MS Awareness Week 2018: 23-29 April
Multiple Sclerosis, shortly known as MS, is a neurological condition - although not terminal, it is a lifelong disease of the central nervous system. The central nervous system consists of your brain and your spinal cord. The central nervous system cells are covered in a protective layer of fatty protein called the myelin sheath (a bit like the insulation on an electrical cable). MS is an auto-immune disease, where the immune system gets confused and instead of attacking an infection or virus, the immune system turns on itself and attacks the nerve cells, damaging this protective sheath. This process is called demyelination. The demyelination disrupts the ‘messages’ being transmitted from and to the brain, causing them to slow down, become distorted or not get through at all. 'Sclerosis' means scarring or hardening of tiny patches of tissue. 'Multiple' is added because this happens at more than one place in the brain and/or spinal cord.
It's estimated that there are more than 100,000 people diagnosed with MS in the UK. It's most commonly diagnosed in people in their 20s and 30s, although it can develop at any age. It's about two to three times more common in women than men.
Your symptoms will largely correspond to the areas of your brain and spinal cord that have been damaged, therefore, varying from person to person. The main symptoms include:
- difficulty walking
- vision problems, such as blurred vision
- problems controlling the bladder
- numbness or tingling in different parts of the body
- muscle stiffness and spasms
- problems with balance and co-ordination
- problems with thinking, learning and planning
Formal diagnosis is based on a number of things such as looking into medical history, neurological examinations and a series of tests. Other conditions need to be ruled out before a diagnosis can be confirmed. If your doctor thinks you could have MS, you'll be referred to a neurologist (a specialist in conditions of the nervous system), who may suggest tests such as a magnetic resonance imaging, (MRI) scan, to check for features of MS. You may also need blood tests or a lumbar puncture done. Once confirmed, you will be diagnosed with a type of MS.
Types of MS
MS starts in one of two general ways: with individual relapses (attacks or exacerbations) or with gradual progression.
Between 10 and 15% of people with MS are diagnosed with primary progressive MS (or less commonly chronic progressive MS). In this type of MS, disability increases from the beginning, and it is rare to have any relapses. 'Progressive' is the word used to describe the change towards more disability in MS. Although disability increases in progressive MS, the rate at which this happens varies from person to person and you may have times of improvement and times when symptoms stay the same.
The majority of people with MS (around 85%) are diagnosed with the relapsing remitting form. This means that they will have periods when symptoms flare up aggressively - known as a relapse, an attack or an exacerbation - followed by periods of good or complete recovery - a remission. Relapses are episodes of new or worsening symptoms lasting at least 24 hours, but usually anything from a few days to a number of weeks or months. Some relapses are relatively mild, but some are more severe. Symptoms usually improve and may go away completely as the body repairs itself. Relapses may be treated with steroids in the first few days to speed up recovery.
Many people who are initially diagnosed with relapsing remitting MS find that, over time, their MS changes. They have fewer or no relapses but their disability increases. As this follows an initial (primary) relapsing remitting phase, this is known as secondary progressive MS. Some people are already experiencing secondary progressive MS when they receive their diagnosis as the relapsing remitting stage went undiagnosed.
There's currently no cure for MS, but a number of treatments can help control the relapses. Unfortunately, there's currently no treatment that can slow the progress of primary progressive MS or secondary progressive MS in the absence of relapses. Many therapies aiming to treat progressive MS are currently being researched.
The treatment you need will depend on the specific symptoms and difficulties you have. It may include:
- treating relapses with short courses of steroid medication to speed up recovery
- specific treatments for individual MS symptoms
- treatment to reduce the number of relapses with medicines called disease-modifying therapies
Disease-modifying therapies may also help to slow or reduce the overall worsening of disability of MS in people with relapsing remitting MS, and in people with secondary progressive MS who are still having relapses.
If you would like to learn more about MS or take part in any activities to raise awareness, please speak to one of our pharmacists or visit www.mstrust.org or www.ms-uk.org.