What is MS?
Multiple sclerosis (MS) is a disease of the central nervous system – it may affect the brain, spinal cord and/or optic nerve. It is a very variable condition and the symptoms depend on which areas of the central nervous system have been affected. There is no set pattern to MS and everyone with MS has a different set of symptoms, which vary from time to time and can change in severity and duration, even in the same person.
Whether you or someone you know has been diagnosed with MS, please find below a number of questions you may be looking for answers to. If you have any further questions about MS or how we at MS Queensland can help, please contact our InfoLine Monday to Friday between 9.00am – 4.00pm on 1800 177 591.
Please note: the information provided in this section should not be taken as medical advice. Each individual with MS should consult his/her neurologist or family GP for advice regarding diagnosis, symptoms and treatment.
WHAT CAUSES MS?
We do not yet know the answer to this question. The current hypothesis is that the disease appears in those individuals who have a genetic predisposition to react to some infectious agent in the environment such as a virus or bacterium. This means that the disease is not genetically transmitted in the same way as hair or eye colour, for example. There seems to be a combination of genes that makes one person more susceptible to the agent(s) than someone else with a different genetic makeup. While several different viruses and bacteria have been studied for their possible role in MS, the trigger(s) have not yet been found. Environmental and psychological factors may play a part that we do not yet understand. We do know, however, that MS is not a contagious disease and you do not need to be concerned about transmitting MS to those around you.
Wrongly programmed immune cells enter the CNS, causing inflammation in the brain, spinal cord, and/or optic nerves. It is this inflammation that can cause damage to the protective myelin coating around the nerve cells, producing scars (also called plaques or lesions) that interfere with nerve transmission. While many of these scars may have no apparent effect, others are responsible for the various symptoms of MS. Each person’s symptoms will vary depending on the particular location(s) where the scarring (demyelination) occurs. The possible symptoms of MS include: fatigue, changes in vision, stiffness, weakness, imbalance, sensory problems such as numbness, tingling, and pain, changes in bladder and/or bowel function, sexual changes, emotional changes, speech difficulties, and problems with thinking and memory. Fortunately, most people develop only a few of these symptoms over the course of their MS, and most are able to manage their symptoms with assistance and support.
WHAT ARE THE MAIN SYMPTOMS OF MS?
- Fatigue: a debilitating kind of general fatigue which is unpredictable or out of proportion to the activity. Fatigue is one of the most common (and one of the most troubling) symptoms of MS.
- Visual problems: blurring of vision, double vision (diplopia), optic neuritis, involuntary rapid eye movement, (rarely) total loss of sight.
- Balance and coordination problems: loss of balance, tremors, unstable walking (ataxia), giddiness (vertigo), clumsiness of a limb, lack of co-ordination, weakness (this can particularly affect the legs and walking).
- Spasticity: altered muscle tone can and muscle stiffness can affect mobility and walking, spasms.
- Altered sensation: tingling, ‘pins and needles’, numbness (paraesthesia), burning sensations.
- Pain: muscle pains, facial pain (such as trigeminal neuralgia), stabbing sharp pains, burning tingling pain.
- Abnormal speech: slowing of speech, slurring of words, changes in rhythm of speech, difficulty in swallowing (dysphagia).
- Bladder and bowel problems: bladder problems include the need to pass water frequently and/or urgently, incomplete emptying or emptying at inappropriate times. Bowel problems include constipation and, infrequently, loss of bowel control.
- Sexuality and intimacy: impotence, diminished arousal, loss of sensation.
- Sensitivity to heat: this symptom very commonly causes a transient worsening of symptoms.
- Cognitive and emotional disturbances: loss of short-term memory, loss of concentration, judgment or reasoning.
Whilst some of these symptoms are immediately obvious, others such as fatigue, altered sensation, memory and concentration problems are often hidden symptoms. These can be difficult to describe to others and sometimes family and carers do not appreciate the effects these have on the person with MS and on employment, social activities and quality of life.
ARE THERE DIFFERENT TYPES OF MS?
People with MS can typically experience one of four disease courses, each of which might be mild, moderate, or severe.
- Relapsing-Remitting MS: People with this type of MS experience clearly defined attacks of worsening neurologic function. These attacks—which are called relapse or exacerbations —are followed by partial or complete recovery periods (remissions), during which no disease progression occurs. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.
