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Multiple Sclerosis (MS)

What is multiple sclerosis (MS)?

Find out more about MS and the symptoms.

Author: Natasha Dadour MPH, MPAS, PA-C, Physician Associate.

What is multiple sclerosis (MS)?

From the Greek word sklerosis, or hardening of tissue, multiple sclerosis refers to the scarring (gliosis) and inflammatory damage of white matter (demyelination) to the central nervous system which includes the brain, brain stem and spinal cord. Myelin is the insulating material that allows for smooth transmission of signals between nerve cells. When demyelination occurs, as is the case in MS, it essentially causes signaling between neurons to go array resulting in sensory, movement and cognitive abnormalities.

What causes Multiple Sclerosis (MS)?

Until now, research reveals that MS is a disease of the immune system (autoimmune) where the body mistakens its own myelin producing cells (oligodendricytes) as foreign material that should be destroyed and erradicated. What ignites this autoimmune raction is unknown, but it could be multifactorial involving genetics and enviornment. A common hypothesis is that populations living furthest from the equator are prone to lower sunlight exposure and thus have lower Vitamin D levels which when mixed with a genetic mutation, can increase their risk of developing an autoimmune disease. The female sex, smoking, childhood obesity and or prior infection with Epstein Barr Virus (EBV) are other possible risk factors.

What are the symptoms of Multiple Sclerosis (MS)?

Symptoms are neurologically related and overlap with other neurologic disorders (stroke, depression, spinal cord disorders). Symptoms include: painful visual loss in one eye, facial numbness, vertigo, electric shocks down the spine, heat intolerability, erectile dysfunction, imbalance, urgency to urinate, fatigue, burning sensation and or paralysis involving the legs more commonly than the arms. They vary from subtle to stark in intensity and can develop within hours to days and take several weeks to settle on their own. A known characteristic of MS is the cycle between a relapse of symptoms (an acute exacerbation) which is often brought on by stress, followed by a remission (recovery) of symptoms.

What are the treatments for Multiple Sclerosis (MS)?

Disease Modifying Treatments (DMTs) consisting of immunotherapy are used in the long run to help reduce damage to the nervous system while improve quality of life by limiting relapse episodes. Acute relapses are effectively treated with glucocorticoids. Therapy is tailored to each patient’s needs ; some in need of more occupational therapy and or physiotherapy versus others in need of more mental health services. While MS is a devastating and debilitating disease, research has come a long way to optomize treatment while minimizing side effects.

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