Multiple Sclerosis -- Adult
- Relapsing-remitting MS—Symptoms suddenly reappear periodically. They last for a few weeks or months, then go back into remission (a period with no symptoms). Symptoms may get worse with each occurrence.
- Primary progressive MS—Symptoms gradually worsen after symptoms first appear. Relapses and remissions usually do not occur.
- Secondary progressive MS—After years of relapses and remissions, symptoms suddenly begin to progressively worsen.
- Progressive relapsing MS—Symptoms gradually worsen after symptoms first appear. One or more relapses may also occur.
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- Viral or other infection
- Genetic factors (heredity)
- Environmental factors
- Breaking down of parts of the nervous system
- Sex: female
- Age: 15-50 years old
- Being exposed to certain viruses
- Having family members who have MS or other autoimmune disorders
- Being of Northern European descent
- Growing up in a colder climate, as opposed to a tropical climate
- Having certain immune system genes
- Having inflammation of the optic nerve
- Numbness or tingling in the face or limbs
Impaired vision in one or both eyes, including:
- Blurred vision
- Double vision
- Loss of vision
- Eye pain
- Muscle stiffness
- Muscle spasms
- Muscle weakness
- Incoordination or falling
- Trouble walking or maintaining balance
- Weakness in one or more limbs
Bladder problems including:
- Incomplete emptying
- Bowel problems, including constipation
- Sexual dysfunction
- Slurred speech
- Difficulty swallowing
- Forgetfulness, memory loss, and confusion
- Difficulty concentrating or solving problems
- Hot weather
- Hot baths or showers
- Overexertion—intense physical activity
- MRI scan—a test that uses magnetic waves to make pictures of structures inside the brain and spinal cord
- Sensory evoked potentials—a test that records the electrical responses evoked after a sensory stimulus
- Lumbar puncture (spinal tap)—removal of a small amount of cerebrospinal fluid (CSF) from around the spinal cord to check for white blood cells, antibodies, and proteins
- Blood tests to rule out other diseases that may mimic MS (such as, B12 deficiency, Lyme disease, autoimmune disease)
- Visual evoked potential test—to look for problems in the brain that affect vision
- Interferon beta (such as Betaseron, Avonex, Rebif)—(a protein that naturally occurs in the body)—used to suppress the immune system
- Glatiramer acetate (Copaxone)—to help prevent MS relapses by modifying the function of the immune system
Other immunosuppressive drugs, such as:
- IV immunoglobulin (IVIG)
- Cyclophosphamide (Cytoxan)
- Mitoxantrone (Novantrone)
- Azathioprine (Imuran, Azasan)
- Methotrexate (Rheumatrex, Trexall)
- Natalizumab (Tysabri)—for relapsing-remitting MS (This medicine is under a mandatory registration program.)
- Muscle relaxants—to treat muscle spasms or stiffness
- Fingolimod (Gilenya)—a new oral medicine to reduce relapses and slow the progression of MS
Physical Therapies and Lifestyle Changes
- Regular moderate exercise with your doctor's permission—Swimming may be especially beneficial.
- Physical therapy to help maintain muscle strength and tone, dexterity, and walking ability
- High-fiber diet to prevent constipation
- Stress reduction techniques
- Quitting smoking—Smoking may worsen MS, causing the condition to progress to a more severe form.
- Take medications as prescribed.
- Avoid hot weather.
- Stay in air-conditioned places during periods of hot weather.
- Get adequate rest.
- Get regular, moderate exercise with your doctor's permission.
- Avoid hot showers or baths.
- Make sure to get enough fiber in your diet.
- To aid in stress reduction, consider getting regular massages.
Try to avoid infection. You can do this by:
- Practicing good hygiene
- Staying away from people who are sick
- Cooking food thoroughly
- Practicing safe sex
Multiple Sclerosis Association of America http://www.mymsaa.org
National Multiple Sclerosis Society http://www.nationalmssociety.org
Health Canada http://www.hc-sc.gc.ca
Multiple Sclerosis Society of Canada http://mssociety.ca
About MS. National Multiple Sclerosis Society website. Available at: http://nationalmssociety.org/about-multiple-sclerosis/index.aspx. Accessed August 31, 2012.
Ascherio A, et al. Vitamin D and multiple sclerosis. Lancet Neurol. 2010;9(6):599-612.
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FDA approves Ampyra to improve walking in adults with multiple sclerosis. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm198463.htm. Published January 22, 2010. Accessed August 30, 2012.
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Multiple sclerosis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 10, 2012. Accessed August 31, 2012.
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Multiple Sclerosis. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/multiple%5Fsclerosis/multiple%5Fsclerosis.htm. Accessed August 31, 2012.
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Van der Mae IA, et al. Individual and joint action of environmental risk factors and MS. Neurol Clin. 2011;29:233-55.
1/4/2011 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Healy B, Ali E, Guttmann C, et al. Smoking and disease progression in multiple sclerosis. Arch Neurol. 2009;66(7):858-864.
1/4/2011 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: FDA approves Botox to treat spasticity in flexor muscles of the elbow, wrist and fingers. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm203776.htm. Updated March 9, 2010. Accessed March 19, 2010.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: US Food and Drug Administration. FDA approves first oral drug to reduce MS relapses. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm226755.htm. Published September 22, 2010. Accessed September 24, 2010.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Kang JH, Sheu JJ, Kao S, Lin HC. Increased risk of multiple sclerosis following herpes zoster: a nationwide, population-based study. J Infect Dis. 2011;204(2):188-92.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2012 -
- Update Date: 00/93/2012 -