The cause of multiple sclerosis isn't known but thought to be due to a combination of genetic and environmental factors, with symptoms ranging from tiredness to weakness, visual problems and loss of coordination.
Dr Trisha Macnair last medically reviewed this article in March 2011.
Multiple sclerosis (MS) is a neurological condition that damages the nerves and affects the transfer of messages from the central nervous system to the rest of the body. As there's no cure, medical treatment concentrates on symptom relief and preventing relapses (the episodes of deterioration which can permanetly scar the nervous system).
MS has a wide range of symptoms, is unpredictable and affects everyone differently. There are several different types, with different patterns of disease. It often starts with a relapsing/remitting pattern with symptoms appearing and then improving either partially or completely until the next episode.
One in five people affected has a benign form with mild attacks and no permanent disability, while another 15 per cent have a progressive disease that steadily worsens.
Symptoms vary depending on the type of MS, but typically come and go. The condition can affect any part of the body but usually starts with a single episode of nerve dysfunction, classically inflammation of the optic nerve in one eye.
Other common symptoms include:
Later there can be loss of coordination and speech difficulties. Depression often develops.
MS appears to develop because of an autoimmune response - for some unknown reason the immune system in the body attacks the nerves.
Although MS isn't primarily regarded as an inherited disorder, twin studies strongly suggest the presence of certain genes can make an individual susceptible to it. But other factors, possibly a viral infection, also play a part in triggering the abnormal immune response. There are no prenatal tests available.
People with the condition experience recurrent episodes of inflammation and destruction of the sheaths that surround and protect nerves (known as dymyelination). Small plaques form throughout the central nervous system.
MS is the most common neurological disorder among young adults, affecting 85,000 people in the UK with 2,500 newly diagnosed each year. It's more common in temperate rather than tropical climates. Scotland has the highest incidence in the world. Onset is usually between 20 and 40 years of age.
As the precise cause of MS remains unclear, it's not possible to prevent the condition and there's no cure. However, treatment can play an important part in controlling symptoms, and preventing the relapses which gradually damage the nervous system. Treatment may also help to slow the progression of the disease and the decline in function.
Treatments which may be used for specific symptoms include medication to relieve pain (especially a range of drugs which help a type of pain that results directly from damage to the nerves, called neuropathic pain) and drugs which target muscle spasms. Physiotherapy can also help with pain and muscle spasticity. An oral spray form of cannabis is also now available as a treatment for muscle spasticity in MS.
Steroids are usually used to treat a relapse in MS. These drugs reduce the inflammation, and shorten the duration of the relapse but they don’t prevent long term disability which results from the damage that occurs in a relapse.
Treatments known as ‘Disease-modifying drugs’ are used patients with relapse remitting MS (RRMS) and secondary progressive MS (SPMS) to prevent relapses and slow the progression of MS by limiting the scarring that occurs in the nervous system. These powerful drugs, which include interferon and natalizumab, act by interfering with the immune system’s attack on the nerves. Although these drugs can cut the relapse rate by 50 per-cent or more, they often cause side effects which can sometimes be severe. They also usually need to be given by injection although a new tablet form of disease-modifying treatment is now in use.
A wide range of supportive treatments and therapy are also important to help people living with MS to maintain their independence and mobility as far as possible.
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