Multiple Sclerosis (MS): Symptoms, Causes, Diagnosis and Treatment

Multiple sclerosis is a chronic disease of the central nervous system. It is considered an immune-mediated or autoimmune disorder in which the immune system mistakenly attacks structures within the central nervous system. A major target is myelin, the protective layer surrounding nerve fibres. Nerve fibres themselves may also be affected.

To understand the meaning of multiple sclerosis, it helps to understand its name. Damage caused by the disease can result in areas of scar-like tissue known as plaques or lesions. "Sclerosis" refers to these areas of scarring, while "multiple" reflects the fact that the disease can affect multiple areas of the central nervous system.

The location and extent of this damage help determine the symptoms a person experiences. This is one reason MS can look very different from one person to another.

Multiple sclerosis symptoms vary considerably between individuals because different areas of the brain, spinal cord or optic nerves may be affected.

Common or recognised symptoms include:

• Reduced or lost vision in one eye, sometimes accompanied by pain with eye movement
• Double vision
• Numbness, tingling or altered sensation
• Weakness in the arms or legs
• Muscle stiffness or spasms
• Difficulty with balance, coordination or walking
• Dizziness
• Fatigue
• Bladder problems, including urinary frequency or impaired bladder control
• Constipation or other bowel difficulties
• Tremor
• Pain or abnormal sensations
• Problems with concentration, memory, learning or multitasking
• Mood changes.

Some people experience Lhermitte's sign, an abnormal sensation that may travel down the back and sometimes into the limbs when the neck is bent forwards.

Symptoms may occur during a relapse and then improve completely or partially. Other symptoms can persist or change over time. Existing MS symptoms may also temporarily worsen during fever, heat exposure or infections.

Having one or more of these symptoms does not necessarily mean a person has multiple sclerosis. Many other neurological and non-neurological conditions can cause similar symptoms, which is why medical assessment is important.

At present, there is no established way to completely prevent multiple sclerosis.

This is partly because MS does not have one clearly established cause. It appears to arise through a complex relationship between immune processes, genetic susceptibility and environmental influences.

For people who already have MS, attention to modifiable health factors forms part of long-term management. NICE guidance includes exercise, reducing or stopping smoking and appropriate vaccination among considerations aimed at reducing the risk of relapse or progression.

These measures support MS management, but they should not be described as guaranteeing prevention of MS or its progression.

At Apollo Hospitals, patients with suspected or diagnosed multiple sclerosis can be assessed by specialists in neurology, with investigations and management planned according to the individual's clinical needs.

The evaluation of possible MS may involve clinical neurological assessment and appropriate diagnostic investigations. For people living with MS, care may include neurological follow-up, treatment planning, symptom management and rehabilitation depending on individual requirements.

Because MS can affect movement, vision, sensation, bladder function, cognition and other aspects of everyday life, coordinated care across relevant specialties may be needed.

Patients experiencing symptoms suggestive of a neurological disorder should seek medical assessment rather than trying to diagnose MS from symptoms alone.