Multiple sclerosis

Multiple sclerosis (MS) is a neurological disease that gradually destroys the protective layer of nerves in the brain and spinal cord. The cause of MS is still unknown, and its progression and symptoms can vary. Find out more about MS.

What is multiple sclerosis?

Multiple sclerosis (MS) is a disease of the central nervous system, particularly the brain and spinal cord. The central nervous system is made up of nerves that carry messages from the brain to the limbs and from the limbs to the brain. These nerves are covered with insulation or a sheath called myelin. Myelin protects messages as they pass along the nerve and prevents them from getting interrupted or changed. In people with multiple sclerosis, myelin is destroyed or hardened (sclerosis).

Multiple sclerosis is an autoimmune disease, which means that the body's immune system no longer recognizes myelin as a normal part of the body and starts attacking it. The messages sent back and forth from the nervous system to the limbs is therefore changed by the body’s own immune cells.

Despite several decades of research, the cause of multiple sclerosis is still unknown and we still don't know why the immune system attacks myelin.

Who can get MS?

Multiple sclerosis can occur at any age, but it appears most often in people between the ages of 20 and 40. Women are twice as likely as men to get MS. We know that MS is more prevalent among white people. It is also more common in countries in temperate latitudes away from the equator , although the reason for this is unknown.

Current evidence suggests that the disease may be triggered by a viral infection in people with susceptibility to the disease because of hormones, environmental conditions (i.e., diet or pollution), or their genes. However, MS isn’t a hereditary disease and is therefore not passed down from parents to children.

Studies have shown that the life expectancies of people with MS is 5 to 10 years less compared to the general population, but their quality of life is what is affected in particular.

MS symptoms

The initial symptoms of MS are highly variable. They can range from insignificant to very debilitating depending on the brain area affected.

Depending on how the disease progresses, symptoms may be momentary, partially present, or constantly progressing. Some people may need to use a cane or wheelchair to get around on a daily basis or only during an attack.

Below are the main MS symptoms, which can vary greatly from person to person depending on the stage of the disease:

  • itching
  • depression
  • pain
  • numbness or tingling in the limbs
  • dizziness
  • constant fatigue
  • limb spasticity
  • headaches
  • partial or complete paralysis of a part of the body
  • vision and hearing loss
  • concentration or memory problems
  • balance problems
  • sleep problems
  • bladder problems
  • muscle spasms
  • feelings of electric shock
  • tremors
  • problems walking
  • problems with sexual intercourse

How MS progresses

Most often, multiple sclerosis occurs through attacks (also called flare-ups or relapses), during which symptoms occur or recur. There are four main forms of MS:

  • The relapsing-remitting form is the most common and represents 80% of cases. This type of MS is characterized by periods when symptoms last from 24 hours up to 2 weeks. These attacks are followed by periods when symptoms disappear or become less severe for weeks or even years. The disease doesn’t progress between relapses.
  • The primary progressive form represents approximately 15% of cases. When this form starts, the disease constantly worsens, generally without remissions. People with this type don't get attacks, and they gradually lose function over a number of years.
  • The secondary progressive form begins with the relapsing-remitting form and then progresses into a continued worsening of symptoms and disability. For approximately 30% of people with the relapsing-remitting form, the disease will evolve into the secondary progressive form within 5 years.
  • The progressive relapsing form, which represents 5% of cases, causes severe attacks at the start of the disease that have major consequences. The disease progresses constantly. This type is a combination of the relapsing-remitting form and primary progressive form.

Multiple sclerosis is diagnosed by a neurologist, or a doctor who specializes in the nervous system. In addition to confirming symptoms, the doctor will run a number of tests to confirm the diagnosis.

MS treatment

Since the exact causes of multiple sclerosis are not yet known, the disease doesn’t yet have a cure, and treatment is constantly changing. However, MS treatment does include medications that help reduce the inflammation of nerves , reduce the frequency and severity of attacks, and relieve symptoms.

Corticosteroids (injectable or oral) are mainly used to treat relapses. They are only used for a short time, and they aren’t appropriate for everyone who has MS.

Medications called immunomodulators change the response of the immune system. These relatively new treatments have greatly improved the quality of life for many people with MS. In addition to relieving symptoms, they slow the progression of the disease. They come in injectable and oral forms. 

A number of other drugs can directly relieve different MS symptoms, such as pain, tremors, fatigue, erectile dysfunction or muscle spasms.

Don't hesitate to consult your pharmacist, who is an expert when it comes to choosing the best medication for you.

An occupational therapist can also help you set up your home to make your daily life easier.

Physiotherapy exercises can help strengthen mobility, improve balance and better control muscle spasms.

MS and heat

For many people, MS symptoms are aggravated by heat. You should avoid hot showers and baths, hot tubs, and saunas as well as travel to hot and humid regions.

With the right treatment, the majority of people with MS can function without significant disability for even 20 years after the onset of the disease. Most people still manage to lead active and rewarding lives.

Support is important

After receiving a diagnosis of MS and learning about the difficulties of this disease, some people develop feelings of sadness and distress. Living with the disease can be an incredible daily challenge. If you or a loved one suffers from MS, make sure you get all the help you need.

Support from family and friends is essential. Psychotherapy and support groups are also important to help you accept and understand the disease and enjoy a good quality of life. 

Resource: Multiple Sclerosis Society of Canada:

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