Overview
What is multiple sclerosis? an expert explains
Learn more from neurologist Oliver Tobin, M.B., B.Ch., B.A.O., Ph.D.
I'm the dr. Oliver Tobin, a neurologist specializing in multiple sclerosis at the Mayo Clinic. In this video we cover the basics of multiple sclerosis. What is? who gets it Symptoms, diagnosis and treatment. Whether he's looking for answers about his own health or that of a loved one, we're here to provide you with the best information available. Multiple sclerosis is a disease in which the body's immune system attacks the protective covering of nerve cells in the brain, optic nerve, and spinal cord called the myelin sheath. And this coating is often compared to the insulation on an electrical wire. When this sheath is damaged, it exposes the actual nerve fiber, which can slow down or block the signals being transmitted within it. The nerve fibers themselves can also be damaged. Damage to the myelin sheath can be repaired by the body, but it is not perfect. The resulting damage leaves lesions or scars, hence the name: multiple sclerosis, multiple scars. Now everyone loses brain cells and spinal cord cells as they age. But when MS damages part of the brain or spinal cord, nerve cells in that area die faster than the normal areas around it. This happens very slowly, usually over decades, and usually presents as gradual walking difficulties that appear over several years. When you read about multiple sclerosis, you may hear about different types, the most common being relapsing-remitting multiple sclerosis. And this is characterized by attacks or relapses.
We don't know what causes MS, but there are certain factors that can increase the risk or trigger the flare. So while MS can occur at any age, it most often appears for the first time in people between the ages of 20 and 40. Low levels of vitamin D and low sun exposure, which allows our bodies to produce vitamin D, are associated with an increased risk of developing MS. Because people with MS who have low vitamin D levels tend to have more severe disease. Therefore, obese people are more likely to develop MS, and people with MS who are overweight tend to have more severe disease and more rapid progression. People who have MS and smoke tend to have more flare-ups, worse disease progression, and worse cognitive symptoms. Women are up to three times more likely than men to develop relapsing-remitting MS. The risk of MS in the general population is around 0.5%. If a parent or sibling has MS, your risk is about double, or about 1%. Certain infections are also important. A variety of viruses have been linked to MS, including the Epstein-Barr virus, which causes mononucleosis. Northern and southern latitudes have a higher prevalence, including Canada, the northern US, New Zealand, southeastern Australia, and Europe. Whites, particularly those of Northern European descent, are most at risk. People of Asian, African, and Native American descent have the lowest risk. A slightly increased risk is seen when a patient already has autoimmune thyroid disease, pernicious anemia, psoriasis, type 1 diabetes, or inflammatory bowel disease.
Relapse symptoms usually appear within 24 to 48 hours, last a few days to a few weeks, and then range from 80 to 100 percent improvement. These symptoms include loss of vision in one eye, loss of strength in an arm or leg, or increased numbness in the legs. Other common symptoms associated with MS include seizures, fatigue, depression, incontinence problems, sexual dysfunction, and difficulty walking.
There is currently no single test to make a diagnosis of MS. However, there are four key features that help confirm the diagnosis. First: Are there typical symptoms of multiple sclerosis? Again, this is loss of vision in one eye, loss of strength in an arm or leg, or loss of feeling in an arm or leg that lasts for more than 24 hours. Second, do you have any physical examination findings consistent with MS? Next, Does MRI of Your Brain or Spine Support MS? It's important to note here that 95 percent of people over the age of 40 have abnormal brain MRIs, just as many of us have wrinkles on our skin. Finally, are the results of the analysis of the cerebrospinal fluid compatible with MS? Your doctor may recommend blood tests to check for other diseases that have the same symptoms. They may also recommend an OCT test or optical coherence tomography. This is a quick scan of the thickness of the layers at the back of your eye.
The best thing you can do when living with MS is to find a trusted multidisciplinary medical team that can help you monitor and manage your health. A multidisciplinary team is essential to address the individual symptoms you are experiencing. If you have an MS attack or recurrence, your doctor may prescribe corticosteroids to relieve or improve your symptoms. And if your seizure symptoms don't respond to steroids, plasmapheresis, or plasma exchange, another option is a treatment similar to dialysis. About 50 percent of people who do not respond to steroids have a significant improvement with a brief plasma exchange. Currently, there are more than 20 drugs approved to prevent MS flare-ups and prevent new MRI lesions.
Because MS can be difficult to cope with, there are medical experts who are ready to work with you to help you cope so that you can still live a full life. Seeing a physiatrist, physical therapist, or occupational therapist can help you cope with physical problems. Physical activity is highly recommended for all people with MS. Mental health is also an important aspect. Therefore, it is important to maintain personal connections with friends and family and try to stay engaged in your hobbies. But also be kind to yourself and realistic about what you plan to do. This can change from day to day, so it's okay to give yourself permission if something seems like too much or if you need to cancel plans. You may also find support groups helpful in connecting with people who understand what you are going through and in discussing your feelings and concerns with a doctor or counselor. Meanwhile, scientists are working hard to expand our understanding of this disease and to develop new treatments and drugs that are increasingly effective. If you want to learn more, watch more of our videos or visit mayoclinic.org. We wish you all the best.
Multiple sclerosis
Multiple sclerosis
In multiple sclerosis, the protective covering of nerve fibers (myelin) is damaged and can eventually be destroyed. Depending on where the nerve damage occurs,FRAUIt can affect vision, feeling, coordination, movement, and bladder or bowel control.
Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).
InFRAUThe immune system attacks the protective sheath (myelin) that surrounds nerve fibers, causing communication problems between the brain and the rest of the body. Eventually, the disease can cause permanent damage or deterioration of nerve fibers.
signs and symptoms ofFRAUthey vary greatly from patient to patient and depend on the location and severity of nerve fiber damage in the central nevus system. Some people with severeFRAUyou may lose the ability to walk independently or walk at all. Other people may experience long periods of remission without new symptoms, depending on the type of disease.FRAUThey have.
Multiple sclerosis is not curable. However, there are treatments that help speed recovery from attacks, modify the course of the disease, and control symptoms.
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symptom
Damage to myelin and the nervous system
Damage to myelin and the nervous system
In multiple sclerosis, the protective coating on nerve fibers (myelin) in the central nervous system is damaged. This creates a lesion that, depending on its location in the central nervous system, can cause symptoms such as numbness, pain, or tingling in parts of the body.
The signs and symptoms of multiple sclerosis can vary greatly from person to person depending on the location of the affected nerve fibers and the course of the disease.
Common symptoms are:
- Numbness or weakness in one or more extremities, usually on one side of the body at a time
- tingle
- Electric shock sensations that occur with certain neck movements, particularly bending the neck forward (Lhermitte's sign)
- Mangel and Coordination
- Unsteady gait or inability to walk
- Partial or complete loss of vision, usually in one eye at a time, often with pain when moving the eyes
- prolonged double vision
- Blurry vision
- dizziness
- Problems with sexual, bowel, and bladder function
- fatigue
- difficulty speaking
- cognitive problems
- mood disorders
when to the doctor
See a doctor if you notice any of the above symptoms for unknown reasons.
disease course
Most people withFRAUThey have a relapsing-remitting course of the disease. You experience periods of new symptoms or flare-ups that develop over days or weeks and usually improve partially or completely. These outbreaks are followed by quiet periods of disease remission that can last for months or even years.
Small increases in body temperature can temporarily worsen the signs and symptoms ofFRAU. These are not considered real buds, but pseudo-buds.
At least 20% to 40% of patients with relapsing-remitting remissionFRAUthey eventually develop a steady progression of symptoms with or without periods of remission for 10 to 20 years after disease onset. This is called secondary progressive.FRAU.
Worsening of symptoms usually involves problems with mobility and gait. The rate of disease progression varies widely among people with secondary progressive disease.FRAU.
some people withFRAUexperiencing a gradual onset and steady progression of signs and symptoms without recurrence, known as primary progressiveFRAU.
More information
- Multiple sclerosis treatment at Mayo Clinic
- Multiple sclerosis: can it cause seizures?
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causes
The cause of multiple sclerosis is unknown. It is considered an immune-mediated disease in which the body's immune system attacks its own tissues. In case ofFRAU, this immune system malfunction destroys the fatty substance that covers and protects the nerve fibers in the brain and spinal cord (myelin).
Myelin can be compared to the insulating coating on electrical wires. When the protective myelin is damaged and a nerve fiber is exposed, messages traveling along that nerve fiber can be slowed down or blocked.
it is not clear whyFRAUit develops in some people and not in others. A combination of genetic and environmental factors appears to be responsible.
risk factor's
These factors can increase your risk of developing multiple sclerosis:
- Years. FRAUIt can occur at any age, but the onset usually occurs between the ages of 20 and 40. However, people young and old can be affected.
- Sex.Women are 2 to 3 times more likely to have an epileptic illness than menFRAU.
- Family history.If one of your parents or siblings hadFRAU, you have a higher risk of developing the disease.
- Certain infections.A variety of viruses have been implicatedFRAU, including Epstein-Barr, the virus that causes contagious mononucleosis.
- the race.Whites, particularly those of Northern European descent, are at the highest risk of developingFRAU. People of Asian, African, or Native American descent have the lowest risk. A recent study suggests that the number of black and Hispanic young adults with multiple sclerosis may be higher than previously thought.
- Climate. FRAUit is much more common in temperate countries, including Canada, the northern United States, New Zealand, southeastern Australia, and Europe. The month you were born can also affect your chances of developing multiple sclerosis, as sun exposure during pregnancy appears to decrease the later development of multiple sclerosis in these children.
- Vitamin D.Low vitamin D levels and low sun exposure are associated with increased riskFRAU.
- your genes.A gene on chromosome 6p21 has been found to be associated with multiple sclerosis.
- Obesity.In women, it has been linked to obesity and multiple sclerosis. This applies in particular to obesity in women in childhood and adolescence.
- Certain autoimmune diseases.They have a slightly higher risk of development.FRAUif you have other autoimmune diseases such as thyroid disease, pernicious anemia, psoriasis, type 1 diabetes, or inflammatory bowel disease.
- From smoking.Smokers who experience an initial symptom that may indicateFRAUare more likely than non-smokers to develop a second confirming event of relapseFRAU.
complications
People with multiple sclerosis can also develop:
- muscle stiffness or cramps
- severe weakness or paralysis, typically in the legs
- Bladder, bowel, or sexual function problems
- Cognitive problems, such as forgetfulness or difficulty finding words
- Mood problems such as depression, anxiety or mood swings
- Seizures, although very rare
By Mayo Clinic staff
December 24, 2022