Multiple sclerosis

MS is where the protective coating (myelin sheath) around the nerves in your brain and spinal cord (your central nervous system) is damaged due to inflammation. This affects how well your nerves can conduct electrical impulses to and from the brain. This causes various symptoms, depending on which nerves are damaged.

MS affects over 100,000 people in the UK. It’s typically first diagnosed in young adults and is more common in women.

MS is a lifelong condition. Most people (nine in 10) find their symptoms can come and go – this is called relapsing-remitting MS (RRMS). Others find their symptoms are permanent and gradually get worse – this is called progressive MS. Half of people who have RRMS go on to develop progressive MS, with or without relapses, which is called secondary progressive MS (SPMS).

Over time, symptoms can cause serious disability.

There’s no cure for MS, but treatments are available which can help flare-ups (periods when symptoms are worse), ease symptoms and even slow the progress of the disease.

There are many symptoms associated with MS, though most people will only experience a few of them. The most common MS symptoms include:

• Fatigue
• Blurred vision
• Mobility problems – such as difficulty walking or with balance
• Cognitive problems – such as problems learning or difficulty concentrating
• Pain, tingling sensations or numbness
• Muscle stiffness or spasms
• Bowel and bladder problems

Diagnosis for MS can be difficult because many of the symptoms are non-specific, meaning they’re associated with other diseases. There’s no single test, so you may have a combination of:

• Physical examination by a neurologist (a doctor specialising in the nervous system)
• Blood tests to rule out other conditions
• An MRI scan to look for damage in your brain or spinal cord
• Evoked potential tests which measure the speed of electrical impulses to the brain in certain nerves
• Lumbar puncture where a needle is used to remove some of the fluid that surrounds your spinal cord for analysis

MS is an autoimmune disease, meaning your immune system mistakenly attacks healthy cells in your body. In MS, your immune system attacks nerve cells in your central nervous system, causing inflammation and breakdown of the protective myelin sheath around these nerves.

No one knows for sure why MS happens in some people and not others, but it could be a combination of:

• Your genetics
• Environmental factors – such as some infections or a lack of vitamin D
• Your lifestyle – smoking or obesity

Relapses or flare-ups can occur for no apparent reason, though triggers may be:

• Infections
• Exercise
• Hot weather

Although there’s no cure, symptoms can often be eased through various treatments.

Medications include:

• Disease-modifying medications – can help slow worsening disability by reducing the damage to the protective myelin sheath around your nerves
• Steroids – to help improve relapses by reducing inflammation
• Other medications depending on your symptoms such as painkillers, antidepressants and antispasmodics

Not all medications will be suitable for everyone – a medication that works for some people may not work in others.

Other therapies which may help include:

• Physiotherapy
• Occupation therapy
• Speech therapy
• Psychological therapies
• Counselling