Multiple sclerosis (MS) is a chronic disease of the central nervous system in which abnormal immune activity damages myelin and nerve fibers in the brain, spinal cord and optic nerves.
Multiple sclerosis is a chronic neurological disease affecting the central nervous system. It can cause episodes of neurological dysfunction and, in some people, progressive disability over time. Disease course varies considerably between individuals.
The central nervous system consists of the brain and spinal cord. Optic nerves are also commonly affected in MS. Myelin normally surrounds many nerve fibers and helps electrical signals travel efficiently.
MS develops through a combination of immune, genetic and environmental susceptibility. Abnormal immune activity targets components of the central nervous system and can produce inflammatory lesions.
The immune system attacks components of the central nervous system, causing inflammation and damage to myelin and sometimes the underlying nerve fibers. Repeated or persistent injury can interfere with nerve signaling and cause neurological symptoms.
MS is commonly described by clinical course, including clinically isolated syndrome, relapsing-remitting MS, secondary progressive MS and primary progressive MS. Disease activity and progression are also considered when describing individual patients.
Clinical courses include relapsing-remitting MS, secondary progressive MS and primary progressive MS. Some people initially present with a clinically isolated syndrome that may or may not later meet criteria for MS.
Blurred or reduced vision
Pain with eye movement
Numbness or tingling
Muscle weakness
Balance or walking difficulty
Dizziness or vertigo
Fatigue
Muscle stiffness or spasticity
Bladder urgency or other urinary symptoms
Bowel dysfunction
Cognitive or concentration difficulties
Tremor or coordination problems
The exact cause is unknown. MS appears to result from interactions between genetic susceptibility, immune regulation and environmental factors. It is not caused by a single infectious agent.
Family history of multiple sclerosis
Female sex
Young or middle adulthood
Smoking
Certain geographic or ancestral backgrounds
Low vitamin D or limited sunlight exposure
Certain previous viral exposures
Other immune or environmental susceptibility factors
Diagnosis involves medical history, neurological examination and usually MRI of the brain and spinal cord. Cerebrospinal-fluid testing, evoked potentials and blood tests may help support diagnosis or exclude other disorders.
Reduced visual acuity or abnormal color vision
Abnormal eye-movement findings
Reduced sensation
Muscle weakness
Increased muscle tone or spasticity
Abnormal reflexes
Balance or coordination impairment
Abnormal gait
Cognitive or concentration difficulties
Bladder dysfunction
Cerebrospinal-fluid analysis
CSF oligoclonal band testing
Complete blood count when evaluating alternatives or treatment safety
Vitamin B12 and other deficiency testing when clinically appropriate
Thyroid and metabolic testing when alternative diagnoses are considered
Infectious disease testing when clinically indicated
Autoimmune or inflammatory testing when another diagnosis is suspected
Other targeted blood tests to exclude MS mimics
MRI brain
MRI cervical and thoracic spinal cord
Contrast-enhanced MRI when assessment of active lesions is needed
Optical coherence tomography in selected patients
Follow-up MRI to monitor disease activity and treatment response
Detailed neurological examination
Evoked potential testing
Lumbar puncture
Cerebrospinal-fluid oligoclonal band assessment
Optical coherence tomography
Functional and disability assessment
Neuromyelitis optica spectrum disorder
MOG antibody-associated disease
Vitamin B12 deficiency
Migraine with neurological symptoms
Stroke or transient ischemic attack
Autoimmune or inflammatory CNS disorders
Spinal cord compression
Certain infections affecting the nervous system
MS is not generally staged like cancer. Clinicians describe the clinical course, relapse activity, MRI activity and disability progression. Common courses include relapsing-remitting, secondary progressive and primary progressive MS.
Staging or grading systems differ between diseases. The information here is educational and should be interpreted by a qualified healthcare professional in the context of the individual case.
Treatment includes disease-modifying therapies to reduce inflammatory disease activity and relapses, corticosteroids for selected acute relapses, rehabilitation and symptom-specific treatment. The choice of disease-modifying therapy depends on disease activity and individual factors.
Disease-modifying therapies selected according to MS type and disease activity
Interferon-based disease-modifying therapy for selected patients
Glatiramer acetate for selected relapsing MS patients
Oral disease-modifying therapies such as fumarates or other appropriate agents
Monoclonal antibody therapies for selected active MS
High-dose corticosteroids for selected acute relapses
Symptom-specific medicines for spasticity, bladder symptoms, pain or other problems
Medicines listed here are for educational information only. Do not start, stop, or change a medicine without professional medical advice.
Possible complications include mobility impairment, falls, spasticity, bladder or bowel dysfunction, vision problems, cognitive changes, chronic pain, fatigue, depression and disability. Some complications require urgent assessment.
Sudden new weakness or paralysis
Sudden facial drooping or difficulty speaking
Sudden severe loss of vision
New seizure or loss of consciousness
Severe new headache with neurological symptoms
Rapidly worsening neurological symptoms with breathing or swallowing difficulty
If symptoms are severe, rapidly worsening, or life-threatening, seek emergency medical care immediately.
The course is highly variable. Some people remain minimally affected for many years, while others develop significant disability. Prognosis depends on disease activity, clinical course, MRI findings, treatment response and other individual factors.
Survival statistics describe outcomes in groups of people and cannot predict exactly what will happen to one individual. Prognosis depends on factors such as cancer stage, tumor biology, treatment response, overall health, and follow-up.
MS can occur at any age but commonly begins in young adulthood. It is more frequently diagnosed in women than men, and occurrence varies substantially by geographic and ancestral population.
There is no established guaranteed prevention strategy. Avoiding smoking, maintaining general health, staying physically active and addressing modifiable health risks are reasonable supportive measures.
Does my clinical history meet the diagnostic criteria for MS?
What type or clinical course of MS do I have?
What do my brain and spinal MRI findings show?
Do I need a lumbar puncture or CSF testing?
Could another condition be causing these symptoms?
Should I start disease-modifying treatment?
Which disease-modifying therapy is most appropriate for me?
How should relapses be treated?
What rehabilitation or exercise program should I follow?
What symptoms require urgent or emergency assessment?
BimariDur provides educational health information to help people understand diseases, symptoms, tests, and treatment concepts. It does not replace examination, diagnosis, or treatment by a qualified healthcare professional.
Do not delay professional medical care because of information read on BimariDur.