Multiple sclerosis, also called MS is considered an autoimmune disease. This is where a person’s immune system mistakenly attacks some bodily system and causes illness. In the case of MS, the sheath that protects the patient's nerve cells is attacked and may be gradually destroyed. The sheaths are made of a substance called myelin, which is made up of fats and proteins. When nerves are protected by their myelin sheath, they can easily send and receive signals from other nerves. These signals allow bodily systems, from the eyes to the muscles to the central nervous system to the digestive tract work the way they should.
People who are at the highest risk for MS are white women between 20 and 40, though it can happen to people who are older or younger. As with many autoimmune diseases, women are more likely to get MS than men. With MS, women are two or three times more likely to get the disorder than men.
Because MS attacks the nerve cells, its symptoms are varied, hard to predict, and even vary in severity, sometimes in the same patient. General symptoms of multiple sclerosis can be vague and nonspecific, which means they could belong to many other disorders. A person with MS symptoms needs diagnostic tests, including a brain MRI, to determine whether they have the disease or something else.
In general, symptoms of multiple sclerosis include:
Pain is one of the most common symptoms of multiple sclerosis as the sheaths around the nerves deteriorate. Among the many kinds of pain experienced by a person with the disease are the “MS hug” which feels like a burning, tightening ligature around the body.
Other types of MS pain resemble a broken tooth and what feels like a lightning strike down the spine or the neck. These painful sensations can happen when the patient moves their neck a certain way, especially when they bend their neck forward. This is called Lhermitte or barber chair sign. The pain shoots down the back and into the appendages.
Painful and uncontrollable spasms are also symptoms of multiple sclerosis. The pain is often accompanied by stiffness and commonly happens in the patient’s legs.
Some of the earliest symptoms of multiple sclerosis are problems with vision. As a result of the optic nerve being attacked, the patient often sees double, has blurred vision, or experiences blindness. The blindness can be complete or partial and usually affects only one eye at a time. Some patients find looking up or looking to the side painful. Some MS patients also find it difficult to see colors or have poor contrast vision.
Numbness and Tingling
People with MS regularly experience numbness and tingling in their fingers and toes, feet and hands, and areas around their face.
This symptom, the inability to control their urinary bladder, is common among people with MS. They may also feel a frequent urge to urinate. In some cases, patients do not have control of their bowels. This can lead to both constipation and diarrhea.
Most people with multiple sclerosis suffer from fatigue. Fatigue isn’t merely being tired. It is chronic and not ameliorated by resting or even by getting a good night's sleep. It’s often accompanied by muscle aches and weakness, headaches, and slow reflexes. People who experience fatigue often don’t know why they have it until they see their doctor.
When a person is weak, as opposed to fatigued or tired, they can’t find the strength in their body to do what used to be normal, everyday tasks. Some people with multiple sclerosis find that they are too weak to perform household chores such as cooking and cleaning. Some are so weak that they can’t walk without help. Indeed, the first signs of weakness in an MS patient are most often felt in their legs.
Dizziness and Lightheadedness
Multiple sclerosis patients sometimes feel that the room is spinning or that they’re about to pass out. The symptoms worsen when they stand up abruptly but ease if they take a few minutes to sit or lie still.
Patients with multiple sclerosis often find that they can’t balance the way they used to and this affects the way they walk.
Though it’s an uncommon symptom, some MS patients complain that they can’t hear as well as they should. Rarely, loss of hearing is one of the first signs that MS is developing.
Patients with MS sometimes find that they can’t remember things the way they used to. Their attention span may also be shorter than it was, and they may have language problems and problems retaining information. If they had good organizational skills before the onset of their disease, those skills may start to diminish.
Along with impaired memory and the inability to process language, people with MS find that the way they speak has become difficult to control. They slur words, stutter, and may speak more softly or more loudly than they intend to. The tone of their voice is also hard to control.
People with multiple sclerosis also find that their sexual performance is badly affected by their disease. As with everything else, this is because of the way the disease attacks their nerve cells. It's also a result of the pain, fatigue, muscle stiffness, and depression caused by MS.
Reproductive Problems in Women
For many women of childbearing age, their multiple sclerosis problems are made worse during their periods. They suffer from increased clumsiness, fatigue, weakness, and depression.
Women who are menopausal are not spared the effect of multiple sclerosis on the reproductive system. In some women, the symptoms of MS worsen after menopause, most likely because of lower estrogen levels. Indeed, some postmenopausal women who go on hormone replacement therapy, or HRT find that the symptoms of their multiple sclerosis ease a bit.
On the other hand, multiple sclerosis doesn’t seem to alter a woman’s ability to get pregnant or for the pregnancy to have a healthy outcome. In some cases, the symptoms of MS are improved when a woman becomes pregnant.
Doctors aren’t sure whether people with multiple sclerosis are depressed because they are victims of a frustrating disease or whether the disease itself, with its effects on the nervous system, causes depression. Whatever the cause, patients with MS commonly deal with mood swings simply because of the stress of having the disease. Some patients suffer from pseudobulbar affect or PBA. This is when a person bursts into uncontrollable laughter or tears at inappropriate moments. Uncontrollable weeping for no reason is more common, which can make onlookers believe the person is depressed. The crying bouts aren’t the result of the depression, though the anxiety and stress of having PBA can lead to depression.
Types of Multiple Sclerosis
Not only does the disease have an array of symptoms, but there are also different types of multiple sclerosis.
• RRMS, or relapsing-remitting MS
• SPMS, or secondary progressive MS
• PPMS, or primary progressive MS
Before a person is diagnosed with MS, they may have CIS or clinically isolated syndrome. CIS is the first appearance of symptoms caused by the breakdown of the myelin sheath. The symptoms have to last for at least 24 hours and come with brain lesions that can be found on an MRI test. A person who has these types of lesions is more likely to progress to RRMS, but if the lesions are absent, they are at much lower risk of developing multiple sclerosis.
Most people with multiple sclerosis have RRMS. These people have episodes of new or worsening symptoms that are followed by remissions. Symptoms may completely disappear while the patient is in remission, or some may persist but not progress.
Some people with RRMS progress on to SPMS. This is when the disease gets worse over time. It can be active or not active. The disease can also come with progression, which shows an accumulation of disabilities as time goes on. Progression can also be absent. SPSMS with progression can come with relapses or without relapses.
The symptoms of a patient with PPM get progressively worse over time, and they have neither relapses nor remissions. PPM can be active, with a relapse here and there, not active, with progression or without progression. However, the disease can be stable for a long time.
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