- Primary-Progressive MS: This disease course is characterised by slowly worsening neurologic function from the beginning—with no distinct relapses or remissions. The rate of progression may vary over time, with occasional plateaus and temporary minor improvements. Approximately 10% of people are diagnosed with primary-progressive MS.
- Secondary-Progressive MS: Following an initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, with or without occasional flare-ups, minor recoveries (remissions), or plateaus. Before the disease-modifying medications became available, approximately 50% of people with relapsing-remitting MS developed this form of the disease within 10 years. Long-term data is not yet available but we hope that current treatments significantly delay this transition.
- Progressive-Relapsing MS: In this relatively rare course of MS (5%), people experience steadily worsening disease from the beginning, but with clear attacks of worsening neurologic function along the way. They may or may not experience some recovery following these relapses, but the disease continues to progress without remissions. Since no two people have exactly the same experience of MS, the disease course may look very different from one person to another. And, it may not always be clear to the physician — at least right away — which course a person is experiencing.
WHO CAN GET MS?
Anyone may develop MS but there are some patterns. More than twice as many women as men have MS. Studies suggest that genetic factors make certain individuals more susceptible than others, but there is no evidence that MS is directly inherited. It occurs more commonly among people with northern European ancestry. People of African, Asian, and Hispanic backgrounds are also diagnosed with MS, however, the incidence is much lower.
HOW MANY PEOPLE HAVE MS?
Approximately 23,000 Australians have MS, and it is estimated that every year the number of people diagnosed increases by 4%. Worldwide, MS affects about 2.5 million people. Because of the difficulty in diagnosing the disease, and because symptoms can be completely invisible, these numbers can only be estimated.
IS MS FATAL?
In rare cases MS is so malignantly progressive it is terminal, but most people with MS have a normal or near-normal life expectancy. Severe MS can shorten life.
DOES MS ALWAYS CAUSE PARALYSIS?
No. Moreover, the majority of people with MS do not become severely disabled. Two-thirds of people who have MS remain able to walk, though many will need an aid, such as a cane or crutches, and some will use a scooter or wheelchair because of fatigue, weakness, balance problems, or to assist with conserving energy.
IS MS CONTAGIOUS OR INHERITED?
No. MS is not contagious and is not directly inherited. Studies do indicate that genetic factors may make certain individuals susceptible to the disease.
CAN MS BE CURED?
Not yet. There are now FDA-approved medications that have been shown to "modify" or slow down the underlying course of MS. In addition, many therapeutic and technological advances are helping people manage symptoms. Advances in treating and understanding MS are made every year, and progress in research to find a cure is very encouraging.
WHY IS MS SO DIFFICULT TO DIAGNOSE?
In early MS, symptoms that might indicate any number of possible disorders come and go. Some people have symptoms that are very difficult for physicians to interpret, and these people must "wait and see." While no single laboratory test is yet available to prove or rule out MS, magnetic resonance imaging (MRI) is a great help in reaching a definitive diagnosis.
QUICK MS FACTS
Here are some quick facts about MS you may not know...
- MS is a progressive disease of the nervous system, for which there is no cure.
- An estimated 2.5 million people in the world have MS.
- More women than men have MS, with a ratio of 2 men to 3 women affected.
- MS is the most common diseases of the central nervous system in young adults.
- There are four types of MS: relapsing remitting, secondary progressive, primary progressive and progressive relapsing.
- Sclerosis means scars; these are the plaques or lesions in the brain and spinal cord.
- In MS, the protective myelin covering of the nerve fibres in the central nervous system is damaged.
- Inflammation and ultimate loss of myelin causes disruption to nerve transmission and affects many functions of the body.
- While the exact cause of MS is not known, much is known about its effect on immune system function which may be the ultimate cause of the disease.
- MS is not directly hereditary, although genetic susceptibility plays a part in its development.
- MS is not contagious.
- Diagnosis of MS is generally between 20 and 40 years of age, although onset may be earlier.
- MS is rarely diagnosed under 12 and over 55 years of age.
- Life span is not significantly affected by MS.
- There are a wide range of symptoms. Fatigue is one of the most common.
- The incidence of MS increases in countries further from the equator.
- There is no drug that can cure MS, but treatments are now available which can modify the course of the disease.
- Many of the symptoms of MS can be successfully managed and treated.
If you have any further questions about MS or how we at MS Queensland can help, please contact our InfoLine Monday to Friday between 9.00am – 4.00pm on 1800 177 591.