What Is Multiple Sclerosis? How Is It Treated? (video/podcast)

MS is a lifelong condition that most often begins in adults in their 20s and 30s and is three times more common in women. It develops when the body’s own immune system mistakenly attacks myelin, which is the insulation around the nerve cells in the brain and the spinal cord. As a result, those nerves don’t conduct their electrical signals as well as they should. This “short circuit” of the central nervous system potentially affects any function of the brain or spinal cord.

This is why the symptoms of MS can be so different from person to person. If MS attacks the optic nerve, it can lead to symptoms ranging from loss of vision or blurry vision in one eye to complete blindness in that eye. MS can also affect movement and sensation in the arms and legs, balance, coordination, urinary continence, speech and voice, cognitive function and more.

“MS appears as spots or scars in the brain from these immune attacks. Where those scars are is what determines the symptoms of the disorder,” explains Dr. Goodrich. “It really comes down to which parts of the brain or spinal cord are impacted in any specific person.”

Moreover, symptoms can come and go. Most people with MS have what is called “relapsing remitting” MS. A relapse is the period of time during which they experience a new neurologic symptom, followed by a remission period where symptoms are quiet until the next relapse. 

“Symptoms of a typical relapse will become apparent over the course of a day or so, and can last an indefinite amount of time,” says Dr. Goodrich. “Our goal when someone is having a relapse is to treat them acutely with steroids to try to get them to recover more quickly.”

Usually, the relapsing phase will naturally quiet down as people age. By the mid-60s, new relapses are rare.

Because so many MS symptoms can be caused by other conditions, it can be challenging to diagnose the disease based on symptoms alone. A brain MRI scan is typically needed to see the spots or lesions that indicate MS.

In the past, MS was a much more progressive disorder, and newly diagnosed patients could expect to be significantly disabled within 10 years. Fortunately, treatments have evolved over the years to change the prognosis.

Various MS medications can slow down an overactive immune system to control the disease and help prevent further attacks. The treatment plan also addresses symptoms that developed before the person started medication or was even diagnosed. This may involve physical therapy, pain management, diet and other lifestyle changes.

Dr. Goodrich encourages anyone who experiences new symptoms like numbness or movement problems, balance problems or vision issues to talk to their doctor. MS is highly treatable, and the earlier treatment begins, the better the outcome and quality of life.

“These days when I meet a patient who’s been newly diagnosed with MS, I tell them that with the disease modifying therapies we now have, my goal is that it never affects them any more than it does in that moment in clinic,” says Dr. Goodrich. “Now, we can expect newly diagnosed patients to have a fairly normal life.”

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