What is multiple sclerosis?

Multiple sclerosis (MS) is a relatively common condition that affects the central nervous system by interfering with the nerve impulses that come from the brain, the spinal cord and the optic nerves. It is characterised by scars which occur within the central nervous system. The symptoms can be quite variable depending on just where in the central nervous system that they develop. More than two million are affected worldwide by multiple sclerosis. Most are diagnosed with it between the ages of 20-40, but it does affect younger and older people as well. It affects women three times more commonly than men. The cause of the condition is not known. Currently there is no known cure for multiple sclerosis, however there are a number of interventions that can help manage the symptoms and slow down the progression of the disease.

The symptoms of multiple sclerosis are variable and often unpredictable because of that involvement of different parts of the central nervous system and just how much each part is affected. It is often the case that no two cases of this condition are the same. Because of this, the initial diagnosis can be difficult until a clearer picture of all the symptoms are more obvious. There are generally a grouping of five major health problems recognised as being a part of multiple sclerosis, but they all could also be due to other causes. The first is problems with motor control. This includes muscle spasms, weakness, co-ordinations and balance issues with the arms and legs. The second is fatigue which is very common in this condition and also includes an increased sensitivity to heat. The third grouping of symptoms are other neurological symptoms that include vertigo, pins and needles, neuralgia and disturbances to vision. The fourth includes bladder incontinence and constipation. The fifth are psychological and psychiatric issues that include depression, memory loss and cognitive difficulties.

The diagnosis is often made by the collection of symptoms, ruling out other causes and imaging that shows the lesions in the central nervous system. The course of multiple sclerosis after diagnosis is difficult to predict. Most can expect a relatively normal life expectancy. Generally, there are three different clinical courses that the condition can take and each of those could be mild, moderate or severe. One is a relapsing-remitting which is characterised by partial or total recovery after attacks which also get called exacerbations, relapses, or flares. This is the most common form of multiple sclerosis. The second is a secondary progressive type which starts as a relapsing remitting course, but later becomes steadily progressive condition. The third is a primary progressive which has a progressive course from the onset or diagnosis and the symptoms generally do not go into remission.

The treatment of multiple sclerosis is by two main means with drugs. One is the use of drugs to ease the symptoms that may develop. The other is to reduce the risk of relapses and the progression of the disease using immune suppressants such as methotrexate or mitoxantrone. Also, of important in the management is physical therapy to keep the muscles active and strong.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.