What is multiple sclerosis? Multiple Sclerosis Multiple sclerosis (MS) is a disease of the central nervous system (the brain and spinal cord). Many people with multiple sclerosis are only mildly affected by the disease and continue to lead their lives much as they did before their diagnosis. However, other people who have multiple sclerosis experience severe loss of coordination and muscle control. There are 2 main patterns of MS symptoms: The most common pattern is episodes of symptoms for days or weeks followed by periods of no symptoms for weeks or months. These episodes are called flares or relapses. This type of MS is called relapsing-remitting disease. It affects about 85% of the people who have MS. Symptoms that keep getting worse after the first signs of illness are a much less common pattern of symptoms. This form of the disease is called progressive disease and there are different types of progressive disease. The course of the disease can look very different from one person to another. It may not always be clear to your healthcare provider at least at first what type of MS you have. What is the cause? A fatty substance called myelin covers nerve fibers. The myelin normally insulates the nerve fibers. It helps nerve messages move between the brain and other parts of the body. When you have multiple sclerosis, some of the myelin is damaged. The damaged areas are called plaques. The damage can make it harder for the nerves to send signals to the body. What causes damage to the myelin is not well understood. Many experts think that the loss of myelin is caused by an autoimmune process. This means that the body mistakenly reacts to some part of itself as foreign and attacks it. In the case of MS, the body destroys areas of its own myelin. What are the symptoms? Common first symptoms of MS are: Tiredness Vague feelings of weakness or clumsiness, Numbness Blurred or double vision Balance or coordination problems Problems with urination, such as needing to urinate often and urgently, trouble starting to urinate, or leaking urine Dizziness Adult Advisor 2014.1 Copyright 2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved. 1
Bowel problems, such as loss of control of bowels, constipation, or diarrhea Depression and mood swings Memory loss and problems with your thinking ability Usually the symptoms come and go unpredictably. The times when you are having symptoms are called flares, relapses, or episodes. The episodes may last a few days or weeks at a time. The times when you are not having symptoms are called remissions. Many people with MS are able to function quite normally during remissions. How is it diagnosed? Your healthcare provider will ask about your symptoms and examine you. Your provider will pay special attention to your nervous system. The best test for MS is MRI (magnetic resonance imaging). MRI gives X-ray-like images that are better than other types of scans for looking at the central nervous system. MRI can show areas of damaged myelin. If the diagnosis is still uncertain after MRI, your healthcare provider may do a test to measure how fast your nerves conduct impulses. A sample of fluid from your spine may be analyzed for changes that are often found in people who have MS. You may have more than 1 MRI over time. Several MRIs may show plaques appearing in different parts of the central nervous system at different times. This confirms the diagnosis of multiple sclerosis. How is it treated? There is not yet a cure for MS. However, you can prevent problems and help maintain your quality of life by following your healthcare provider s treatment plan and taking good care of yourself. Treatment for MS can help: Shorten flare-ups of symptoms Lengthen the time between flare-ups Prevent damage to the nerves Prevent or lessen new symptoms Your healthcare provider may prescribe disease-modifying medicine that keeps the immune system from attacking the myelin. This can help prevent flare-ups of symptoms. Steroid medicine may help symptoms be less severe during a flare-up as well as shorten the time it lasts. Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don t take more or less of it than prescribed by your provider and don t take it longer than prescribed. Don t stop taking a steroid without your provider's approval. You may have to lower your dosage slowly before stopping it. Adult Advisor 2014.1 Copyright 2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved. 2
Other medicines and treatments can help control specific symptoms of MS, such as depression, tiredness, bowel or urinary problems, and muscle spasms. It s important to get enough rest when you have MS. Always try to get plenty of rest, especially when you are having symptoms. Treatment of MS requires a team approach. The doctors treating you may include a neurologist and a rehab specialist. Nurses, counselors, a physical therapist, an occupational therapist, and a social worker may all be part of your healthcare team. For example, a physical therapist can help you keep some strength, coordination, balance, and stamina. A mental health professional or other counselor may be able to help with the depression that often comes with MS. The goal is to enable you to be as independent as possible while also helping you cope with all of the consequences of having a disease that can become disabling. Much research is being done to find better ways to prevent MS symptoms and long-term nerve damage. Keep your follow-up appointments with your healthcare provider to be sure you are up to date on the latest treatments. How long do the effects last? You may have many episodes and remissions. Some people never have more than a few mild, infrequent symptoms. However, with time, the episodes may become more frequent or last longer. Some loss of function may continue between episodes. In some cases the disease eventually results in severe disability. How can I take care of myself? Follow the treatment plan your healthcare provider prescribes. Make sure you take all of your medicines as prescribed. If you have bladder or bowel problems, it may help to talk to your provider about ways to handle them. Talk to your provider about any problems you are having with your thinking or memory. Take care of other problems that could be making your thinking problem worse. For example: Get help for anxiety or depression. Learn how to better manage stress. Take steps to reduce tiredness and improve sleep. Plan your daily activities around your energy levels and learn ways to conserve your energy. Take rest breaks during the day. Learn what things may trigger some of your symptoms, like muscle tightness (spasms), and try to avoid them. For example: Infections may trigger flare-ups of MS or worsen the symptoms. Ask your healthcare provider what you can do to help prevent infections. Getting too hot can cause or worsen symptoms. It may cause extreme muscle weakness. Try to keep cool with air conditioning or fans when it s hot. Swimming in a cool pool may be a good choice for exercise. Adult Advisor 2014.1 Copyright 2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved. 3
Follow a healthy lifestyle. This includes: Eat a healthy diet. Ask your provider about the benefits of talking to a dietician to learn what you need in a healthy diet. Try to keep a healthy weight. If you are overweight, try to lose weight to decrease the stress on your weak muscles. Stay as physically fit as you can by getting regular exercise according to your healthcare provider's instructions. It can help your strength, coordination, and balance. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed. If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Try to get at least 7 to 9 hours of sleep each night. Ask your provider: How and when you will hear your test results What activities you should avoid and when you can return to your normal activities How to take care of yourself at home What symptoms or problems you should watch for and what to do if you have them Make sure you know when you should come back for a checkup. For more information, call or write: National Multiple Sclerosis Society 1-800-FIGHT-MS (344-4867) http://www.nmss.org. Developed by RelayHealth. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Adult Advisor 2014.1 Copyright 2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved. 4
Adult Advisor 2014.1 Copyright 2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved. 5