- Multiple sclerosis is an autoimmune disease that affects the nerves and can cause problems with movement, vision, speech, and balance.
- Common symptoms include fatigue, tingling, muscle weakness, vision changes, and walking problems.
- Multiple sclerosis has no cure, but treatment and physical therapy can help manage symptoms and slow progression.
Multiple sclerosis (MS) is a neurological autoimmune disease in which the immune system attacks the myelin sheath, the protective covering around nerves. This can damage nerves permanently and disrupt how signals travel between the brain and the rest of the body.
Symptoms of multiple sclerosis vary depending on which nerves are affected and how much damage has occurred. Common symptoms include muscle weakness, tremors, fatigue, and trouble with walking, speaking, vision, or coordination.
Multiple sclerosis has no cure, but treatment can help manage symptoms, reduce relapses, and slow disease progression. A doctor may recommend medications such as corticosteroids, anticonvulsants, and immunosuppressive therapies based on the person’s symptoms and disease course.
MS symptoms
The main symptoms of multiple sclerosis are:
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Excessive fatigue
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Numbness or tingling in the legs or arms
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Involuntary eye movements, double vision, or blurred vision
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Muscle stiffness or spasms
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Headache or migraine
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Memory lapses and difficulty concentrating
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Urinary or fecal incontinence
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Difficulty speaking or swallowing
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Changes in gait or loss of balance
MS symptoms are usually more noticeable during flare-ups or relapses, which can happen over time or as the disease progresses.
Because of this, symptoms can vary from person to person and may improve with treatment, sometimes disappearing completely. In other cases, some lasting effects may remain.
Symptoms do not usually appear all at once, but they can affect quality of life. According to the National Multiple Sclerosis Society, symptoms may also get worse with heat exposure or fever and improve when body temperature returns to normal.
Confirming a diagnosis
According to the National Multiple Sclerosis Society, multiple sclerosis is diagnosed by a neurologist based on the person’s medical history, symptoms, neurological exam, and the 2024 McDonald diagnostic criteria.
These criteria are used to support an accurate diagnosis and help show whether there is evidence of damage in different parts of the central nervous system over time or at the same time.
The doctor may also order blood tests and imaging tests, such as magnetic resonance imaging (MRI), to rule out other conditions with similar symptoms, while MRI plays a central role in supporting the diagnosis of multiple sclerosis. Blood tests do not diagnose multiple sclerosis on their own.
In addition, the doctor may recommend tests to evaluate nerve function and an analysis of cerebrospinal fluid, which may show oligoclonal bands or other findings that can support the diagnosis of multiple sclerosis.
Possible causes
The exact cause of multiple sclerosis is unknown. However, the onset of symptoms is known to be related to changes in the immune system.
Some factors that may increase the risk of multiple sclerosis are:
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Being between 20 and 40 years old
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Being female, since women are two to three times more likely to develop multiple sclerosis than men
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Having family members with multiple sclerosis, such as parents or siblings
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Having autoimmune diseases such as thyroid disease, pernicious anemia, psoriasis, type 1 diabetes, or inflammatory bowel disease
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Having low vitamin D levels
In addition, infection with the Epstein-Barr virus, which causes mononucleosis (mono), may increase the risk of developing multiple sclerosis.
However, more studies are still needed to confirm whether Epstein-Barr virus infection directly causes multiple sclerosis and whether medicines or a vaccine targeting the virus could help prevent the disease.
Treatment options
Multiple sclerosis treatment should be guided by a doctor to help prevent disease progression, reduce the duration and intensity of relapses, and control symptoms. Long-term treatment is usually centered on disease-modifying therapies (DMTs), which are used to reduce disease activity and slow progression.
Because of this, the doctor may recommend disease-modifying therapies, along with other medicines used to manage relapses or specific symptoms. Corticosteroids are generally used to treat relapses, while anticonvulsants, pain relievers, and muscle relaxants may be used to help manage symptoms when needed.
One example of a disease-modifying therapy is ofatumumab (Kesimpta). Kesimpta is FDA-approved for relapsing forms of multiple sclerosis in adults, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease.
Physical therapy is also important because it helps keep the muscles active, which can help manage leg weakness, walking difficulty, and muscle atrophy. Physical therapy for multiple sclerosis usually includes stretching and muscle-strengthening exercises.
Care measures
Some important care measures during treatment for multiple sclerosis include:
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Sleeping at least 8 to 9 hours per night
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Doing the exercises recommended by the doctor
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Avoiding heat exposure or very hot places and choosing milder temperatures when possible
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Reducing stress with activities such as yoga, tai chi, massage, meditation, or deep breathing
It is important to follow up regularly with a neurologist, who may also recommend dietary changes and a balanced diet rich in vitamin D.