Multiple Sclerosis: What You Need to Know
By Brett Alldredge, DO
Mar 12, 2021
Updated Nov 17, 2023
5 min read
Multiple sclerosis, or MS, is a disease that affects the brain and spinal cord. It can cause problems with vision, balance, sensation, and muscle control. This disease affects everyone differently. Some people have mild symptoms while others have debilitating symptoms that prevent them from doing daily tasks.
Multiple sclerosis occurs when the immune system attacks the nerves in your brain or spinal cord. When the nerves become damaged the brain isn’t able to send signals through your body correctly.
Relapsing MS is characterized by the unpredictable occurrence of new attacks. These attacks are sometimes also called an exacerbation, a relapse, or flare. An attack involves new neurological signs and symptoms, which typically develop over a few days and subside or completely resolve over the ensuing weeks and months.
The most common symptom of an MS attack is numbness or sensory loss. Numbness occurs when the immune system attacks an area of the brain conducting sensory information to the body. If an attack occurs in an area of the brain transmitting motor information to the limbs, a person may experience weakness in the limbs. Double vision or dizziness may also occur from an MS attack.
In patients who have MS it is important to distinguish a true attack from a pseudoexacerbation. A pseudoexacerbation is when signs and symptoms from an old attack can worsen or reemerge from other causes. Common causes for pseudoexacerbation include a new illness, elevated body temperature, fatigue, stress, and pain.
Multiple sclerosis is a clinical diagnosis made when there is evidence of immune system attacks on the brain and spinal cord. A neurologist looks for evidence of these attacks in a person's symptoms, examination, and MRI scans. Attacks typically leave scars in the brain that are visualized on MRI. Scars from MS have a characteristic appearance and pattern that must be carefully discerned from other causes. The presence of inflammatory and protein markers in the cerebrospinal fluid can also help support the diagnosis.
MS attacks are treated with high dose steroids over 3-5 days. Treating attacks with steroids helps decrease the duration and intensity of symptoms.
Disease modifying therapy (DMT) is central to the care of people with multiple sclerosis. DMTs are the best strategy to alter the course of MS. Clinical studies have demonstrated that DMTs:
Until recent years, only a few injectable medications were available to prevent MS attacks. Now there are many additional medications and these are more effective at preventing attacks. Some medications are oral pills and others are infusions.
Management of MS also includes treating unresolved symptoms from prior attacks. For example:
Dr. Brett Alldredge is a neurologist at the McKay-Dee Neurology Clinic. He specialists in the diagnosis and management of multiple sclerosis. He also provides general neurology care, including treatment for Alzheimer’s disease, Parkinson’s disease, headaches, and stroke.