Multiple Sclerosis (MS) 101: Causes, Symptoms, Diagnosis & Treatments

Multiple Sclerosis (MS) is a progressive neurological disease that affects more than 25,000 people in Australia. Find out more about MS; causes, symptoms, diagnosis & treatments.

by Julia Banks

What Is Multiple Sclerosis?

Multiple sclerosis is an autoimmune disease that affects neurons around one’s body, interrupting messages within the central nervous system and thus affecting a myriad of functioning. How are neurons affected by multiple sclerosis? Neurons are nerve cells, which are cells involved in messaging between the brain and the body. They control both autonomic (automatic) and somatic (deliberate) body functions. In auto-immune disease, your body’s immune system mistakes body tissue as a foreigner and attacks it as it would do to a bacteria or virus. In MS, your body attacks the myelin sheath of neurons – think of the myelin sheath as a protective casing that keeps the “messages” running smoothly across neurons. When the myelin sheath is damaged as it is in MS, it impacts the conveying of these messages and thus impacts a whole lot of bodily functions as a result.

Around 25,000 people in Australia live with MS and women are 3x more likely to have it than men. You are also more likely to develop it if you have a close family member with the disease.

Stages & Types of Multiple Sclerosis

Relapsing-Remitting MS (RRMS)

This is the most common type of MS. In this kind of MS, people experience symptoms or decline in bodily functions that get progressively worse over days, weeks, or months, followed by a period of almost complete remission (where they experience no symptoms at all). These relapses re-occur throughout a person’s illness.

Primary Progressive MS (PPMS)

People with PPMS find their symptoms and level of disability slowly decline, with no separate markings of relapses or periods of remission.

Secondary Progressive MS (SPMS)

SPMS is generally experienced by people who begin with RRMS. This is when a person’s relapses or periods of remission diminish and they are left experiencing a gradual decline in functioning and level of disability.

Symptoms of Multiple Sclerosis

You may be wondering: what are the symptoms of multiple sclerosis? Because MS affects the neurons in general, there is a myriad of different symptoms one person may experience, to do with all kinds of bodily functions. This can be frightening for the individual as they may not know what to expect when diagnosed with MS, or may not be able to differentiate an MS relapse from another kind of medical condition. 

Multiple sclerosis symptoms include symptoms that affect movement, vision, speech, problems with the bladder and bowels, and other non-descript symptoms like fatigue.

Movement Symptoms:

  • Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or on your legs and trunk
  • Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
  • Tremor, lack of coordination or unsteady gait

Vision Symptoms:

  • Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
  • Prolonged double vision
  • Blurry vision

Other Symptoms:

  • Slurred speech
  • Fatigue
  • Dizziness
  • Tingling or pain in parts of your body
  • Problems with sexual, bowel and bladder function

Causes of Multiple Sclerosis

There is not a huge amount of evidence into the actual causes of MS – as is often the case with autoimmune disorders. There has not yet been a singular cause or dominating risk factor determined for such diseases, and MS is no exception. What we do know is that it is an autoimmune disorder – and autoimmune disorders are complex ones to identify the aetiology of, and treat. Autoimmune disorders are usually caused by a complex intersection between genetic predisposition (your family health history), environmental factors (where you were raised, what environmental toxins you were exposed to, etc), and lifestyle factors.

There is some contention about the impact of the Epstein-Barr virus on developing MS. The Epstein-Barr virus is the virus that causes glandular fever – an ailment most of us would be familiar with, with close to 95% of the Australian adults carrying the virus, having usually picked it up in young adulthood. This makes it difficult to draw parallels between infection with the virus and an increased likelihood of having MS later in life. However, it’s not impossible – as aforementioned, autoimmune diseases are complex and may be triggered by a whole host of environmental triggers such as acquiring a virus.

Risk Factors of Multiple Sclerosis

There are certain factors that statistically make your risk of acquiring MS higher, but remember – they are not necessarily causative of the disorder. Risk factors do include:

Age

MS can occur at any age, but onset usually occurs around 20 and 40 years of age. However, younger and older people can be affected.

Sex

Women are more than two to three times as likely as men are to have relapsing-remitting MS.

Family History

If one of your parents or siblings has had MS, you are at higher risk of developing the disease.

Certain Infections
A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis.

Race

White people, particularly those of Northern European descent, are at the highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.

Climate

MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe.

Vitamin D

Having low levels of vitamin D and low exposure to sunlight is associated with a greater risk of MS.

Certain Autoimmune Disease

You have a slightly higher risk of developing MS if you have other autoimmune disorders such as thyroid disease, pernicious anemia, psoriasis, type 1 diabetes or inflammatory bowel disease.

Smoking

Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS.

What Happens if My Doctor Thinks I Have MS?

