What Is MS?
MS is a chronic, unpredictable, and often difficult to diagnose disease which affects the central nervous system (the brain, optic nerves, and spinal cord). It is believed to be an autoimmune disorder (a disease in which the body’s immune system attacks the person’s own tissue).
Myelin
A complex substance that isolates and protects the nerve path. It is essential to conduct electricity so that brain signals can effectively reach their target.
Axon
Threadlike part of the neuron that acts as the path where electrical impulses travel.
Damaged Myelin
In MS, the myelin is attacked by immune cells and destroyed. When the myelin is damaged, nerves in the brain and spinal cord lose their ability to transmit signals.
Synapses
Gap between two nerves where information is passed along.
Dendrites
Part of the neuron that connects with neighboring cells and relays incoming messages to the cell body.
Cell Body
Also known as soma.
What Happens in Multiple Sclerosis?
The short answer is the destruction of myelin. Myelin is a complex substance that surrounds and insulates nerve fibers and is essential for nerves to perform their function and conduct electricity. When the myelin is damaged, nerves in the brain and spinal cord lose their ability to transmit signals. Think about a cable that should bring a clear signal to your TV but has interference due to damage or corrosion.
With MS, the immune system that normally defends against viruses and bacteria acts atypically and actually attacks the central nervous system, damaging the myelin and creating interference in normal nerve functionality and communication to various parts of the body.
The Brain
The Brain
- Tingling or numbness in face, arms, legs, and fingers
- Cognitive changes such as memory loss or shortened attention span
- Unexplained weakness or fatigue
- Dizziness
- Depression
- Tremors
- Difficulty swallowing
- Difficulty with tasks requiring coordination
- Loss of muscle coordination
- Difficulty walking
- Balance problems
Visual
Visual Disturbances
- Vision loss
- Double vision (Diplopia)
- Blurred vision, eye pain, or blindness
- Involuntary eye movement
Speech
Speech
- Muscles in face and mouth may grow weak affecting speech
- Difficulty with word expression
- Slurred speech
Muscular
Muscular
- Pain and muscle stiffness
- Muscle spasms
- Disturbances
Excretory
Excretory
- Dysfunctional bladder
- Sexual dysfunction
- Dysfunctional bowel
Symptoms
Symptoms
Multiple sclerosis is a disease with neurological, diverse, and random symptoms that may vary in intensity and location.
Risk Factors
Despite being discovered in 1868, there is still much mystery surrounding the causes of the disease. We do know there are several factors that may increase your risk for developing multiple sclerosis, including:
Age: Commonly affects people who are between 20-40 years of age
Gender: Women are twice as likely as men to develop MS.
Family History: If one of your parents or a sibling has MS, you have a 1-3% chance of developing the disease
Ethnicity: Caucasian people, particularly those whose families originated in Northern Europe are at the highest risk of developing MS.
There are 4 TYPES OF MS
Relapse
Progressive
- A relapse is also known as an exacerbation or flare-up.
- Occurs as a result of damage in your brain or spinal cord disrupting nerve signals.
- A true relapse lasts more than 24 hours, happens at least 30 days after any previous relapse, and occurs in the absence of infection.
- Relapses will vary in length, severity, and symptoms.
- Many people will recover from their relapse without any treatment.
- Progressive stages of MS will continuously worsen after it first develops.
- Neurological disability will accumulate over time. How fast or to what degree disability develops varies for each person and cannot be predicted.
- Progressive typically means there are no relapses or remissions with the exception of PRMS.
- Usually takes longer to diagnose. Doctors need to determine the disease is progressing without flare-ups which can take several years of observing.
Pediatric Multiple Sclerosis
Although MS occurs most commonly in adults, it is unfortunately also diagnosed in children and adolescents. Estimates suggest that 8,000-10,000 children (up to 18 years old) in the United States have MS and another 10,000-15,000 have experienced at least one symptom suggestive of MS. Studies suggest that two to five percent of all people with MS have a history of symptom onset before age 18.
Diagnosis
Diagnosing MS in children is more challenging than in adults due to shorter medical histories, the frequency of other childhood disorders with similar symptoms and characteristics, and certain diagnostic limitations in criteria and equipment. Pediatricians may not be familiar with MS because they are not expecting to see it in children. Children with MS benefit from comprehensive care through multidisciplinary teams that include pediatric and adult MS experts.
Related Conditions
There is no single test that is proof-positive for diagnosing multiple sclerosis. However, there are accepted criteria for making the diagnosis, but even this system is imperfect.
Since diagnosing MS can be very difficult, a neurologist familiar with treating MS should evaluate your symptoms. As many as 10% of people diagnosed with multiple sclerosis actually have some other conditions that mimic MS. Examples of other conditions that masquerade as MS include inflammation in the blood vessels, multiple strokes, vitamin deficiency, lupus, or a brain infection. Sometimes, stress-related disorders can lead to a misdiagnosis of MS.
MRI
Magnetic Resonance Imaging
- Machine that uses magnetic field and radio waves to capture high-resolution images of internal systems of the body and brain.
- Noninvasive way for doctors to examine organ, tissue, and skeletal system.
Evoked Potential Testing
Evoked Potential Testing
- Series of tests that focuses on nerve reaction time to various forms of stimulation.
- Responses are recorded by monitoring brain waves using electrodes.
- Preformed to see if multiple parts of the CNS are affected.
Visual
- Series of tests that focuses on the optical sensory nerves.
- Can include Strobe lights or checkered patterns
Audio
- Series of tests that focuses on the auditory system.
- Often by playing clicking noises or varying tones through headphones.
Sensory
- Arms & Legs are stimulated using electrical impulses.
- Somatosensory testing focuses on signals sent to the muscular system of the body.
Evoked Potential Testing
Lumbar Puncture
- Analysis of fluid surrounding the brain and spinal cord.
- Fluid is extracted by inserting a needle between two spinal vertebrae in your lower back region.
