This Multiple Sclerosis Awareness Week (which runs from 25 April to 1 May 2022), IP Ability committee member and MS patient Debra Smith helps to shed light on a complex and little understood condition. This is the first of a two-part article series; look out for the second – to include some individual experiences – in the next few days [editor’s note: the second article can now be found here].
150 years after the condition was first recognised, the cause of Multiple Sclerosis (MS) is still unknown. There seems to be no one single cause, but there are several risk factors that make MS more likely to occur. The risk factors for MS are very common, and thousands of people are exposed to them every day, but only a small fraction of people will actually get MS. It’s likely that a number of these different factors need to come together to trigger it.
The most widely held theory is that MS is an autoimmune disease – where the immune system turns on the body’s own tissues. In the case of multiple sclerosis, the immune system attacks myelin, the fatty protein that covers the nerves in the central nervous system. It is thought that some people have an underlying genetic tendency to MS, but it may be triggered by other risk factors, such as a viral infection, smoking, a lack of vitamin D or a combination of these factors. Recent research has been looking at the Epstein-Barr Virus (EBV), a very common virus that causes glandular fever in some people. However, if there is a particular virus or combination of viruses that triggers MS the exact mechanism still has to be identified.
A quick summary:
- Multiple Sclerosis (MS) is a lifelong condition that affects the brain and nerves. It is caused by the immune system mistakenly attacking the brain and nerves.
- There are many symptoms of MS, but common symptoms include tiredness, vision problems and problems with walking or balance.
- Most commonly it is diagnosed in people in their 20s, 30s and 40s, although it may develop at any age and MS is the most common cause of disability in younger adults.
- For some reason it is about two to three times more common in women than men.
The four types of MS:
- Clinically Isolated Syndrome (CIS) – this is the first episode of symptoms caused by inflammation and damage to the myelin covering the nerves in the brain or spinal cord.
- Relapsing Remitting MS (RRMS) – this is characterised by symptoms followed by a remission (a period when symptoms improve or disappear). This sequence can repeat very regularly or sometimes there may be years between symptoms and remission.
- Secondary Progressive MS (SPMS) – this is characterised by worse symptoms that may or may not include some remissions.
- Primary Progressive MS (PPMS) – this is characterised by worsening neurologic function (accumulation of disability) from the onset of symptoms, without early relapses or remissions.
MS can cause a wide range of symptoms and affect any part of the body. Each person with the condition is affected differently. The symptoms are unpredictable. Some people’s symptoms develop and worsen steadily over time (PPMS), while for others they come and go (RRMS). Periods when symptoms get worse are known as relapses, flares or flare-ups. MS can manifest in many different forms, both in its degree of severity and in the myriad of symptoms which may or may not affect different people. For this reason, it is one of the conditions often given the nickname “the Snowflake disease” along with conditions such as Parkinson’s because each case is unique.
Some of the most common symptoms include:
- vision problems
- numbness and tingling
- muscle spasms, stiffness and/or weakness
- mobility problems
- problems with thinking, learning and planning
- depression and anxiety
- sexual problems
- bladder problems
- bowel problems
- speech and swallowing difficulties
Most people with MS only have a few of these symptoms and sometimes different groups of symptoms may come and go during the course of the condition.
For those interested, more information can be found on the following websites: