The low-down on multiple sclerosis

Multiple sclerosis (MS) is a neurological disorder that was described as far back as 1868. It is one of the major causes of disabilities in adults under the age of 65. Canada has one of the highest rates of MS in the world; an estimated 90,000 Canadians have MS, with over 4000 new cases of MS diagnosed every year – an average of 12 new cases diagnosed every day.

Women are more than 3 times as likely as men to develop MS. Symptoms usually first show up in people between 20 and 49 years of age but can appear as early as 2 years of age. MS appears to be more common in people of northern European background. No one yet knows what causes MS.

The symptoms of MS appear when the body's immune system begins to break down the myelin sheath that protects nerve cell fibres. Myelin is wrapped around these fibres like insulation around electrical wiring. When this protective sheath is damaged, nerve impulses from the brain to the muscles can no longer be effectively transmitted.

Symptoms can range from very mild and barely noticeable to debilitating, depending on the location of the damage – known as lesions or plaques – and its ability to heal or develop scars. Because the damage can be so varied and can come and go, diagnosis isn't always easy.

There are four main types of MS:

  • clinically isolated syndrome (CIS): a single episode where the person experiences neurological symptoms similar to multiple sclerosis. Experiencing multiple CIS events can lead to relapsing-remitting MS
  • relapsing-remitting MS (RRMS): the most common form of MS, which involves "flareups" where symptoms get worse, followed by "remissions" where symptoms decrease or disappear
  • primary progressive MS (PPMS): this type of MS develops slowly but continuously and gets worse over time
  • secondary progressive MS (SPMS): this type of MS starts out like RRMS, but then steadily gets worse over time

Some symptoms of MS include:

  • altered sensation (tingling, numbness, or a burning feeling in a part of the body)
  • difficulty controlling bladder or bowels
  • double vision
  • fatigue
  • lack of coordination
  • muscle spasticity (tightness or stiffness)
  • slurred speech
  • tremors
  • weakness

There's no definitive way to test for MS, though many neurologists may make a diagnosis after someone experiences an "attack" of symptoms and if an MRI scan shows damage suggestive of MS.

Still, certain types of tests can be done to rule out other neurological disorders or to look for signs of the disorder in the brain (usually lesions). Your doctor may order investigations to check how quickly impulses travel along the nerve fibres, use MRIs (magnetic resonance imaging) to look for affected areas, do a test to measure the speed of your nerve impulses or even do a spinal tap to rule out other diseases.

MS isn't fatal for most people stricken with the disease. Most people with MS can expect to live a normal or near-normal lifespan. This is because there have been many improvements made in the treatment of MS and the complications that may arise from it.

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