Multiple sclerosis (MS) is a chronic neurological disorder that affects the central nervous system (CNS), which includes the brain and spinal cord.
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Multiple sclerosis, commonly known as MS, is a chronic neurological disorder that affects the central nervous system (CNS), which includes the brain and spinal cord. It’s considered an autoimmune disease. This is where your body's immune system mistakenly attacks its own healthy tissues.
In MS, your immune system attacks the protective covering of nerve fibres called myelin. Myelin serves as insulation around nerve fibres, allowing for efficient transmission of electrical signals between your brain and the rest of your body.
When the myelin is damaged or destroyed in multiple sclerosis, it disrupts the normal flow of nerve impulses. This can lead to various neurological symptoms, depending on the location and extent of the damage.
Fortunately, the treatment of MS has greatly advanced in the last few years with treatments from tablets to stem cell therapies which can transform the prognosis of MS.
Around 7,100 people are diagnosed with multiple sclerosis (MS) every year in the UK. This is equivalent to around 1 in every 400 people.
Multiple sclerosis can present with a wide range of symptoms, and they can vary from person to person depending on the location and extent of nerve damage in the central nervous system.
Symptoms can also change over time, and you may experience periods of relapse (exacerbation of symptoms) followed by remission (partial or complete recovery).
It's important to note that the symptoms of MS can be non-specific and resemble those of other medical conditions, making the diagnosis challenging. If you experience any persistent or worsening neurological symptoms, seek medical attention for proper evaluation and diagnosis as soon as possible, as an early diagnosis can lead to timely management and better outcomes. As some of these symptoms are not uncommon, it is recommended they are assessed by a neurology specialist.
Here are some common symptoms of multiple sclerosis:
A feeling of extreme tiredness and lack of energy is one of the most prevalent and debilitating symptoms of MS.
Blurred or double vision, pain with eye movement, and temporary loss of vision can occur.
You may experience various types of pain, including neuropathic pain (burning, stabbing, or electric shock-like sensations).
While uncommon, you experience tinnitus - a ringing, buzzing, whistling or other sounds ears.
You may experience problems with balance, coordination, and dizziness.
MS can cause bowel and bladder problems, leading to constipation, frequent urination, or urinary incontinence.
You may experience problems with memory, attention, and thinking processes.
Sensations of numbness, tingling, or pins and needles in the face, body, or limbs may occur.
Increased sensitivity to heat can worsen MS symptoms temporarily.
Weakness in the muscles, difficulty walking, and muscle spasms or stiffness are common symptoms.
MS can affect the muscles involved in speech and swallowing, leading to slurred speech and difficulty swallowing.
Depression, anxiety, and mood swings are common emotional symptoms associated with MS.
You may experience problems with balance, coordination, and dizziness.
Females are more likely to be diagnosed with MS than males, in fact, MS is two to three times more common in females.
While both sexes can be affected by the symptoms listed above, sex-specific factors may cause them to experience them differently.
For example, females may experience more MS symptoms just before and during menstruation (their period). MS has also been linked to irregular periods in some people.
More research is needed, but there is also some evidence to suggest that, due to hormonal changes, MS progresses more quickly after menopause.
While MS is more common in females than males, males are more likely to be affected by a type of MS called primary progressive MS (PPMS). This type of MS causes a gradual worsening of neurological symptoms, with no relapses or remissions. People with PPMS often experience more problems with balance and tend to need more assistance day-to-day.
Research has also found that males with MS often experience a more rapid decline in their health than women.
The exact cause of multiple sclerosis isn’t fully understood, but it’s believed to be a complex interplay of genetic, environmental and immunological factors.
Researchers have made significant progress in understanding the underlying mechanisms, but a definitive cause remains elusive.
Here are some of the key factors thought to contribute to the development of MS:
Autoimmune response: MS is considered an autoimmune disease, which means the body's immune system mistakenly attacks its own tissues. In the case of MS, the immune system targets the myelin, the protective coating surrounding nerve fibres in the central nervous system. This immune attack leads to inflammation and damage to the myelin and nerve cells.
Genetics: MS is not directly inherited, but there is a genetic component. Certain genetic variations appear to increase the susceptibility to developing MS. Family history of MS can slightly increase the risk of developing the disease, but most people with MS have no family history of the condition.
