Frequently Asked Questions
about Multiple Sclerosis
- What is multiple sclerosis?
- What causes MS?
- Is MS fatal? Can MS be treated?
- What Type of doctor specializes in MS? How is MS Diagnosed?
- Who gets MS? How many people have MS?
- Is it safe to get pregnant?
- Can I inherit MS?
What is multiple sclerosis?
Multiple Sclerosis, also referred to as "MS," is a neurological disorder affecting the nerves of the brain and spinal cord. MS is thought to be an "autoimmune" disease, which means that a person's own immune system is attacking his or her body. This attack damages the protective covering to the nerves (myelin) and eventually the nerves (axons) as well.
MS is most often diagnosed in young adults, and symptoms can range from visual changes, numbness, and vertigo, to bladder and bowel problems, weakness, and spasticity (muscle tightness), among other symptoms. Individuals may also experience emotional difficulties, such as depression, or cognitive issues, such as forgetfulness. For most people with early MS, symptoms tend to flare up ("exacerbation") and subside ("remission") for long periods of time.
What causes MS?
An exact cause of MS has not been identified, however, most researchers believe that more than one factor is involved in the development of this disease. One popular theory involves a slow-acting virus, such as Epstein-Barr virus (EBV) or measles, which could remain dormant (inactive) for many years before contributing to the development of MS in genetically susceptible people. Genes appear to play a role as well.
Additionally, researchers are now looking at a vitamin D deficiency (vitamin D may be derived from both sunshine and diet), along with the types and amounts of fat intake in one's diet, as possible contributing factors of MS. While cigarette smoking has already been shown to increase the rate of progression of one's MS, studies now suggest that smoking may also increase the risk of developing MS. MS is not contagious.
Is MS fatal? Can MS be treated?
In general, MS usually does not shorten one's life expectancy. Only a very small percentage of patients experience a rapidly progressive type of MS which may cause more significant health issues early in the disease. Some individuals, particularly those who are significantly inactive, may experience the typical complications of a prolonged chronic illness (such as infection or pneumonia). Additionally, a recent study has shown that for individuals with relapsing forms of MS, those who begin treatment early with a disease-modifying therapy and stay on the therapy, may outlive those who are not on treatment.
With various adjustments made along the way, most individuals with MS may look forward to a fulfilling and productive lifetime. As for anyone, other health factors play a role in determining one's quality of life as well as life expectancy. Examples of such health factors include smoking, diet, exercise, and family history of disease.
While no cure for MS has been found, eight FDA-approved drugs are now available for the long-term treatment of MS. These have been shown to reduce the number and severity of MS flare-ups, along with possibly delaying disease progression. Many more experimental MS therapies are being studied in clinical trials, and these may lead to even greater treatments -- and possibly a cure -- for MS.
What Type of Doctor Specializes in MS ? How is MS Diagnosed?
Being a neurological condition, MS is usually diagnosed and treated by a neurologist. Other professionals specializing in neurology in conjunction with another area of medicine — such as radiology (neuroradiologist), ophthalmology (neurophthalmologist), and psychology (neuropsychologist), may also assist with one's diagnosis and ongoing treatment plan.
Because the symptoms of early MS can come and go, and because a single test is not available to determine if one has MS, getting a diagnosis is often difficult. Several appointments and tests (to exclude other conditions) may be necessary.
Tools used to help diagnose and evaluate MS include:
- magnetic resonance imaging (MRI)
- magnetic resonance spectroscopy (MRS)
- lumbar puncture (spinal tap)
- evoked potentials (EP) tests
- Expanded Disability Status Scale (EDSS)
- Functional System (FS) scale
- MS Functional Composite (MSFC) scale
For descriptions of these diagnostic and evaluative tools, please visit the "Health and Wellness" column from the summer 2007 issue of The Motivator.
Who gets MS? How many people have MS?
Most people with MS experience their first symptoms and are diagnosed between the ages of 15 and 50. Previously, MS in younger children was extremely rare. Referred to as "Pediatric MS," the diagnosis of MS at a young age is on the rise. Researchers do not know if this is an indication of people developing MS at an earlier age, or if this is a result of greater disease awareness and more sensitive diagnostic procedures.
Women are two to three times more likely to develop MS versus men. Caucasians, especially those of European or Scandinavian ancestry, are at a much greater risk of MS than those of African heritage.
Individuals growing up in regions closer to the equator have a lower incidence of MS. The rate of MS increases as distance from the equator increases. This environmental factor may relate to diet, exposure to sunshine, and/or other lifestyle traits.
Estimates of MS populations vary, and specific numbers are difficult to confirm through healthcare organizations. Many groups estimate that between 350,000 and 400,000 individuals in the United States have MS, although this number could be much higher. Additionally, estimates range from one to two-and-a-half million for people living with MS throughout the world.
Is it safe to get pregnant?
Many of those diagnosed with MS are young women with plans of having children at some point in their future. The good news is that MS does not affect fertility, and pregnancies progress "normally" (that is, having the same benefits and risks as someone without MS).
For most women with MS, MS symptoms often stabilize or improve during pregnancy. Unfortunately, 20-to-40 percent of women have a relapse following delivery, so new mothers will need to plan for more rest and assistance during the first few months. Disease progression and long-term risk of additional relapses are not affected by pregnancy.
Some of the medications taken for MS can increase the risk of miscarriage and are transmitted in breast milk. Women considering pregnancy should discuss their medications with their neurologist in advance. Some medications may need to be discontinued a few months before attempting to become pregnant.
Having a child is an important decision for any person or couple. With MS, parents need to consider that fatigue and other symptoms may well affect the amount of activity the mother may be able to perform with the child or children in their younger years. Assistance from others — such as family and friends — may be needed at certain times. Before making the commitment, individuals and couples may want to discuss the different issues with their healthcare provider.
Can I inherit MS?
Many people ask if MS may be inherited. While MS in not hereditary, individuals may be "genetically susceptible," increasing their risk of MS. This risk is slight, however, with only a three-to-four percent chance of a child (with a parent who has MS) being diagnosed with MS sometime in his or her future.
Researchers believe that genetics are only one piece to the puzzle, and other factors (such as common viruses, environment, diet, etc.) are also necessary to develop MS. Furthermore, MS research is making great strides toward identifying causes and fine-tuning effective treatments.