What Is Multiple Sclerosis?

Multiple Sclerosis (MS) is one of the most common neurological diseases of young adults and affects an estimated 2.3 million people worldwide including more than 130,000 in the UK and almost 1,000, 000 in the USA.

MS is the result of damage to a substance called myelin. Myelin is a protective protein and lipid sheath surrounding many of the nerve fibres in the body. It acts much like the covering of an electric wire and enables high speed conduction of electrical impulses and signals along the nerves throughout the body. It is the speed with which these impulses are transmitted that permits smooth, rapid and co-ordinated movements to be performed. When myelin is damaged, messages are slower, distorted, or non-existent.

MS occurs when myelin is damaged in the central nervous system (the brain, spinal cord and optic nerve). This damaged myelin interrupts the nerve conduction leading to various symptoms of MS depending on where the nerves are and what their function normally is. The areas where myelin is lost or damaged are known as plaques or lesions. These lesions cause scars to form and the term Multiple Sclerosis literally means “many scars”.

Scientists know about the different types of MS and how they develop, but they are still not sure why. They have plenty of clues about the causes, but still cannot quite piece them together. Treatments are available to help manage the symptoms, and new ones are being developed which have an impact on the course of the condition.

What Causes Multiple Sclerosis?

Although the exact cause of MS is not known, it is now considered to be an “Autoimmune” condition which occurs when our immune system fails to recognise a part of our own body and attacks it even though it may be healthy.

The big question for scientists is to discover what triggers the immune system to work incorrectly. There are many factors which may be associated with this and there is much research being undertaken worldwide into all of these.

Some of the factors are: a previous viral infection (such as the Epstein Barr Virus which causes Glandular Fever), a lack of vitamin D, smoking, teenage obesity or the genetic makeup of a person.

Who Gets MS?

MS is often a disease of young adults with the majority being diagnosed between the ages of 20-50 years old. Although it can occur in children, this is rare. MS is more than twice as common in women than men. Although it is not inherited, there is a slightly higher risk for someone if it has already occurred in their family. The incidence of MS is much higher the further north and south you travel away from the equator. This may be due to the temperate climate in these areas or reduced sunlight exposure there. The country with the highest rate of people with MS is Canada.

What are the types of MS?

MS shows up differently in each person. Some people with MS are only mildly affected throughout their lives and at the other extreme are those who deteriorate rapidly from the beginning and can have a shortened life span. Most people with MS experience something in between these two scenarios.

There are three main types of MS and there is a great deal or variability within each of them:

• RELAPSING-REMITTING MS

  About 85% of those with MS start with this type which means they have attacks (relapses) followed by remissions. During a relapse new symptom may occur or previous ones return. A relapse may last hours, days, weeks or months and vary in severity, sometimes requiring hospitalisation. The attack settles and is then followed by a period of remission.

  There is also a Benign form of MS. This starts with a small number of mild attacks followed by complete recovery. It does not worsen over time and there is no permanent disability. People can only be classified as having benign MS when they have little sign of disability 15 years after the original onset. Around 5-10% of people with MS have the benign form.

 

• SECONDARY PROGRESSIVE MS

  Many people who start out with relapsing-remitting MS develop a form known as secondary progressive MS. This means that either the disability does not go away after a relapse and progressively worsens between them, or that the attacks disappear and instead there is a steady progression of disability. Many people with RRMS will develop the secondary progressive type usually about 15-20 years after the initial onset of MS.

 

• PRIMARY PROGRESSIVE MS

  Some people with MS never have distinct relapses and remissions. From the start they experience steadily worsening symptoms and progressive disability. This may level off at any time or may continue to get worse. Around 15% of people with MS have the primary progressive form of the disease.

What are the symptoms of MS?

The course of MS is unpredictable. Some people are minimally affected by the disease while others have rapid progress to total disability. Every individual will experience a different combination of symptoms depending on which areas of the central nervous system have been affected. There is not a typical set of symptoms that applies to everyone and they can vary in severity and duration.

Symptoms may start with visual problems such as double or blurred vision or pain at the back of the eye . Lethargy is also very common. Some people experience hearing problems, tingling or numbness, giddiness, or loss of balance. Others find it hard to concentrate and may become forgetful, or experience anxiety or depression or changes in behaviour. Other affected areas are those controlling sensation, strength, speech and swallowing, bladder control and sexuality. There may be nothing wrong with the actual muscles or sensory organs; it is simply that not all the right messages are getting through.

What’s being done through research?

There is on-going research worldwide looking to further understand the causes of MS, the processes involved in MS, the management and treatment of MS and the search for a cure.

Since AIMS2CURE was founded in 1999 it has funded research in all these areas at various leading institutions in London and Oxford and continues to do so.