Multiple sclerosis

Multiple sclerosis (MS) is a neurological condition affecting the central nervous system, which is made up of the brain and spinal cord and controls all functions in the body. An autoimmune disease, Multiple sclerosis (MS) occurs when the body’s immune system becomes overactive and mistakenly attacks itself by producing antibodies which damage the brain or spinal cord.

More than 100,000 people in the UK have MS, with three times as many women than men affected.

Causes

When someone has MS their immune system attacks the myelin sheath, a substance that surrounds and protects the nerve fibres in the central nervous system which deliver messages between the brain and rest of body, in the brain and/or spinal cord. The damage to the myelin sheath causes scarring (sclerosis) and inflammation. These scars, known as plaques or lesions, disrupt the messages travelling along the nerves, distorting them and slowing them down.

While it’s not clear what causes this to happen, it is likely that MS is at least partly caused by genetics, with an estimated two to three per cent chance of a sibling or child of someone with MS developing it. Viral infections, such as the Esptein-Barr virus, may trigger the disease and it's more common in people with MS than those without it.

There’s increasing evidence that lack of sunshine and vitamin D may possibly trigger MS, and it’s found to be more common in countries further away from the equator. A 2015 study found that those with MS who took high doses of vitamin D showed a decrease in some specific immune system cells associated with the disease when compared to those on the lower dose.

Smoking almost doubles the risk of developing MS.

Symptoms

In one in four cases of MS, the earliest noticeable symptom is a problem with the eyes (optic neuritis), where temporary vision loss, colour blindness and eye pain occur.

Some of the most common symptoms include: fatigue; balance problems and dizziness; bladder and bowel problems; numbness and tingling; stiffness and/or spasms; speech and swallowing problems; depression and anxiety; problems affecting sexual function (in both men and women). Approximately half of all those with MS experience cognitive impairment, such as problems with memory, learning, planning and thinking.

MS can either start with individual attacks (known as relapses) or more gradually. Eighty-five per cent of people with MS are diagnosed with relapsing and remitting (RRMS), where there are episodes of worsening symptoms (a relapse) and then a complete recovery (a remission). Primary progressive MS (PPMS) affects 10 to 15 per cent of people with MS, where symptoms worsen and there’s no recovery.

Diagnosis

No single test can diagnose MS. If suspected, your GP will refer you to a neurologist for investigatory tests to look for changes or weaknesses in your eye movements, reflexes, speech and balance and leg or hand coordination are done.

Other tests include: a magnetic resonance imaging (MRI) scan, which uses magnetic and radio waves to produce images of inside the body and will identify the scaring on the myelin sheath; an evoked potential test, which measures how long it takes for messages to reach the brain by placing electrodes on the head; and a lumbar puncture (spinal tap), which removes some spinal fluid (this surrounds your brain and spinal cord) to check for antibodies.

Who gets MS?

MS is three times more common in women than it is in men, and most people are diagnosed in their 20s and 30s.

Treatment

There’s currently no cure for MS, but there are treatments that can help you manage the symptoms.

Disease modifying drugs should be offered as soon as possible after diagnosis to prevent further nerve damage to the body as they can reduce the number of relapses. If you have RRMS or scans show your MS is active (new lesions), beta interferon or glatiramer acetate amongst others may be recommended, whereas for those with more frequent relapses, fingolimod or natalizumab may be recommended.

For relapses, steroids can improve symptoms and speed up recovery. Doctors will usually prescribe a five-day course of steroid tablets to be taken at home, or injections to be given at hospital for three to five days.

The individual symptoms of multiple sclerosis (MS), such as fatigue, depression, pain and incontinence will be treated individually with antidepressants and painkillers.

Lifestyle changes such as taking regular exercise, eating a healthy and balanced diet and giving up smoking can help with symptoms.

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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