What Is Multiple Sclerosis?

Transcript

Dr. Marissa McGinley:

Hi, I'm Dr. Marissa McGinley. I'm a neurologist at the Cleveland Clinic.

What is multiple sclerosis?

Multiple sclerosis is an autoimmune condition in which a person's immune system becomes dysregulated and starts to attack certain nerves in the brain and the spinal cord. And what these nerves do is they produce something called myelin, which is a coating around certain cells in the nervous system. And these cells really protect those nerves, and they provide almost like an insulation. And so when it gets damaged, they can't function as well, and they can't transmit the signals as effectively.

What are some common early symptoms of MS?

You can get a variety of symptoms in MS, and it really depends on which cells are being affected in the brain and the spinal cord. For example, if you affect the cerebellum, or the balance center of the nervous system, people can feel unsteady. Other nerves affect sensation, and so you can feel numbness, tingling. And also, if you can't feel things correctly, that can upset your balance. You can also have the nerves that affect our movements, and so people can become weak. Sometimes people will lose vision in one eye. Other times, they'll have double vision. And most of these symptoms come on very quickly over a day or two. And then these symptoms last pretty strongly for a couple of days to a few weeks and then slowly improve.

Who does MS affect?

So in the United States alone, there's nearly one million people living with MS. We really don't know what causes the disease. We think that it's a combination of factors, some genetic and some environmental. We do also see MS occurs more frequently in women and that it also affects individuals typically sort of earlier in life, so between the ages of 20 to 40.

How can living with MS impact your daily life?

When we think about some of the decreased sensations, so the numbness or trouble with weakness, this can affect how people walk. And so sometimes people need to use different types of aids to get along, or they may need to engage in some physical therapy and things like that to improve their walking abilities. Other things with hand function, it may slow you down a little bit with those fine motor movements. And then there can be some effects on cognition. Individuals with MS may take a little bit longer to process some information and then be able to respond.

What are the treatments for MS?

Currently, there's no cure for MS, and everything that we do is really about helping patients maintain their function and prevent any more relapses or approval of disability. So that's the hope with a lot of our new treatments. Major one that I think most is something called disease-modifying therapies. And so what these medications do is they're trying to calm down the immune system. But equally important are two other factors. One is rehabilitation, and the other one is lifestyle.

So when we think about rehabilitation, this is about recovering from some of those relapses, and so we think about really engaging with our physical, occupational and speech therapists. We also think of other adaptive devices and then making sure that patients have all the equipment they need to carry out functions at jobs and also at home effectively.

And then lastly, we really think about lifestyle, too. So we know that MS can worsen if you have other medical conditions. So we think it's really important that we keep people physically active, and we also think about their diet. So we're reducing the risk for these other medical conditions in addition to treating their MS.

I think it's really important for patients to understand that although the disease isn't curable, our treatments have really evolved in the last 20 years, and patients are doing remarkably well. And really, our goal is that we have them engage and do all the things with their life that they want to.