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Understanding Multiple Sclerosis (MS)

Multiple sclerosis (MS) is a chronic condition involving your central nervous system (CNS). With MS, your immune system attacks myelin, which is the protective layer around nerve fibers.

MS causes inflammation and temporary lesions. It can also lead to lasting lesions caused by scar tissue, which can make it hard for your brain to send signals to the rest of your body.

There’s no cure for MS, but it’s possible to manage symptoms. Learn more about the causes of MS, how it’s treated, and more.

What are the symptoms of MS?

People with MS experience a wide range of symptoms. Due to the nature of the disease, symptoms can vary widely from person to person.

They can also change in severity from year to year, month to month, and even day to day.

Here are some of the most common symptoms associated with MS.

Fatigue

Around 80 percent of people with MS report having fatigue, according to the National Multiple Sclerosis Society (NMSS). Fatigue that occurs with MS can make it harder for you to go about your everyday tasks.

Difficulty walking

Difficulty walking can occur with MS due to:

  • numbness in your legs or feet
  • difficulty balancing
  • muscle weakness
  • muscle spasticity
  • difficulty with vision

Difficulty walking can also lead to injuries if you fall.

Vision problems

Vision problems are often some of the first symptoms for many people with MS. Vision problems may affect one or both eyes. These issues may come and go, or get worse over time. They can also resolve entirely.

Some common vision problems associated with MS include:

  • optic neuritis, which can cause pain or blurry vision in one eye
  • diplopia, or double vision
  • nystagmus, or involuntary movement of the eyes
  • blindness
  • Speech issues

MS causes lesions in the brain that can affect speech. These speech issues, also known as dysarthria, can range from mild to severe.

Symptoms of dysarthria can include the following:

  • slurred speech

“scanning” speech, where there are long pauses between words or syllables
changes in volume of speech

Other symptoms

Other fairly common symptoms of MS include:

  • acute or chronic pain
  • tremors
  • cognitive issues involving concentration, memory, and word-finding
  • difficulty chewing and swallowing
  • sleep issues
  • problems with bladder control.

How is MS diagnosed?

A healthcare professional, often a neurologist, will need to perform a neurological exam. They will also talk with you about your clinical history and order a series of other tests to determine if you have MS.

Diagnostic testing may include the following:

  • MRI scan. Using a contrast dye with the MRI allows your doctor to detect active and inactive lesions throughout your brain and spinal cord.
  • Optical coherence tomography (OCT). In this test, a picture is taken of the nerve layers in the back of your eye to check for thinning around the optic nerve.
  • Spinal tap (lumbar puncture). Your doctor may order a spinal tap to find abnormalities in your spinal fluid. This test can help rule out infectious diseases. It can also be used to look for oligoclonal bands (OCBs), which can be used to diagnose MS.
  • Blood tests. Doctors order blood tests to help eliminate the possibility of other conditions that have similar symptoms.
  • Visual evoked potentials (VEP) test. This test requires the stimulation of nerve pathways to analyze electrical activity in your brain. In the past, brain stem auditory-evoked and sensory-evoked potential tests were also used to diagnose MS.

An MS diagnosis requires evidence of demyelination occurring at different times in more than one area of your brain, spinal cord, or optic nerves. Demyelination is a process that prevents nerves from efficiently sending signals.

A diagnosis also requires ruling out other conditions that have similar symptoms. Lyme disease, lupus, and Sjögren’s disease are just a few examples.

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