Cookies help us deliver our services. By using our services, you agree to our use of cookies. Learn more

Multiple Sclerosis

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a neurological, autoimmune disorder of the central nervous system.  The immune system is the body’s defense against foreign materials such as viruses and bacteria. An autoimmune disorder arises when the immune system attacks a normal body part resulting in damage. In MS, the immune system attacks the myelin sheath, a membrane composed of protein and fatty substances that surrounds nerve cells in the brain and spinal cord. The myelin sheath enhances the conduction of neural signals. Damage to myelin sheath disrupts communication in nerve cells. In MS, immune cells enter the brain and cause local inflammation, resulting in neurological damage.  Inflammation is a natural process that facilitates the immune response. Prolonged inflammation is harmful to the body. A multitude of factors contribute to MS including genetic predisposition and environmental factors.

MS has four subtypes: relapsing-remitting, primary progressive, secondary progressive, and progressive relapsing. Relapsing-remitting MS is the most common type which is characterized by periods of sudden flare-ups (relapse) of symptoms followed by a period where symptoms improve (remission). MS is classified as primary progressive when symptoms gradually continue to worsen without relapses or remissions. Secondary progressive occurs when the symptoms continue to worsen after a period of relapsing-remitting MS. Progressive-relapsing MS is the rarest subtype. It begins as a progressive disorder characterized by intermittent periods of flare-ups with worsening symptoms.

 

Multiple sclerosis (MS) is a neurological, autoimmune disorder of the central nervous system.  The immune system is the body’s defense against foreign materials such as viruses and bacteria. An autoimmune disorder arises when the immune system attacks a normal body part resulting in damage. In MS, the immune system attacks the myelin sheath, a membrane composed of protein and fatty substances that surrounds nerve cells in the brain and spinal cord. The myelin sheath enhances the conduction of neural signals. Damage to myelin sheath disrupts communication in nerve cells. In MS, immune cells enter the brain and cause local inflammation, resulting in neurological damage.  Inflammation is a natural process that facilitates the immune response. Prolonged inflammation is harmful to the body. A multitude of factors contribute to MS including genetic predisposition and environmental factors.

MS has four subtypes: relapsing-remitting, primary progressive, secondary progressive, and progressive relapsing. Relapsing-remitting MS is the most common type which is characterized by periods of sudden flare-ups (relapse) of symptoms followed by a period where symptoms improve (remission). MS is classified as primary progressive when symptoms gradually continue to worsen without relapses or remissions. Secondary progressive occurs when the symptoms continue to worsen after a period of relapsing-remitting MS. Progressive-relapsing MS is the rarest subtype. It begins as a progressive disorder characterized by intermittent periods of flare-ups with worsening symptoms.

Acknowledgement of Multiple Sclerosis has not been added yet.

MS affects women twice more than men and arises most commonly between the ages of 20 to 40. Caucasians are most susceptible to develop MS than other ethnicities.

Name Abbreviation
MS MS

The cause and the mechanism of MS are not well-understood. It is known to be a multifactorial disorder that occurs due to a combination of genetic predisposition, environmental exposures, and immune-mediated abnormal processes.

The symptoms of MS are present due to damage to the brain and the spinal cord. The blood-brain barrier is a protective layer that separates the spine and the brain from the circulating blood. At the early stages of MS, the blood-brain barrier is disrupted which allows immune cells to enter the brain. In MS, the body’s natural defense becomes abnormally primed to attack the brain and the spine and causes local inflammation. Inflammation is the primary cause of damage in MS. The trigger to this inflammation is not known. However, evidence suggests that it might be initiated by a combination of genetic predisposition and environmental exposures.

The brain and the spine are primarily made of nerve cells or neurons. Neurons have a specialized structure that enables them to conduct nerve impulses in the form of electrical signals. A neuron is made up of different components. An axon is the part of a neuron that conducts the electrical message to another neuron. Axons are covered by a fatty-protein coat called the myelin sheath. Oligodendrocytes are cells that produce myelin in the brain and the spinal cord.

