Multiple sclerosis

Multiple sclerosis (MS) is a disease that attacks the central nervous system. This includes the brain and spinal cord. The central nervous system is responsible for controlling the majority of the body's functions (e.g., mobility, vision, balance, memory).

More specifically, MS affects the protective sheath surrounding the nerves, which is called myelin. This sheath protects the nerves and acts as a conductor for the electrical signals we need to function. When the myelin sheath is damaged, these electrical signals can no longer reach their destination efficiently. Our functions are therefore impaired.

Multiple sclerosis usually arises between the ages of 20 and 40. In most cases, the disease tends to be episodic, with alternating periods of flare-ups and remission (no symptoms). The episodes may vary in duration and intensity. That being said, because this is a degenerative disease, it tends to worsen over time. Eventually, it's possible that a person will show symptoms constantly. There is currently no cure for multiple sclerosis.

The symptoms of the disease can vary a great deal and are related to the functions served by the affected nerves. The main symptoms of the disease are as follows:

• Loss of balance and dizziness
• Difficulty moving your body
• Numbness or tingling in the limbs
• Muscle spasms
• Fatigue
• Impaired vision
• Impaired speech
• Urinary and fecal incontinence
• Depression
• Memory problems

Although multiple sclerosis can cause some disability (e.g., the person may need a cane to get around), most people with MS lead normal lives. The life expectancy of people with multiple sclerosis is not significantly lower than that of individuals who do not have the disease.

Causes and triggers

We still don't know what causes multiple sclerosis. The primary hypothesis is that MS is an autoimmune disease. This means that at some point, the body's immune system recognizes nerve myelin as a foreign substance in the body, and it attacks the myelin in order to destroy it.

It has been established that certain factors can increase a person's risk of developing the disease. These include:

• Not enough sun exposure during childhood (vitamin D deficiency)
• Childhood obesity
• Certain viral infections (e.g., Epstein-Barr virus)
• Tobacco use

In addition, people with a family history of multiple sclerosis are at greater risk of developing the disease.

Many people find that their symptoms worsen in hot conditions. For example, taking a hot shower, soaking in a hot tub, or travelling to a tropical region can make symptoms more difficult to deal with.

Treatment

There is no cure for multiple sclerosis. Nevertheless, several medications exist to limit the immune system's attack to the body's myelin. As a result, it is possible to reduce the frequency of attacks and slow the progression of the disease. Some of these medications are administered orally, while others must be injected under the skin or into a vein. Some treatments can also relieve specific symptoms of the disease (e.g., fatigue, urinary incontinence, muscle spasms).

Your health care provider may also recommend taking vitamin D supplements.

Certain lifestyle habits can help slow the progression of the disease and the intensity of symptoms. Some of these daily habits include:

• Engaging in regular physical activity
• Maintaining a healthy diet
• Maintaining a healthy weight
• Quitting smoking
• Reducing your stress levels

When should I see a health care professional?

Speak with your health care provider if you experience any of the following symptoms:

• New symptoms of the disease
• Symptoms that affect your quality of life
• A sudden increase in the intensity of your symptoms
• Psychological distress

For more information:

• Multiple Sclerosis Society of Canada