Multiple sclerosis is a disease that may affect any area of the brain and spinal cord. Multiple sclerosis does not affect nerve cells. Multiple sclerosis affects transmission of electrical signals to nerve cells. Multiple sclerosis is the most common cause of chronic neurological disability in young adults. Multiple sclerosis is not contagious. As multiple sclerosis progresses, problems of sight become serious, such as dimness of vision, partial blindness, double vision, and the inability to control the movement of the eyeball. Multiple sclerosis is also called MS.

Complications of Multiple Sclerosis

In some cases, people with multiple sclerosis may also develop:

• Muscle stiffness or spasms
• Paralysis, most typically in the legs
• Problems with bladder, bowel or sexual function
• Mental changes, such as forgetfulness or difficulties with concentration
• Depression
• Epilepsy

Causes of Multiple Sclerosis

• Multiple sclerosis is an autoimmune disease, where the body's immune system attacks its own tissues. In multiple sclerosis, this process destroys myelin — the fatty substance that coats and protects nerve fibers in the brain and spinal cord.
• Myelin can be compared to the insulation on electrical wires. When myelin is damaged, the messages that travel along that nerve may be slowed or blocked.
• Doctors and researchers don't understand exactly why multiple sclerosis occurs in some people and not others. A combination of factors, ranging from genetics to childhood infections, may play a role.

Signs & Symptoms of Multiple Sclerosis

Signs and symptoms of multiple sclerosis vary widely, depending on the location of affected nerve fibers. Multiple sclerosis signs and symptoms may include:

• Numbness or weakness in one or more limbs, which typically occurs on one side of your body at a time or the bottom half of your body
• Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement (optic neuritis)
• Double vision or blurring of vision
• Tingling or pain in parts of your body
• Electric-shock sensations that occur with certain head movements
• Tremor, lack of coordination or unsteady gait
• Fatigue
• Dizziness

Most people with multiple sclerosis, particularly in the beginning stages of the disease, experience relapses of symptoms, which are followed by periods of complete or partial remission. Signs and symptoms of multiple sclerosis often are triggered or worsened by an increase in body temperature.

Diagnosis of Multiple Sclerosis

There are no specific tests for multiple sclerosis. Ultimately, the diagnosis relies on ruling out other conditions that might produce similar symptoms. Your doctor may base a multiple sclerosis diagnosis on the following:

Blood tests

Analysis of your blood can help rule out some infectious or inflammatory diseases that have symptoms similar to multiple sclerosis.

Spinal tap (lumbar puncture)

In this procedure, a doctor or nurse removes a small sample of cerebrospinal fluid from within your spinal canal for laboratory analysis. This sample can show abnormalities associated with multiple sclerosis, such as abnormal levels of white blood cells or proteins. This procedure can also help rule out viral infections and other conditions that can cause neurological symptoms similar to those of multiple sclerosis.

MRI

This test uses a powerful magnetic field and radio waves to produce detailed images of internal organs. MRI can reveal lesions, indicative of the myelin loss caused by multiple sclerosis, on your brain and spinal cord. However, these types of lesions can also be caused by other conditions, such as lupus or Lyme disease, so the presence of these lesions isn't definitive proof that you have multiple sclerosis.

During an MRI test, you lie on a movable table that slides into a large, tube-shaped machine, which makes loud tapping or banging noises during the scans. Most MRIs take at least an hour. While the test is painless, some people feel claustrophobic inside the machine. Your doctor can arrange for a sedative if necessary.

You may also receive an intravenous dye that may help highlight "active" lesions. This helps doctors know whether your disease is in an active phase, even if no symptoms are present. Newer MRI techniques can provide even greater detail about the degree of nerve fiber injury or permanent myelin loss and recovery.

Evoked potential test

This test measures the electrical signals sent by your brain in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli, in which short electrical impulses are applied to your legs or arms.

Treatments of Multiple Sclerosis

There is no cure for multiple sclerosis. Treatment typically focuses on combating the autoimmune response and managing the symptoms. Some people have such mild symptoms that no treatment is necessary.

Medications

Drugs that are commonly used for multiple sclerosis include:

• Corticosteroids. The most common treatment for multiple sclerosis, corticosteroids reduce the inflammation that spikes during a relapse. Examples include oral prednisone and intravenous methylprednisolone.
• Interferons. These types of drugs — such as Betaseron, Avonex and Rebif — appear to slow the rate at which multiple sclerosis symptoms worsen over time. But interferons can cause serious liver damage.
• Glatiramer (Copaxone). Doctors believe that glatiramer works by blocking your immune system's attack on myelin. You must inject this drug subcutaneously once daily. Side effects may include flushing and shortness of breath after injection.
• Natalizumab (Tysabri). This drug is designed to work by interfering with the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. Tysabri is generally reserved for people who see no results from or can't tolerate other types of treatments. This is because Tysabri increases the risk of progressive multifocal leukoencephalopathy — a brain infection that is usually fatal.
• Mitoxantrone (Novantrone). This immunosuppressant drug can be harmful to the heart, so it's usually used only in people who have advanced multiple sclerosis.

Therapies

A physical or occupational therapist can teach you stretching and strengthening exercises, and show you how to use devices that can make it easier to perform daily tasks.

Procedures

Plasma exchange (plasmapheresis) looks a little like dialysis as it mechanically separates your blood cells from your plasma, the liquid part of your blood. Plasma exchange is sometimes used to help combat severe symptoms of multiple sclerosis relapses, especially in people who are not responding to intravenous steroids.