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What is MS?

Multiple sclerosis (MS) is a chronic, often disabling disease that attacks the central nervous system. Symptoms may be mild, such as numbness in the limbs, or severe enough to cause loss of vision or complete paralysis. The progress, severity, and specific symptoms of MS in any one person cannot be predicted. Today, advances in research and treatment are providing hope to those affected by the disease.

An estimated third of a million Americans have multiple sclerosis, with nearly 200 new cases diagnosed every week. Counting family members and those who care for people with MS, the disease impacts more than one million of our friends and neighbors.

Most people with MS are diagnosed between the ages of 20 and 50, but the unpredictable physical and emotional effects last a lifetime. The National MS Society is dedicated to ending the devastating effects of multiple sclerosis.

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What causes MS?

The cause of MS is currently a mystery. However, scientists do have an understanding of how the disease develops in the central nervous system.

The nerve fibers of the brain and spinal cord (collectively known as the central nervous system) are surrounded and protected by a fatty substance called "myelin." Myelin functions much like the insulation on an electrical wire, protecting the flow of electrical impulses along the line.

In multiple sclerosis, an immune system reaction causes a breakdown in the myelin layer, or sheath. When any part of the myelin sheath is destroyed, nerve impulses to and from the brain are distorted or interrupted. These "shorts" in the system may impair bodily functions such as movement, speech, or sight, depending on where in the central nervous system they occur.

The result is multiple sclerosis. "Multiple" because many areas of the brain and spinal cord are affected. "Sclerosis" because scleroses, or hardened patches of scar tissue, may form over the damaged myelin. Some people remember this more easily by thinking that MS is short for "many scars."

It was long believed that no nerve damage accompanied damage to the myelin sheath in MS. Recent studies have, however, drawn this belief into question. Other research indicates that some day it may be possible to regenerate myelin or nerve fibers.

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What are the symptoms of MS?

No two cases of multiple sclerosis are the same. Symptoms not only vary greatly from person to person, but may also vary from time to time in the same person.

The symptoms of MS often begin as mild tingling or numbness in body parts. They may include slurred speech, blurred or double vision, tremors, loss of balance, and poor coordination. Many people with MS experience muscle tightness or "spasticity." Problems with bladder, bowel, or sexual function may occur. Severe cases of MS can result in blindness and paralysis.

MS may also have more subtle, "invisible" symptoms. These may include pain, extreme fatigue, and mental changes such as mood swings, forgetfulness, and confusion.

Unpredictability is the hallmark of MS. Symptoms may appear in any combination, may come and go, and may vary from mild to severe.

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What is the general pattern of MS?

MS is an unpredictable disease. At present there is no way to predict when or even if attacks of the disease will occur. Symptoms not only vary greatly from person to person, but may also vary from time to time in the same person.

Periods of active MS symptoms are called "attacks," "exacerbations" or "relapses." These may be followed by quiet periods called "remissions."

The disease ranges from mild and intermittent to steadily progressive. Some people have few attacks, and little if any disability accumulates over time. At diagnosis, most have what is called "relapsing-remitting" MS. This means they have exacerbations, which take place unpredictably, followed by periods of partial or total remission, which may last months or even years. Others experience a progressive disease course with steadily worsening symptoms ("primary progressive MS"). Some people initially diagnosed with relapsing-remitting MS may eventually develop a progressive pattern called "secondary progressive MS."

Because MS affects individuals so differently, it is difficult to make generalizations about disability. Statistics suggest that two out of three people with MS remain able to walk over their lifetimes, but many of them will need a cane or other assistive device. Some choose to use a scooter or wheelchair to conserve energy. Others will require a  wheelchair to maintain mobility. New treatments developed in the 1990s should favorably alter these statistics.

Multiple sclerosis is not fatal. With modern medicine and technology, people with MS live 90 to 95% of the normal life span. Most people with MS learn to cope with the disease and live full, productive lives.

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Who gets multiple sclerosis?

Every hour in the United States, another adult hears that frightening diagnosis: multiple sclerosis. An estimated third of a million Americans have MS, and about two million people worldwide.

Multiple sclerosis is most often diagnosed in people between the ages of 20 and 50 -- adults just starting careers, starting families, starting their lives. It is very rarely diagnosed in children and teens (but we do provide programs for youth with MS as well).

About two-thirds of people with MS are women. MS occurs most commonly among Caucasians, especially those of Northern European ancestry, but people of African, Asian, and Hispanic backgrounds are not immune.

The disease is most frequently found among people in colder climates. Scientists don’t understand why this is so, but studies strongly suggest that where a person is born and lives during his or her first 15 years strongly influences the likelihood of developing MS.

Studies also indicate that genetic factors make certain individuals more susceptible to the disease, but there is no evidence that MS is directly inherited.

Multiple sclerosis is not contagious.

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Is MS easily diagnosed?

MS is not always easy to detect or diagnose. This is because its symptoms tend to come and go and because other diseases of the central nervous system have similar symptoms. In addition, no single neurological or laboratory test can confirm or rule out the disease. Thus people may be told they have "probable" or "possible" MS.

Recent advances in medical technology, particularly in imaging techniques such as magnetic resonance imaging (MRI), have helped clarify the diagnosis process. A conclusive or definitive diagnosis of MS requires evidence of:

1. multiple patches of scar tissue in different parts of the central nervous system and

2. at least two separate attacks of the disease

A definitive diagnosis can take several months. Sometimes it takes years.

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Can MS be treated?

Yes! Today, there are five federally approved medications that treat MS. Avonex, Betaseron, Copaxone, and Rebif have been shown to slow the natural course of MS. Novantrone is the first medication available for people with secondary progressive MS. 

Steroids may be used to shorten acute attacks of MS. Many other drug therapies are being clinically tested, and researchers feel hopeful that more new treatments for MS will be available in the near future.

In addition to these medications, a wide range of therapies are available to treat the symptoms of MS. Physical therapy, occupational therapy, and vocational or cognitive rehabilitation may help a person remain independent. Attention to diet, appropriate exercise, and adequate rest are important for a person with MS, as they are for anyone. 

Spasticity, pain, fatigue, depression, bowel or bladder distress, and other symptoms can be eased with medication or therapy. Professional or peer counseling may also prove valuable in helping people with the disease and their loved ones cope with emotional stress.

The appropriate combination of these treatment elements will allow a person with MS to attain the highest quality of life possible. Prompt management of symptoms is important. They should be discussed with a knowledgeable physician.

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Can MS be cured?

The answer is no -- not yet. The cause and the cure of MS are the subject of intensive worldwide research. The National Multiple Sclerosis Society is the world’s largest private funder of MS research. Hundreds of research grants and fellowships funded by the Society go forward each year. 

Knowledge about MS, autoimmune disorders, and other diseases of the central nervous system is growing quickly. Many clinical trials are in progress, and there is an air of optimism among MS researchers everywhere.

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