Multiple Sclerosis

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is a disease that impacts the brain and spinal cord, part of the central nervous system. MS is the most common disabling neurological disease affecting young adults, being most common in people aged 20 to 40. Today, there are more than 2.8 million people affected by MS [1]. There are 3 types of MS. 

Relapsing-remitting MS. This is the most common type of MS, characterised by clearly defined attacks. Attacks happen when you experience symptoms, which are followed by periods of complete or partial recovery, where your symptoms might disappear or some might continue or become permanent. Attacks last at least 24 hours, and are separated from the previous attack by at least 30 days. Approximately 85% of people have this kind of MS [2].

Secondary progressive MS. This kind of MS is diagnosed when an initial relapsing-remitting MS phase happens before a progressive phase, where the disease worsens. Attacks and remissions can continue in this phase.

Primary progressive MS. This is diagnosed when the condition continually worsens from the beginning. You might experience increasing disability, without attacks or recovery. Around 10% to 15% of patients with MS have this kind of MS [2].

What causes Multiple Sclerosis?

The exact cause of MS is unknown, but it is known that something triggers the immune system to attack the brain and spinal cord, damaging the fatty material (myelin) that insulates the nerves. This causes inflammation and scarring around the nerves (multiple sclerosis means many scars), which disrupts ability to transmit signals between the brain and other parts of the body. 

Other external factors have been shown to influence the onset of MS, including low levels of vitamin D, lack of exposure or overexposure to UV light, previous diagnosis of the Epstein-Barr virus, obesity and smoking.

What does Multiple Sclerosis Feel Like?

The initial symptom of MS is usually blurred or double vision, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities (arms and legs) and difficulty with coordination and balance. 

MS causes other unpredictable symptoms such as tremors, numbness, tingling, pain, speech impediments, dizziness, fatigue, blindness and even paralysis. You might also experience bladder and bowel issues. These symptoms may be temporary or long-lasting. Approximately half of all people with MS face cognitive difficulties such as issues concentrating, remembering things and paying attention to things. However, these symptoms are usually mild.

How does Multiple Sclerosis Affect You?

MS can affect your ability to function whenever you get attacks, and symptoms can be debilitating especially as they tend to worsen over time. From eating to changing to walking around, MS can affect your daily life, especially when not managed properly.

How do we diagnose Multiple Sclerosis?

To confirm a diagnosis of MS, your doctor might refer to your detailed medical history, family medical history, and analyse the symptoms you are experiencing. You might be referred to a neurologist or even a specialist MS neurologist to help with the diagnosis. They will have access to the proper diagnostic tools and facilities needed to help you, and they will also be able to provide you with advice for your treatment options.

Diagnostic tests for MS include:

Neurological examinations. Your doctor may perform a Nerve Conduction Study (NCS) which measures the rate at which electrical impulses move through your nerves.

Blood tests.  Your doctor may request a blood test to rule out other health problems that might be causing your symptoms.

MRI scans. MRI scans help your doctor to look for scarring in your brain and spinal cord.

Lumbar Puncture. Also known as a spinal tap, a lumbar puncture might be performed, to extract a sample of your cerebrospinal fluid for testing and rule out other disorders.

Finding the Right Treatment

During attacks, your doctor might prescribe steroids to you, to be taken orally for a few days. They do not have any long term benefits for the disease, but can help to reduce your inflammation and shorten the length of each attack. Besides this, there are many drug options available used to modify the disease course in the different kinds of MS. Remember not to self-medicate, and if you suspect that you have narcolepsy, book an appointment with your doctor to run some tests and find out more about the treatment options available for you.

Living with Multiple Sclerosis

Mobility difficulties caused by MS can be treated with mobility aids like mobility scooters, canes, walkers and wheelchairs. Safety supports can be used to help with your deteriorating balance, flexibility and coordination. These can be installed around your home to prevent falls and injuries, and these can include railings by stairs and in showers, shower chairs and bed railings.

Lifestyle habits can be taken up in order to maintain your brain’s health, such as eating healthily, keeping your weight under control, keeping your mind and body active, and avoiding smoking and limiting your alcohol intake.

  1. What is MS | Multiple Sclerosis. (2014). MS International Federation.
  2. Multiple sclerosis (MS). (2012). Vic.Gov.Au.
  3. Definition of MS. (2012). National Multiple Sclerosis Society.
  4. Dobson, R., & Giovannoni, G. (2018). Multiple sclerosis – a review. European Journal of Neurology, 26(1), 27–40.
  5. Multiple Sclerosis. (n.d.). NCCIH.
  6. Multiple Sclerosis Information Page | National Institute of Neurological Disorders and Stroke. (2019). Nih.Gov.