Multiple sclerosis

Multiple sclerosis (MS) is a non-contagious chronic disease of the brain and spinal cord characterized by a variety of neurologic symptoms caused by demyelination of neurons. Multiple sclerosis results from attack by a patient's own immune system on their central nervous system and is thus categorized as an autoimmune disease.

Signs and symptoms

Individuals with multiple sclerosis may experience a wide variety of symptoms. The initial attacks are often transient, mild (or asymptomatic), and self limited. They often do not prompt a health care visit and sometimes are only identified in retrospect once the diagnosis has been made based on further attacks. The most common initial symptoms reported are: changes in sensation in the arms, legs or face (33%), complete or partial vision loss (optic neuritis) (16%), weakness (13%), double vision (7%), unsteadiness when walking (5%), and balance problems (3%). Fifteen percent of patients have multiple symptoms when they first seek medical attention. {{an|Paty}} Most people find their initial MS symptoms occur over a period of hours to weeks. For some people the initial symptoms are preceded by infection, trauma or strenuous physical effort.

Related Topics:
Sensation - Optic neuritis - Double vision - Infection - Trauma

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Other symptoms and physical findings common in multiple sclerosis are flickering eye movements, speech difficulties, tremor, clumsiness of the hands, abnormal muscle spasms, bladder and bowel difficulties, and sexual dysfunction. Cognitive impairments are also common, such as difficulty performing multiple tasks at once, difficulty following detailed instructions, loss of short term memory, emotional instability, and fatigue. Emotional aspects are common and can either be a normal response to a debilitating disease or a result of involvement of emotional control systems by MS. The most common condition, depression, is product of both causes. Feelings such as anger, anxiety, frustration, and hopelessness are common and suicide is a very real threat.

Related Topics:
Flickering eye movements - Tremor - Abnormal muscle spasms - Sexual dysfunction - Short term memory - Emotional instability - Fatigue - Depression - Anger - Anxiety - Frustration - Suicide

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Three clinical entities warrant further discussion because of the frequency with which affected patients are later diagnosed with MS.

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• Optic neuritis

:Patients typically experience rapid onset of pain followed by blurry vision in part or all of the visual field in one eye. This is a result of involvement of the optic nerve by MS. At least 15% and as many as 75% of patients who have an episode of optic neuritis go on to develop MS. Blurred vision typically resolves by six months, but patients are often left with less vivid color vision (especially red) in the affected eye.

Related Topics:
Pain - Vision - Visual field - Eye - Optic nerve - Color vision

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• Internuclear ophthalmoplegia

:Patients usually notice double vision (diplopia), especially when looking to one side. This is the result of failure of the lateral rectus muscle to contract appropriately, leading to independent movement of the eyes (disconjugate gaze) and the symptom of diplopia. Internuclear ophthalmoplegia results from MS affecting a part of the brain stem called the medial longitudinal fasciculus which is responsible for communication between the two eyes.

Related Topics:
Diplopia - Lateral rectus muscle - Disconjugate - Brain stem - Medial longitudinal fasciculus

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• Transverse myelitis

:Patients typically develop rapid onset of numbness, weakness, bowel/bladder dysfunction, and/or loss of motor function, typically in the lower half of the body. This is the result of MS attacking the spinal cord. As many as 80% of patients are left with lasting disabilities even though there is usually some improvement during the first two years.

Related Topics:
Numbness - Bowel - Bladder - Motor - Spinal cord

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