What is Multiple Sclerosis?

Multiple sclerosis (MS) is a neuroimmulogical disorder that affects the central nervous system. MS is characterized by inflammatory disruption of the myelin sheath (the protective covering of nerve fibers) in the brain and spinal cord, along with injury to axons, the conducting element of a nerves. This can lead to impairment of vision, movement, and sensation.

“When the immune system mistakenly attacks the myelin, the demyelinated axon does not conduct efficiently and sometimes, not at all,” said Herman Sullivan, MD, Executive Medical Director, Trinity Health Grand Rapids Hauenstein Neurosciences, and Medical Director, Multiple Sclerosis Clinic. “The resulting scar tissue – called sclerosis – is what we see in MRI images, these are the so-called lesions.”

The cause of MS is unknown; however, it is an immune-mediated disorder regulated by multiple factors, including genetic predispositions, exposure to infective organisms (especially Epstein-Barr virus, which causes mononucleosis). Vitamin D deficiency can also slightly increase the risk for developing MS.

While there are treatments that can slow the progression of MS, there is no cure.

Types of MS and Symptoms


Understanding the different MS types and associated symptoms is critical to managing the condition effectively. The clinical types of MS are:

• Relapsing MS (RMS)
• Secondary-Progressive MS (SPMS), active or inactive
• Primary-Progressive MS (PPMS)

MS can cause multiple symptoms, including fatigue, numbness or tingling sensations in the limbs, blurred vision, gait and balance problems, weakness, dyscognition (‘brain fog’), and muscle spasms. And, each type has its own symptoms, varying in severity from person to person.

Diagnosing and Treating MS


MS is challenging to diagnose because no single test confirms or rules out the condition.

“The diagnosis is made when multiple lesions develop over time. These lesions may, or may not, cause obvious signs or symptoms. The brain is always involved, but sometime spinal cord and/or optic nerves are also involved,” said Dr. Sullivan. “Because vision difficulties are common with MS, and often one of the first symptoms, our team includes neuro-ophthalmologists, specialists focusing on neurological disturbances of the visual pathway inclusive of the optic nerve.”

Tests to confirm or rule out an MS diagnosis may include:

• MRI scans to look for brain or spinal cord lesions. MRI imaging is the most sensitive test for MS
• Blood tests to rule out other conditions that could mimic MS, like Lyme disease
• Neurological examination to evaluate the neurological function
• Lumbar puncture (spinal fluid sampling) to show whether there are abnormally high levels of immune system proteins and clones of specific white blood cells
• Neuropsychological testing to assess cognitive and mood-related disturbance associated with MS

Treatment options depend on the severity of the condition and may include:

• Medications to reduce inflammation, slow down nerve damage, modify the disease course (cross link to article 2), treat relapses — also called attacks or exacerbations — and manage symptoms
• Physical therapy to improve mobility and strength
• Lifestyle changes like stress reduction or exercise programs

Coping Strategies and Managing Long-Term Effects


“People with MS may experience long-term effects such as fatigue, pain, impaired mobility, cognitive impairment and depression,” said Dr. Sullivan. “It is essential to understand these long-term effects and develop effective coping strategies that can lead to healthier lives despite their diagnosis.”

Coping strategies for people with MS involve both physical and psychological approaches:

• Staying active with exercise
• Restorative therapies like yoga or tai chi
• Lifestyle modifications like getting proper nutrition and rest
• Stress management techniques like mindfulness meditation
• Cognitive behavioral therapy (CBT)

Additionally, support groups can be a great source of emotional support for people living with MS.

Learn more about Multiple Sclerosis Care at Trinity Health.