Multiple Sclerosis

Multiple sclerosis is an immune-mediated disease in which the immune system targets for destruction the insulation (myelin sheath) of the brain, optic nerves and spinal cord, resulting in areas of loss of myelin (demyelination), also called plaques. The plaques, visible on MRIs of the brain and spinal cord, are responsible for the symptoms. 

Most patients experience attacks of symptoms (exacerbations), including visual loss, numbness, abnormal walking, urinary symptoms, followed in days or weeks by full or at least partial improvement (remissions). A small number of patients do not have exacerbations at all, but instead experience a slow worsening (progression) from the onset of their symptoms. Because the symptoms are variable, it is sometimes difficult to make the diagnosis promptly.

Because the symptoms of multiple sclerosis can differ greatly from person to person, it may be difficult to make a diagnosis. The most common symptoms of MS include:

• Numbness
• Weakness
• Spasticity (constant muscle contraction or spasms)
• Difficulty walking (gait)
• Bladder problems
• Cognitive and memory problems
• Speech disorders
• Vision problems

Having any of these symptoms does not mean you have multiple sclerosis. Many of these symptoms can be caused by other conditions. But if you do have these symptoms, make an appointment with your physician to find the cause and appropriate treatment.

During an evaluation for multiple sclerosis, your neurologist will conduct an examination to look for signs of damage, such as abnormal changes or plaque on the brain, spinal cord and optic nerves. The doctor also will rule out other diseases and conditions with similar symptoms.

Following a complete medical history review, tests to diagnose multiple sclerosis include:

• Magnetic resonance imaging (MRI)
• Blood work to rule out other health problems that might mimic MS

Some patients may require other tests, such as:

• Spinal tap to analyze cerebral spinal fluid
• Evoked potential tests, which are a series of tests designed to induce a brain response to visual or audio stimulation or stimulation to the arms or legs (increased response times can indicate damage to the neural pathways connecting the senses to the brain)

We take a comprehensive and collaborative approach to treating multiple sclerosis. Our neurologists, physicians, therapists and other professionals work together to provide personalized care for every patient. The earlier treatment is started, the more effective it may be. 

We offer a full range of treatments, including:

• Medications to treat the symptoms of MS
• Disease-modifying medications to stop progression of the disease
• Occupational therapy, physical therapy and speech therapy to address rehabilitative needs
• Counseling designed to improve coping skills and adjustments with a diagnosis of multiple sclerosis
• Special evaluations for patients with memory and other cognitive problems

In addition, complementary therapies from Scripps Center for Integrative Medicine are available for patients interested in blending traditional MS treatments with complementary approaches.

For many people living with multiple sclerosis, the greatest challenge is managing day-to-day living. While multiple sclerosis cannot be cured, rehabilitation can help manage symptoms such as numbness and tingling, weakness, tremors, visual loss, fatigue, depression, spasticity, and bladder, bowel or sexual problems. The goal of rehabilitation is to help relieve symptoms and compensate for some of the physical and neurological problems caused by the disease. 

Scripps Health offers comprehensive outpatient rehabilitation therapy for people with MS by therapists who are specially trained to care for people with neurological conditions. Many of our expert physical, occupational and speech therapists have advanced certifications, including neuro-developmental treatment (NDT) certification and neurological clinical specialists (NCS).

Scripps Health offers multiple sclerosis treatment and rehabilitation at the following locations in San Diego County:

• Scripps Clinic Carmel Valley
• Scripps Clinic La Jolla
• Scripps Clinic Rancho Bernardo
• Scripps Clinic Torrey Pines
• Scripps Encinitas Rehabilitation Services
• Scripps Memorial Hospital La Jolla