Multiple sclerosis, complex and debilitating disease, affects an estimated 2.3 million people worldwide.  This disease affects and its severity covers a wide spectrum from being relatively benign cases to the devastatingly disabling, bringing partial or complete paralysis to the body.  According to the National Institutes of Health (NIH), somewhere between 250,000 and 350,000 people in the US have been diagnosed with multiple sclerosis (MS). It’s a complex disease to diagnose, and so many people must live with their chronic disease untreated until doctors can rule out all other possibilities. 

MS is a condition in which the body’s immune system targets its own central nervous system – the brain, spinal cord and optic nerves. The precise target that the immune system attacks – the antigen – is unknown, leading experts to regard MS as “immune-mediated” rather than an “autoimmune” disease. 

When MS attacks the central nervous system, a fatty substance that protects the nerve fibers called myelin is damaged, along with the nerve fibers themselves. After becoming damaged, myelin forms scar tissue, in a process known as sclerosis. This damage leads to disruption and interruption of electrical signals being transmitted throughout the central nervous system, and it is this effect that MS has on the nerve impulses that produces the symptoms of the disease. 

People with MS can experience a wide range of symptoms. The National MS Society (NMSS) emphasize the point that no two people have exactly the same MS symptoms, and each person’s symptoms can change or fluctuate over time. 

Due to the role the central nervous system has in the body, many areas can be affected by the disease. Common symptoms include fatigue, walking difficulties, vision problems, bladder problems, pain and cognitive changes. One of the characteristic features of this disease is that they have “invisible symptoms.”

Due to the presence of invisible symptoms, some people with MS may appear to be much healthier than they are. Others might not be aware of symptoms they are inwardly struggling with, and, therefore, might have unreasonable expectations of the person with MS. 

The NMSS describes the different types of disease courses in MS:

• Relapsing-remitting (RRMS) – around 85% of people with MS are believed to have this form, characterized by clearly defined flare-ups (relapses) of worsening symptoms, followed by periods of partial or complete recovery (remissions). During remission periods, no disease progression is apparent.

• Secondary-progressive (SPMS) – many people transition to this form of the disease, whereby MS begins to progress more steadily, with or without periods of remission.
• Primary-progressive (PPMS) – around 10% of people are believed to have this form of MS, characterized by neurologic function steadily worsening over time. While there may be temporary improvements from time to time, there are no distinct relapses or remissions.
• Progressive-relapsing (PRMS) – the least common disease course, whereby MS is characterized by steadily worsening neurologic function with occasional relapses occurring from time to time. In PRMS, the disease continues to progress without remissions.

The prospect of an MS diagnosis can be a daunting one, and not just because of the symptoms that can potentially be experienced. At present, there is no known cure for MS, although studies often claim to offer hope.