Multiple sclerosis (MS) is an immune disorder that primarily affects the central nervous system, so it’s also a neurological disorder.
Read on to learn more about how MS affects the central nervous system, what to do if you suspect you have it, and what types of doctors diagnose and treat MS.
MS involves an immune system attack within the central nervous system, making it a neurological disorder. MS is the most common disabling neurological disease of young adults, according to the
In MS, the immune system mistakenly attacks myelin in the brain and spinal cord. Myelin is a substance that coats and protects nerve fibers. Nerve fiber pathways are needed to send electrical signals within the central nervous system.
Loss of myelin is called demyelination, a process that makes it difficult for electrical signals to get through. This disruption in electrical impulses can lead to a long list of potential symptoms.
Repeated attacks on myelin cause the formation of scar tissue, or sclerosis, which is how the disease gets its name. These areas are also called plaques or lesions.
Common symptoms of MS
Symptoms vary from person to person, depending on which nerve pathways are involved. Some common early symptoms of MS are:
- blurry vision or double vision
- optic neuritis
- numbness and tingling
- muscle weakness, stiffness, and spasms
- balance and coordination difficulties
- bladder problems
Some people may experience flare-ups of disease activity followed by remissions.
In MS, the immune system attacks myelin in the central nervous system. What triggers this process is not clear.
We do know that MS is not contagious or directly inherited.
According to the
Risk factors are things that increase the chances of having MS. Having one or more MS risk factors doesn’t mean you’re destined to have it. And you can get MS even if you have no known risk factors.
Here are some things that may affect your risk of MS:
- Age. Symptoms usually start between the ages of
20 and 40, though they can begin in childhood or in later years.
- Sex. MS affects 2 to 3 times as many women as men.
- Genetics. There’s no specific gene known to cause MS. But
researchsuggests that different combinations of 233 genes may be associated with an increased risk of developing MS.
- Family history. While MS is not directly inherited, the risk is increased if you have first degree relatives who have MS.
- Other autoimmune disorders. Co-morbidities, especially autoimmune disorders, are common in people with MS. However, there’s no evidence of cause and effect.
Environmental factors that may contribute to the development of MS include:
- viruses and other infections
- vitamin D deficiency
If you suspect you have MS, keep in mind that it’s
1. Start a detailed log of symptoms
Start a detailed log of all your symptoms, even if they seem unrelated. This will provide a timeline of possible relapses and remissions that can help with the diagnosis.
2. Make a doctor’s appointment
Make an appointment to see a doctor. You can start with a primary care physician. If the doctor also suspects MS, they will most likely refer you to a neurologist. Arrange to have your medical records sent over before your visit with a neurologist. That should include relevant laboratory tests, imaging scans, and clinical notes.
3. Prepare to answer the following questions
You’ll also need to provide a lot of information, so it helps to be prepared to answer questions such as:
- What are your symptoms?
- When did symptoms start and how long have they lasted? Do they come and go?
- Have you noticed anything that triggers these symptoms?
- Have you found anything that makes you feel better?
- Have you seen a doctor for these or similar symptoms in the past?
- Do you have a diagnosis for any other underlying conditions?
- Do you take over-the-counter (OTC) medications, prescription medications, or dietary supplements? How often and in what dosages?
- Has anyone in your family ever been diagnosed with a neurological or autoimmune disease?
4. Discuss diagnostic testing with your doctor
After a neurological examination, diagnostic testing may include:
- MRI of the brain and spinal cord, with and without contrast dye
- lumbar puncture (spinal tap)
- blood tests
- evoked potential tests to measure the brain’s activity
Misdiagnosis can be a problem.
The path to diagnosis involves careful evaluation and ruling out other diseases, which can take time. Along the way, you might feel frustrated, but it’s important to get the correct diagnosis.
If you receive an MS diagnosis, you’ll want to have a care team in place. MS is a chronic condition. You’ll have it for the rest of your life, but there’s no way to predict how it will progress. There are many medical professionals who treat MS or help with symptoms. Your primary team should consist of:
- neurologist: a doctor who treats disorders of the central nervous system, some of whom specialize in MS
- primary care doctor: to oversee and coordinate all your healthcare
Depending on your specific needs, here are some more MS providers who may be of help:
- ophthalmologist: for vision problems and disorders of the eyes
- neuro-ophthalmologist: for treatment of eye problems related to the central nervous system
- urologist: for urinary tract problems
- rehabilitation specialists: physical therapist, occupational therapist, speech-language pathologist
- mental health specialists: psychologist, psychiatrist, therapist, social worker
- pharmacist: to dispense medication, provide education on side effects and risks, and monitor for potential drug interactions
MS is considered a neurological disorder as well as an immune disorder. It starts when the immune system mistakenly attacks myelin, the protective coating around nerve fibers. This interferes with electrical signals, making it difficult for the brain to communicate with the rest of the body.
MS is typically treated by a neurologist. But it’s also important to have a primary care physician to coordinate all your care. Other specialists can be added to your team as needed.