitamin D are linked to a lower risk of MS. Taking a vitamin D supplement and consuming foods naturally high in or fortified with vitamin D may be helpful.

Prognosis

Most people with multiple sclerosis have relapsing-remitting disease, which means they experience periods of symptoms or relapses that develop over days or weeks and then improve partially or completely. Periods of remission can last months or even years. Some people with MS experience a steady progression of signs and symptoms, without remission, known as primary-progressive MS.

Life expectancy for people with MS has increased over time. Treatment breakthroughs, improved healthcare and lifestyle changes likely have contributed to this. Recent research does indicate that people with MS may live an average of about 7 years less than the general population because of complications from the disease or other medical conditions. However, many of these complications are manageable or can be prevented. Attention and commitment to health and wellness can help reduce the risk of complicating medical conditions, such as heart disease and stroke. Only in rare instances does MS progress rapidly and become fatal.

Treatment and Recovery

Multiple sclerosis treatment during attacks may include:

Corticosteroids

These synthetic hormones, which can be administered intravenously or taken by mouth, can reduce nerve inflammation.

Plasma Exchange

During this procedure, the liquid portion of the blood (plasma) is removed and separated from the blood cells. Blood cells are then mixed with a protein solution and transferred back into the body.

Treatment options for relapsing-remitting MS may include:

Alternative Medicine

Some people with MS benefit from exercise, massage, yoga, dietary changes, acupuncture, relaxation techniques and other complementary treatments to manage symptoms like fatigue and pain.

Beta Interferons

These medications, the most commonly prescribed to treat MS, are injected under the skin or into the muscle to help prevent or reduce inflammation. Possible side effects include flu-like symptoms, injection site reactions and liver damage with long-term use.

Other Medications

A physician may prescribe other medications to reduce or control symptoms of MS, including drugs that block immune responses, deplete white blood cells and otherwise reduce relapse frequency and severity. Because these drugs lower immunities, they have many possible side effects.

The physician may also prescribe medications to treat depression and anxiety, pain, sexual dysfunction and bladder/bowel dysfunction associated with MS, as well as muscle relaxants or medications to reduce fatigue.

Physical Therapy

A therapist can teach stretching and strengthening exercises that may increase mobility, reduce pain and make performing everyday tasks easier. The therapist can also help people manage with mobility aids, like canes and walkers, which may be prescribed if walking is affected.

Complications

Complications of multiple sclerosis may include:

Aspiration pneumonia: Some people with MS have trouble swallowing, which can increase the risk for food and/or liquid spilling into the lungs. This can cause choking, coughing, infection and difficulty breathing.

Depression: Living with a chronic and unpredictable disease can increase the risk of developing depression.

Pressure ulcers: Also known as bedsores, this skin breakdown occurs if MS causes a person to spend too much time sitting or lying down, decreasing blood flow.

Osteoporosis: Inactivity due to MS can cause the bones to lose density and break more easily. Corticosteroids can increase this risk.

Urinary tract infections: UTIs can occur if MS causes poor bladder control, leading to a person holding urine in the bladder for too long.