The Basics about Multiple Sclerosis

By: Jessica Baity, MD, Neurologist, Thibodaux Regional Health System

Multiple Sclerosis is one of the many disorders diagnosed and treated by neurologists. It is a condition that has been researched extensively over the past few decades and we are more knowledgeable than ever in terms of diagnosis and treatment.

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is an autoimmune disorder, meaning the body produces antibodies that attack its own normal cells. It is the most common neurologic autoimmune disorder and affects nearly one million adults in the United States. Women are more than 3x likely to suffer as men, and disease onset usually occurs between the ages of 20-50. Interestingly, it is more common in colder climates farther from the equator.

What happens in MS?

The part of our nerves that carry impulses are called axons and they transmit instructions to our muscles. Axons have a fatty insulating material around them called myelin which allows conduction down the nerve axons to go faster. In MS, the myelin of the central nervous system (the brain and spinal cord) is attacked by autoantibodies. There is also inflammation and damage to the axons themselves. As a result, nerve impulses are slowed or blocked and cannot get where they need to go.

After these attacks occur, nerves remake myelin and the nerves slowly recover and symptoms may resolve. Recovery, however is not always complete, and residual symptoms can remain. At a later time, another attack may occur in a different location and a new symptom may appear. These attacks are also called ‘flares” or “exacerbations.”

What are the symptoms of MS?

MS symptoms are extremely variable because nerves can be attacked anywhere throughout the brain or spine. Therefore, symptoms will depend on where the attack happened. Some of the more common MS symptoms that we encounter are: pain, blindness or vision changes in one eye, numbness in odd places, weakness in a limb, bladder or bowel problems, muscle aches and fatigue. These symptoms are often worse with heat and improve in colder temperatures.

How is MS diagnosed?

When myelin has been disrupted, inflammation occurs, or axons are damaged we can see this on MRI. If your doctor suspects MS, the first thing they may do is order an MRI of your brain and spinal cord. There is strict diagnosis criteria regarding MS diagnosis and if the lesions seen on MRI meet these and correlate with symptoms, we diagnose with the patient with MS. Sometimes we may also order a lumbar puncture (spinal tap) if the diagnosis is less clear.

How is MS treated?

The answer is- it depends. During flares or exacerbations, patients are admitted to the hospital for steroids or other IV treatments over the course of 3-5 days. The true goal of treatment, however, is to avoid these exacerbations entirely with treatments called DMTs, or Disease Modifying Therapies. There are over 12 DMTs now, and more are released every year. DMTs work to prevent flares and therefore the progression of MS. There are a variety of DMTs, including oral, IV, and infusions and the correct one is very dependent on the unique situation of each patient.

It is an exciting time in the field of multiple sclerosis, as today we have more treatments than ever to help patients. If you suspect you may have MS or have questions, schedule an appointment with a neurologist to be evaluated at Thibodaux Regional Neurology Clinic, 985.493.3090.