Multiple sclerosis (MS) is attacking an estimated 2.3 million global patients’ central nervous systems, but its brain, spinal cord, and optic nerve effects can be unnoticeable. That’s why many people struggle with this chronic disease without treatment until their doctors rule out every other possibility. Experts explore why this debilitating yet hard-to-diagnose condition is so complex and mysterious.
Established MS Basics
Your immune system strikes an unknown antigen in your central nervous system, so doctors consider MS an immune-mediated ― not an autoimmune ― disease. It damages your nerve fibers and myelin, a fatty substance that safeguards those fibers. Through a sclerosis process, your myelin creates scar tissue. Multiple sclerosis, or multiple scars, disrupt and interrupt electrical signal transmissions throughout your central nervous system, so your nerve impulses produce wide-ranging and greatly varying symptoms.
Typical signs of this incurable affliction include difficulty walking, vision problems, cognitive impairments, bladder issues, pain, stiffness, tingling, numbness, weakness, and fatigue. Because some of those symptoms can be invisible, you might appear to feel much better than you do. When other people can’t see your inner struggles externally, they could have unwarranted expectations for you. Other conditions can cause similar symptoms. So whenever new ones occur, consult your doctor. MS severity extends from fairly benign to devastatingly disabling with partial to complete paralysis.
According to the National MS Society (NMSS), these four disease courses differentiate how MS presents and develops:
Relapsing-remitting (RRMS): About 85 percent of MS patients experience this form, which involves clearly defined relapses when symptoms worsen. Limited or full remission periods follow without apparent disease progression.
Secondary-progressive (SPMS): This common transition entails more steady MS progression with or without remission periods.
Primary-progressive (PPMS): Approximately 10 percent of patients have this MS form with neurologic functioning worsening steadily over time. Although temporary improvements may arise at times, no distinct remissions or relapses occur.
Progressive-relapsing (PRMS): If you have the rarest form, your neurologic functions worsen steadily with sporadic relapses by no remissions.
Treating New Classifications
Dr. Annette Langer-Gould advises that three newer MS subtype terms have emerged:
Relapsing non-progressive MS
Relapsing progressive MS
Progressive non-relapsing MS
She reports that relapsing non-progressive MS treatments are highly effective. Gilenya (Fingolimod) prevents immune system cells from damaging brain and spinal cord nerves to decrease MS relapses and delay disability. For the two progressive subtypes, proactive symptom management can maximize patients’ functions and quality of life.
Progressive non-relapsing MS involves a neurodegenerative process that’s more like Alzheimer’s and Parkinson’s diseases than relapsing MS forms. It may require multidisciplinary efforts combining a primary care physician, urologist, physical and occupational therapists, and social worker.
Stem Cell Therapy Approach
Physicians conducted a study, using chemotherapy to neutralize immune system parts that weren’t working properly. Then they rebuilt them with stem cells from each patient’s blood. Nearly 64 percent of study subjects made disability-level improvements. Wheelchair-bound MS patients resumed walking while blind patients recovered their vision.
Unfortunately, this limited study focused on just RRMS and didn’t include a typical control group. So the researchers can’t be sure that their treatment caused the dramatic health upgrades. Also, not everyone can tolerate this study’s aggressive chemotherapy, and the technique was unsuccessful for patients with severe or long-term MS of 10 plus years.
Ongoing Discoveries and Needs
For some time, doctors believed that African-Americans were less susceptible to MS than Caucasians. But health records for more than 3.5 million patients revealed that MS occurs in more black than white women. Such conflicting findings demonstrate the mystery surrounding MS. Experts think that environmental factors like genetics and infectious microbe exposure influence MS development, but they’ve been unable to explain this disease precisely.
Uncertainty also applies to diagnosing MS. Because its symptoms can fluctuate greatly, successful diagnoses can be lengthy processes. Identifying patients with high risks for early or imminent disabilities and initiating optimal treatment plans are neurologists’ biggest challenges today, notes Langer-Gould. Regrettably, MS medications are expensive. Langer-Gould suggests that patient advocacy groups could work with Congress to make these drugs more affordable.
The government also could help track MS at an epidemiological level. Currently, standard testing, diagnosing, classification, and new case reporting methods don’t exist. Due to these inadequacies, all epidemiological statistics are estimates that contribute to this condition’s ambiguities. An official record of all diagnoses would help scientists who are trying to track MS incident and prevalence rates while helping them determine its causes.
Scientists will continue studying and redefining MS as they learn more about it. Disease management has seen great changes over a short period, and personalized MS discussions and treatments will continue to improve. Until more help is available, varied lifestyle adjustments can be beneficial. You may be able to manage occasional symptoms by changing your diet and exercise programs. Frequent bouts could require work and home schedule modifications to avoid relapses. If debilitating exhaustion and pain subside rarely or never, avoid overexertion and overdoing that can worsen your symptoms.