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Multiple Sclerosis

Multiple sclerosis (MS) is the most common disabling neurological disease of young adults. While it most often appears between the ages of 20 and 40, it can also affect children and older people. MS may cause severe disability, but most people with MS have a normal life expectancy.

MS is caused by damage to myelin, nerve fibers and neurons in the brain and spinal cord (central nervous system). MS is more common in colder climates and affects twice as many women as men. Those who live in an area where MS is very common and those with a family history of MS seem to be at a slightly higher risk; however the exact cause is unknown. Experts think there are currently 250,000 to 350,000 people diagnosed with MS in the US, and the rate of the disease has increased steadily over the past 50 years.

Multidisciplinary Multiple Sclerosis Clinic

Because MS is a condition that requires expertise, early diagnosis and access to advanced treatment that may prevent long-term problems, Marshall Neuroscience partners with Cabell Huntington Hospital in hosting a specialized clinic to treat patients with MS. Board-certified neurologist Paul Ferguson, MD, is the medical director of the Multidisciplinary Multiple Sclerosis Clinic. He has significant experience managing the complexities of multiple sclerosis and providing patients with advanced medical treatments, neuroimaging and physical therapy to meet their needs. The multidisciplinary focus of the clinic benefits patients by combining the medical expertise of neurologists with the expertise of therapists from Cabell Huntington Hospital Rehabilitation Services.

Early Treatment & Improved Quality of Life

Although there is no cure for MS, there are treatments and medications that can reduce the number and severity of relapses and delay the long-term progression of the disease. Dr. Ferguson urges patients with suspected or diagnosed MS to seek treatment immediately.

“I think the most important point to highlight is not to ignore the disease process,” Dr. Ferguson said. “Even if you are not having active symptoms, the disease continues to progress in your brain. Patients who do not receive treatment and medication for multiple sclerosis can progress and develop disability rather quickly; however, those who work with their physicians and manage their care can enjoy a longer, active lifestyle.”

For an appointment or more information about the Multidisciplinary Multiple Sclerosis Clinic, please call 304.691.1787.

Signs & Symptoms

Recognizing the initial symptoms of MS may be difficult because they range from mild to severe and may go away quickly or last for months. The first symptoms of MS often include:

  • blurred or double vision or pain in the eye
  • weak, stiff muscles, often with painful muscle spasms
  • tingling or numbness in the arms, legs, torso or face
  • clumsiness and balance problems when walking
  • bladder control problems
  • dizziness that doesn't go away

Later symptoms may include:

  • mental or physical fatigue
  • mood changes, such as depression or euphoria
  • changes in the ability to concentrate or to multi-task effectively
  • difficulty making decisions, planning, or prioritizing
  • muscle weakness in the hands and legs
  • muscle stiffness and spasms severe enough to affect walking or standing
  • tingling and burning sensations
  • numbness and loss of sensation
  • cognitive dysfunction (thinking, learning, memory and judgment difficulties)

Diagnosis

Since MS is a neurological condition, it is usually diagnosed and treated by a neurologist. There are other disorders with symptoms that are similar to MS, so it is important for the neurologist to perform a thorough investigation before making a diagnosis. In addition to completing a medical history and conducting a physical exam and a detailed neurological examination, the doctor will order magnetic resonance imaging (MRI) of the head and spine. MRI is considered the best tool for diagnosing multiple sclerosis because it often detects lesions and abnormalities that would be missed by other imaging techniques.

Disease Progression

A key characteristic of MS is an exacerbation (also called a relapse, flare-up or attack), which is a sudden worsening of MS symptoms, or the appearance of new symptoms that lasts for at least 24 hours. An attack may be mild or severe enough to significantly interfere with life's daily activities. Most exacerbations last from several days to several weeks; when the symptoms of the attack subside, an individual with MS is said to be in remission.

Although it is difficult to predict how each person’s disease will progress, the course of MS generally follows one of two patterns:

  • Primary-progressive MS is characterized by a gradual physical decline with no noticeable remissions, although there may be temporary or minor relief from symptoms. This type of MS usually appears after age 40, and is just as common in men as in women.
  • Secondary-progressive MS begins with a relapsing-remitting course, followed by a later primary-progressive course. The majority of individuals with severe relapsing-remitting MS will develop secondary progressive MS if they are untreated.

Treatment

There is no cure for MS, but there are treatments for initial attacks, medications and therapies to improve symptoms and recently developed drugs to slow the worsening of the disease. These new drugs have been shown to reduce the number and severity of relapses and to delay the long term progression of MS.

MRI imaging plays a very important role in establishing an MS diagnosis, deciding when the disease should be treated and determining whether treatments work effectively or not. It also has been a valuable tool to test whether an experimental new therapy is effective at reducing exacerbations.

Research

Although researchers haven't been able to identify the cause of MS, there has been excellent progress in other areas of MS research. Scientists are exploring common factors that seem to be associated with developing MS, including:

  • Genetic susceptibility: Susceptibility to MS may be inherited.
  • Sunlight and vitamin D: Studies suggest that people who spend more time in the sun and those with relatively high levels of vitamin D are less likely to develop MS.
  • Smoking: Studies have found that people who smoke are more likely to develop MS.
  • Infectious factors & viruses: The virus most consistently linked to the development of MS is Epstein Barr virus.

New discoveries are constantly changing treatment options and creating new and better therapies for MS. Clinical trials are available through the National Institute of Neurological Disorders and Stroke and other agencies.

Source: National Institute of Neurological Disorders and Stroke