Multiple Sclerosis

What is Multiple Sclerosis (MS)?

The cause of MS is unknown and, as yet, there is no cure.

There are many different signs and symptoms, and no two cases of MS are the same. No single test can establish an accurate diagnosis.

However, there is a range of treatments available to ease symptoms and slow down the course of the disease.

Multiple sclerosis, or MS, is one of the most common diseases of the central nervous system. Over 23,000 Australians live with MS, and over two million are diagnosed worldwide.

MS occurs when scars form as a result of cells in the body's own immune system entering the central nervous system and causing inflammation to the brain, spinal chord and optic nerves (‘sclerosis’ is a Greek word meaning ‘scars’). The inflammation damages the myelin, the insulating material that covers nerve fibres. This can result in impairment of motor, sensory and cognitive functions.

Causes of multiple sclerosis

The cause of MS is unknown, but it is likely that both genetic and environmental factors play a role. While MS is not hereditary, people with a parent or sibling with MS are at higher risk.

The course of MS is unpredictable – each person will experience a different combination of symptoms. However, there are distinct patterns. The relapsing-remitting form of MS is the more common, comprising 80% of Australian diagnoses. In this form of the disease, attacks with severe symptoms are experienced for a short time and then there is improvement, often with an almost complete recovery.

In the progressive form of MS, there is a slow onset and steadily worsening symptoms, which may level off at some point or continue over months and years.

Symptoms of multiple sclerosis

Symptoms are varied and unpredictable, and can change or fluctuate over time. One person might experience only one or two of the possible symptoms, while another experiences many more. Symptoms include:

• Vision or eye problems - often a first symptom of the disease
• Fatigue
• Numbness of the face, body or extremities - an early symptom for many
• Loss of motor control
• Vertigo and dizziness
• Continence problems
• Cognitive changes like memory loss and impaired ability to problem-solve and focus attention
• Depression, mood swings and irritability

Diagnosis of multiple sclerosis is based on two criteria

1. There must have been two attacks at least one month apart.
2. There must be more than one area of damage or scarring to central nervous system myelin - the sheath that surrounds and protects nerve fibres.

MRI (magnetic resonance imaging) is currently the preferred method of imaging the brain to detect the presence of plaques or scarring caused by MS.

Treatment of multiple sclerosis

Treatments focus on easing specific symptoms and slowing progression of the disease, and maintaining quality of life for those living with MS.

Immunotherapy treatments modify activity of the immune system to reduce the frequency and severity of attacks, and corticosteroids are used to shorten the duration of an attack by easing inflammation. Other medications might be prescribed to manage symptoms such as pain, spasticity, fatigue, and bladder difficulties.

To manage the complex mix of symptoms, it is often necessary to have a wide-ranging health plan including physiotherapy, occupational therapy and neuropsychological therapy. Alternative therapies, such as acupuncture, massage and meditation may also be beneficial for some people.

Most people with MS can expect 95% of normal life expectancy, and there are many examples of people who are living well with MS through a combination of the right treatment and some simple diet and lifestyle changes. Living a healthy lifestyle with a well balanced diet and regular exercise can help with management of some symptoms.

Ultimately, each case of MS is different and treating and managing symptoms is up to each individual, their loved ones and carers finding the mix that best suits them.

Further information and sources

• Health Direct Australia
• MS Australia
• Better Health Channel