Multiple Sclerosis (MS)

Medical Code: SGM-FS-007
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Condition: Multiple Sclerosis (MS)

Prevalence: 400,000 in US (60% female)

Layman’s Definition:  Random attacks by the immune system on the cells which electrically insulate nerve cells in the brain and spinal cord, resulting electrical signals short circuits which prevent messages from being sent to different areas within the brain.  The symptoms will depend on which specific brain signaling pathways are disrupted.     

Typical Age of Symptom Onset: 30-50 years

Primary Symptoms: Multiple Sclerosis lesions can affect any part of the brain or spinal cord that has myelinated axons, which is basically everything. The onset of symptoms is typically very sudden and may result in loss of vision, hearing, smell, movement, sensation, or the ability to perform particular mental tasks. In addition, those with MS may experience abnormal thoughts or changes in emotional state.

The course of the disease is very unpredictable. While a small percentage of individuals with MS experience only one episode of the disease in their lifetime, and another small percentage keep getting progressively worse, the vast majority of people with MS experience a pattern of symptoms with a lot of ups and downs (relapsing and remitting MS).

For people with relapsing and remitting MS, symptoms appear out of the blue for no reason, with the resulting loss of some ability.  The symptoms then slowly improve over several months or years, and functioning often returns to normal or near normal.   The condition then often remains unchanged for several years before new symptoms appear.   This pattern often continues for decades. Eventually, however, the brain is no longer able to find ways to work around the damaged areas and the person can no longer recover after each new attack.

Secondary Symptoms: About 20% of individuals with MS will experience clinical depression as a result of immune system damage to the emotional centers in the brain.

Cause(s)/Risk Factor(s): Autoimmune disease. The person’s immune system attacks the cells in the brain that produce the electrically insulating material (myelin) that surrounds nerve processes and allows electrical signals to be sent from one cell to another. Inflammation from these immune system attacks may also damage the nerve cells themselves.

Standard Treatment(s): Immune-suppressing drugs are typically prescribed to reduce the frequency and severity of immune system attacks on the brain. Higher doses of immunosuppressants may be given if new symptoms appear (an exacerbation event). MRIs (Magnetic Resonance Images), which can show the presence of MS lesions, may be taken periodically to monitor the progression of the disease or to confirm whether any new symptoms are the result of new MS lesions, or have other causes. Antidepressants may be prescribed to treat MS-caused depression. Other drugs and physical therapy or occupational therapy may be recommended for specific problems. Support groups may be helpful for coping with the unpredictable nature of the disease.

For more information about Multiple Sclerosis symptoms and disease and symptom management, see: nationalmssociety.org

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