Multiple sclerosis (MS) is a disease of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves. It is usually thought of as a single disease, but its course and symptoms vary from person to person.
MS is a chronic and debilitating disease in which the immune system abnormally attacks the insulation and support around the nerve cells (myelin sheath) in the brain, spinal cord and optic nerves, causing inflammation and consequent damage.
This damage severely impacts the quality of life of patients, and they may experience various symptoms such as blurry vision, temporary loss of eyesight, feeling of tingling and numbness, muscle weakness, pain and imbalance, problems with movement and coordination, inability to focus and think, difficulty in holding urine, sexual dysfunction and frequent fatigue. Not all such symptoms are present in every patient but may vary from person to person. If left untreated the disease progresses, leading to permanent disability.
There is no cure for MS, however recent advancements have resulted in the development of new treatments that may substantially reduce disease activity and slow down progression.
It is very important that MS is diagnosed and treated as early as possible. Early treatment can slow disease progression, and may help patients lead a normal life during their productive years.
Find a NeurologistMS is a leading cause of non-traumatic disability in young people. The exact cause of MS is unknown.
It often strikes people in their prime and deprives them from performing their routines and pursuing their aspirations.
It is very important that MS is diagnosed and treated as early as possible. Early treatment can slow disease progression, and may help patients lead a normal life during their productive years.
In addition to the above, feeling of tingling and numbness, muscle weakness, pain, problems with movement and coordination, inability to focus and think, and sexual dysfunction are also symptoms common in MS. The patient might experience complete / partial recovery of symptoms followed by more episodes of new or worsening symptoms.
It is very important that MS is diagnosed and treated as early as possible. Early treatment can slow disease progression, and may help patients lead a normal life during their productive years.
RRMS (Relapsing-Remitting Multiple Sclerosis) is the most common disease course; about 85% of people with MS are diagnosed with RRMS. It is characterized by clearly defined attacks of new or increasing neurological symptoms. These attacks – also called relapses – are followed by periods of partial or complete recovery (remissions). During remissions, all symptoms may disappear, or some symptoms may continue and become permanent. However, there is no apparent progression of the disease during the periods of remission.
SPMS (Secondary Progressive Multiple Sclerosis) follows an initial relapsing-remitting course. Most people who are diagnosed with RRMS will eventually transition to a secondary progressive course in which there is a progressive worsening of neurological function (accumulation of disability) over time. SPMS can be further characterized at different points in time as either active (with relapses and/ or evidence of new MRI activity) or not active, as well as with progression (evidence of disease worsening over time, with or without relapses) or without progression.
PPMS (Primary Progressive Multiple Sclerosis) is characterized by worsening neurological function (accumulation of disability) from the onset of symptoms, without early relapses or remissions. Approximately 15% of people with MS are diagnosed with PPMS. It can be further characterized at different points in time as either active or not active, as well as with progression or without progression.
In every form of MS, the immune system attacks nerve cells in the CNS, which can cause symptoms and disability.
The EDSS (Expanded Disability Status Scale) is a clinical rating scale used to assess disability in MS.
Over time disability progresses in all three forms of MS. Check with your neurologist to assess your status on the EDSS.
It is very important that MS is diagnosed and treated as early as possible. Early treatment can slow disease progression, and may help patients lead a normal life during their productive years.
Symptoms are similar across all forms of MS, but differ for each person, no matter which form.
Most people with RRMS and PPMS experience an increase in physical disability at some point in time.
Disease activity may be outwardly apparent with new or worsening signs or symptoms, or underlying, such as lesions (inflamed or damaged areas of the central nervous system) that are detected with special equipment like magnetic resonance imaging (MRI).
Following are graphical illustrations of disease progression in the three forms of MS.
PPMS is a highly disabling form of the disease. Approximately 15% of people with MS are diagnosed with PPMS.
RRMS is the most common form of the disease. Approximately 85% of people with MS are initially diagnosed with RRMS.
PPMS is usually diagnosed 10 years later than RRMS, after a steady decline in physical abilities can be identified and other diseases can be ruled out. This means diagnosis most often occurs in people in their 40s and 50s.
RRMS is usually diagnosed when people are in their 20s and 30s.
PPMS is a debilitating form of the disease marked by steadily worsening symptoms, typically without distinct relapses or periods of remission. However, some people with PPMS do experience relapses. PPMS tends to be more disabling than RRMS. The accumulation of irreversible disability is twice as high in PPMS than in RRMS, which can mean people with PPMS rely more on mobility aids or wheelchairs.
RRMS is characterised by episodes of new or worsening signs or symptoms (relapses) followed by periods of recovery (remission). The recovery between relapses may be complete or may leave lingering problems.
The most commons symptoms in PPMS include progressive weakness, mobility issues and spasticity. These symptoms are not unique to PPMS but tend to be more persistent and difficult to manage. People may also have more problems thinking and speaking compared to people with RRMS. There is a sharp decrease in quality of life following arm function loss, which may happen earlier in people with PPMS.
The most common symptoms in RRMS include episodic bouts of fatigue, numbness, vision problems, spasticity or stiffness, and bowel and bladder problems.
People with PPMS usually have a lower number of active lesions (new inflamed or damaged areas of the central nervous system) than people with RRMS, and more spinal cord lesions that may lead to walking problems.
People with RRMS often have more active lesions (new inflamed or damaged areas of the central nervous system) than people with PPMS.
PPMS is a highly disabling disease, therefore treatment should be based on clinical need and initiated as early as possible. Recent advancements have resulted in the development of new treatments that may substantially reduce disease activity and slow down progression. Consult your neurologist to find out if you have PPMS, as early management may help to control this disease.
People with RRMS continue to experience disease activity and worsening disability, and treatment should be initiated as early as possible. Recent advancements have resulted in the development of new treatments that may substantially reduce disease activity and slow down progression. Consult your neurologist to find out if you have RRMS, as early management may help to control this disease.References