Environmental triggers: Environmental factors are thought to play a role in triggering MS in individuals with a genetic predisposition. Some of these factors include infections, such as the Epstein-Barr virus (EBV), which has been linked to an increased risk of MS. Additionally, vitamin D deficiency, smoking, and certain toxins or pollutants may also contribute to the development of MS in susceptible individuals.
Complex interactions: MS is likely caused by a combination of genetic susceptibility and exposure to environmental triggers, leading to a cascade of immune responses that ultimately result in the characteristic demyelination and nerve damage seen in the disease.
The exact reason why MS affects more females than males is unclear, but experts think it may be due to the influence of female sex hormones, like estrogen and progesterone. These hormones are believed to play a role in regulating the immune system, so may contribute to the development of autoimmune diseases like MS.
There is no one specific test to diagnose MS. At OneWelbeck, our expert neurologists use a combination of tests to make an accurate MS diagnosis.
These may include:
Tests to evaluate your movement, coordination, vision, balance and reflexes
An MRI scan to detect damage to the brain and spinal nerves
A lumbar puncture - a needle is inserted into the lower back to collect a small sample of spinal fluid
Evoked potential (EP) test - electrodes are placed on the scalp to deliver a stimulus and your brain’s electrical response is recorded to access neurological function
Unfortunately, there’s no cure for MS yet. However, treatments are available to manage symptoms, slow disease progression, and improve the quality of life for individuals living with the condition.
The approach to treatment often depends on the type of MS you have, the severity of your symptoms, and your specific needs. Here are some common treatment strategies for multiple sclerosis:
DMTs have transformed outcomes for MS patients, and these are all available through specialists at OneWelbeck.
These medications are used to modify the course of the disease by reducing the frequency and severity of relapses, as well as slowing the progression of disability. DMTs work by modulating the immune system to reduce inflammation and the immune response against the central nervous system.
There are various DMTs available, and the choice of treatment depends on factors such as the type of MS, disease activity, and individual characteristics. Ocrelizumab is a disease-modifying therapy offered at OneWelbeck that targets specific immune cells involved in MS progression. Clinical trials have shown it to be highly effective in halting the symptoms of MS. In fact, 97% of patients in trials experienced no relapses or new brain lesions over 48 weeks.
Various medications and therapies are used to manage specific MS symptoms, such as muscle spasms, pain, fatigue, bladder and bowel problems, and depression. Symptomatic treatments aim to improve comfort and function and may include muscle relaxants, pain relievers, physical therapy, and counselling.
Physical therapy, occupational therapy, and speech therapy can be beneficial for individuals with MS to improve mobility, maintain independence, and manage speech and swallowing difficulties.
Lifestyle changes can play a significant role in managing MS. Regular exercise, a balanced diet, stress management techniques, and avoiding known triggers (e.g. excessive heat) can help improve overall well-being.
During relapses (flare-ups or exacerbations), when new symptoms appear or existing ones worsen, short courses of high-dose corticosteroids are often prescribed to reduce inflammation and hasten recovery.
Regular follow-up with healthcare professionals, including neurologists, is essential to monitor disease progression, assess treatment effectiveness, and make any necessary adjustments to the treatment plan.
Psychological and emotional support can be vital for individuals with MS. Support groups, counselling, and educational resources can help individuals and their families cope with the challenges associated with the condition.
While there is currently no cure for MS, appropriate treatment and management can help you lead a fulfilling life. At OneWelbeck, our experienced neurologists tailor treatment plans to ensure you receive personalised care for the best possible outcomes.
Working with a multidisciplinary team of experts across many specialities, our consultants ensure you receive the holistic care required to meet your specific and individual needs.
The symptoms of MS vary from person to person so you may experience, one, a combination, or all of the symptoms listed above. How and when these symptoms present can also vary over time.
There are four main types of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS).
During a relapse, symptoms usually come on over a few hours or days and can last for several weeks. For most people, a relapse will usually last less than a month, but they can vary, from a few days to many months.
Studies show that, on average, MS reduces life expectancy by six to seven years. With medical advances and new treatments becoming available, people are living longer and longer with MS.
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