If you’re experiencing MS symptoms and are concerned, you may be considering how you would go about getting diagnosed or even how you may bring the subject up to your doctor. If you are experiencing symptoms that are concerning to you, you can talk to your doctor about them and they will conduct the test they see fit to investigate the symptoms. Your doctor will start with blood tests to test for the markers in the blood that may signal an autoimmune disease, and also rule out any other causes of the symptoms you are experiencing – as MS symptoms are often quite non-specific and interchangeable with the symptoms of other disorders. If the blood tests indicate something related to MS, you may also undergo a spinal tap (lumbar puncture), in which a small amount of cerebral fluid is taken out from the spine and tested for further markers of MS – as well as continuing to rule out other disorders.

Further testing may include an MRI to assess for lesions or marks on the brain and spinal cord. This includes injecting a contrasting dye into the bloodstream so it can highlight any areas that are experiencing active damage. Evoked potential tests may also be used, in which your body’s response to stimuli is recorded. For example, your eyes are assessed for how they react to visual challenges, or your body’s response to electrical impulses on your legs are measured.

These create a greater diagnostic picture for your doctors and specialists to use in diagnosing the potential MS.

Treatment of Multiple Sclerosis

There is a multitude of treatments available for MS, depending on the state of progression of the illness, and whether the aim is to prevent deterioration or alleviate symptoms. There is no cure for MS, as yet, but many options are available to alleviate the pain and frustration associated with it.

Treatments to Prevent Progression

There are innumerable treatments available to try and halt the progression of MS that are specifically helpful in the relapse-remitting kind of MS. Early treatment using these kinds of interventions has shown to greatly reduce the severity of the disease in later years, and slow down progression and lesion-development too.

There are injectable treatments that interrupt the immune system’s attack on the myelin sheath, called interferon beta medications and glatiramer acetate.

There are numerous oral immunosuppressant medications available that also suppress the ability of the immune system to attack the myelin sheath, slowing the progression of the disease.

Lastly, there are infusion treatments available that all work in different ways to interrupt the immune system’s attack on the brain and spinal cord.

Treatments for MS Signs and Symptoms

Treatment for experiencing the signs of symptoms of MS can be pharmacological and non-pharmacological. Corticosteroids can be invaluable in reducing the inflammation and subsequent pain caused by MS. Plasma exchange can also be utilised to reduce symptoms. This involves separating the plasma from the red blood cells and returning only the red blood cells packed with new plasma proteins to the body. The rationale behind this is that in someone’s plasma who is experiencing a flare-up of MS, there may be proteins that are culpable for attacking the tissue. By exchanging their plasma with new proteins, this inflammation may subside.

More pharmacological management includes medications to reduce fatigue, such as medications used for ADHD or depression. Muscle relaxants can also be utilised to reduce the stiffness that may come with MS. Further medication to assist with other diminished functioning of body systems such as bowel and bladder continence can be used.

Non-pharmacological management of MS symptoms includes physical therapy, continence aids, walking aids, etc. Aids to assist with maintaining independence with activities of daily living can be invaluable in a person experiencing diminished mobility and flexibility. Physical therapy can help with someone’s gait and mobility.

How Can Homage Support People With MS?

Homage has a variety of professionals available to assist you with your needs after a diagnosis of MS. Homage has trusted support workers that you can employ to assist you with needs such as transport, escorting you to medical appointments, or providing accompaniment to your hobbies or community engagement activities. Homage also has highly specialised and trained nurses ready to help you with your medical needs at home – if you are experiencing MS at a more progressed stage of the disease, you may find that you need a lot more support medically. You don’t have to worry about attending those appointments if it’s something that can be done at home – as a nurse comes to you! As MS progresses, it may also be difficult to perform functions of living as independently as you used to, such as dressing or feeding yourself. Our professional, qualified and empathetic workers can help you with any kind of task you may need assistance with – and keep you living independently for longer.

Provide the best care to your loved one today!


References
  1. Frothingham, S. (2019, January 11). The Possibility of Multiple Sclerosis Prevention. Healthline; Healthline Media. https://www.healthline.com/health/multiple-sclerosis-prevention#potential-prevention
  2. Mayo Clinic. (2019). Multiple Sclerosis. Mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/diagnosis-treatment/drc-20350274
  3. MS Australia. (n.d.). New evidence: Does the Epstein-Barr virus cause MS? MS Australia. https://www.msaustralia.org.au/news/new-evidence-does-the-epstein-barr-virus-cause-ms/
  4. MS Queensland. (n.d.). Medication for Multiple Sclerosis | MS Queensland. Https://Www.msqld.org.au/. https://www.msqld.org.au/about-ms/ms-medications/

 

About the Writer
Julia Banks
Julia is a nurse, disability support worker and writer. She has thoroughly enjoyed her career in care provision, and believes the key to great health is education and empowerment. When she's not working, she fills her days with travelling, salsa dancing, and hanging out with her foster cats.
Make Home Care Personal To Your Loved One
curve

Make Home Care Personal To Your Loved One

Have an obligation free conversation with our Care Advisory team today and learn why thousands of families trust Homage to deliver the best care in their homes.

Get Care Support