Multiple Sclerosis

MS is believed to be autoimmune in nature. This means that the body’s own immune system attacks healthy tissues and cells. In the case of MS, the immune system attacks myelin, the central nervous system’s protective covering. This causes inflammation and damage, which can interrupt or distort the transmission of nerve impulses (messages) and cause a range of symptoms. People are often diagnosed between the ages of 15 and 40, but MS can develop at any age. It is diagnosed in women three times as often as it is in men.

The cause of MS is unknown. Researchers are exploring genetic, biological, environmental and lifestyle factors that may play a role. While MS is not yet curable, disease-modifying therapies and improved symptom management have enabled most people with this condition to have a normal or near-normal life span, and there is reason for optimism as research continues to unravel the secrets of MS.

Symptoms

Symptoms vary depending on which parts of the central nervous system are affected. Symptoms can also change within the same person over time. People living with MS may experience:

• Fatigue
• Balance problems or dizziness
• Poor coordination
• Muscle weakness
• Sensory impairment (numbness, tingling)
• Increased sensitivity to heat
• Vision problems
• Spasticity
• Tremors
• Speech or swallowing difficulties
• Pain
• Sexual dysfunction
• Bladder and bowel problems
• Cognitive impairment, such as memory problems

Many of these symptoms can be managed with interventions such as medication, rehabilitation therapies, mobility aids or lifestyle changes.

Diagnosis

There isn’t a single test for MS. Physicians consider a patient’s medical history and perform a neurological exam and perhaps other tests, such as magnetic resonance imaging (MRI), to find evidence of disease activity and rule out other health conditions.

There are four types of multiple sclerosis:

• Relapsing-remitting (RRMS): This type alternates between periods of recovery and relapse (attacks, flare-ups or exacerbations of symptoms). During relapses, existing symptoms can worsen and new symptoms may appear. About 85% of people who have MS are diagnosed with this type.
• Secondary-progressive (SPMS): This diagnosis occurs when symptoms of relapsing-remitting MS worsen, and the recovery and relapse periods become less distinct. According to the Multiple Sclerosis Society of Canada, about half of people with relapsing-remitting MS experience a worsening of symptoms within 10 to 20 years of diagnosis.
• Primary-progressive (PPMS): In this type of MS, symptoms become progressively worse from the beginning, with growing disability. There may be stable periods or temporary improvement, but no remission. About 10% of people with MS have this type.
• Progressive-relapsing (PRMS): This is the rarest type, affecting about 5% of people with MS. The disease worsens steadily from the beginning, with or without periods of recovery.

Treatments

Treatment for MS is individualized and may include different types of therapies.

Relapse management therapies suppress the inflammation that causes attacks, reducing their severity and duration and preventing further damage to nerve fibres. Disease-modifying therapies, available for relapsing-remitting and secondary-progressive MS, can slow progression and reduce relapses. Other medications can help manage symptoms such as pain or fatigue. (Learn more about treatments from the MS Society.)

Some people with MS use complementary and alternative medicine (CAM); however, these therapies are not well supported by scientific research. People with MS are wise to discuss CAM with their physicians before trying it.

Benefits of healthy living

While there is not yet a cure for MS, there is much that people can do to improve their overall well-being:

• Exercise: Physical activity can boost energy and improve balance and cognitive function. Adults with MS should aim for 30 minutes of moderate-intensity aerobic activity twice a week, alternated with strength training for major muscle groups. The MS Society offers resources and tips online.
• Nutrition: Strive for a diet that is rich in vegetables, fruits, whole grains and fish, and also low in sugar, salt and red meat (which have been linked to inflammation). For guidance on food choices and portion sizes, consult Canada’s Food Guide or talk to a registered dietitian.
• Smoking: Smoking increases the likelihood of accelerating the progress of MS from RRMS to PPMS. Talk to your physician about quitting and take advantage of free resources for smoking cessation (see “Additional resources”).
• Mental health: About half of people with MS experience clinical depression. Medication, support groups and counselling can help.

Many people with MS find it beneficial to receive rehabilitation therapy, such as physiotherapy, to maintain or improve mobility and physical function. Speech/language pathologists can help with problems with speaking or swallowing, and mental health professionals can assist with mood and cognitive issues.

Bayshore is pleased to provide health information to our clients and their families and caregivers. This information is not medical advice and should not be treated as such. For more information on multiple sclerosis, please consult your doctor.

Additional Resources

Multiple Sclerosis Society of Canada
https://mssociety.ca/
1-800-268-7582
This is your best source for up-to-date MS information.
Visit the website for support and services, physical activity guidelines, research news and ways to get involved.

The Lung Association: Quit Now
https://quitnow.ca
Create a plan to quit smoking, consult a Quit Coach and find other resources at this helpful site.
quitnow.ca

Canadian Cancer Society: Smokers’ Helpline
https://smokershelpline.ca/
1-877-513-5333. Free, personalized tools to help smokers quit.

Health Canada: Natural and Non-prescription Health Products
https://hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php
Learn about Canada’s regulation of natural health products, including herbal remedies, vitamin and mineral supplements, traditional and homeopathic medicines, probiotics and enzymes.