Inflammation leads to the release of toxic substances that destruct the myelin sheath in a process called demyelination which is the major hallmark of MS. As MS progresses, inflammation damages the underlying axons. As a result of demyelination and axonal damage, nerve impulses cannot be properly conducted, leading to neurological deficits.

MS is believed to be associated with genetic factors because family members of individuals affected by MS have a higher risk of developing MS. Human leukocyte antigen DR beta 1 (HLA-DRB1) is a gene that encodes an important protein in the immune system and is most strongly associated with MS. Other identified genes include the interleukin-2 receptor alpha gene (IL2RA) and interleukin-7 receptor alpha gene (IL74). Both of these genes encode proteins that are involved in the activity of the immune system.

Environmental factors include exposure to certain viruses such as the Epstein Barr virus, the cause of an infectious disease called mononucleosis. Furthermore, smoking, vitamin D deficiency, and exposure to UV radiation are also associated with the onset of MS.

 

Since MS can damage any part of the brain or the spine, the symptoms vary between individuals. The most common symptoms are weakness, numbness, or pins and needles in one or more limbs, inflammation of the optic nerve (optic neuritis) and complete or partial loss of vision in one eye, presence of tremor or unsteady, staggering movement (ataxic gait), double vision, difficulty producing speech, dizziness, and fatigue.

Approximately, one-third of affected individuals experience continuous contraction (spasticity) in some of their muscles, mostly in legs. A common presentation is numbness in one leg that spreads to the other leg and eventually to the pelvis, abdomen, and chest. Most individuals affected by MS experience bladder dysfunction which may lead to incontinence in some.

Different MS subtypes may have different manifestations as well.

Relapsing-remitting MS is associated with visual impairment, numbness or tingling, fatigue, spasticity, and learning and memory impairment. These symptoms are experienced during relapses which develop over hours to days. Relapse episodes often reach a plateau for several weeks and then begin to improve. During the early stages of MS, symptoms recover completely during remission. However, as the disease progresses, some abnormalities from relapses continue to persist during remission.

Typically, relapsing-remitting MS develops into secondary progressive MS. There is no clear transition from one subtype to another. The flare-ups in relapsing-remitting MS gradually begin less suddenly and persist more chronically. As remissions become less complete, the flare-ups become less dominant and well-defined and the progressive form of MS dominates. Affected individuals may also experience psychological impairment and increased weakness.

Primary progressive MS occurs when the affected individual develops a progressive disease from the beginning without experiencing any relapses or remissions. This subtype of MS affects the spinal cord more than the brain. The most common symptoms are the progressive weakness and stiffness of the legs (progressive spastic paraparesis).

Progressive relapsing MS is the least common type and symptoms include double vision and pain in the eyes, sexual and urinary dysfunction, dizziness, and depression.

MS is diagnosed based on medical history, neurological examination, symptoms, and imaging techniques and laboratory tests. The most commonly used diagnostic criteria requires the presence of damage to the brain and spinal cord over time and space. This means that scars or lesions in the brain or spine must be detected at multiple locations and must have occurred during multiple episodes. These lesions must be located at the white matter of the brain and the spinal cord which is the region made of myelin-covered axons that have a white appearance. In addition, the brain or the spinal cord must also show signs of inflammation. The clinical diagnosis of MS can be supported using imaging techniques such as magnetic resonance imaging (MRI).

Although the diagnosis of MS is mainly clinical, laboratory tests can confirm the diagnosis. The most sensitive imaging test for MS is an MRI which can show the scarring of the white matter. Evoked potential tests are another group of tests that facilitate the diagnosis of MS. These tests evaluate how long the brain takes to respond to sensory stimuli. During an evoked potential test, electrodes are placed on the scalp and detect the electrical signals sent to the brain following auditory, visual, or sensory stimulation. If it takes too long for the brain to respond to the stimuli, it might suggest the presence of inflammation and demyelination. Another useful test is the cerebrospinal fluid (CSF) analysis. CSF is a fluid around the brain and the spinal cord that provides protection for these vital organs. The blood-brain barrier separates the blood and the CSF tightly regulates the content of the CSF. In MS, certain immune proteins can pass through the impaired blood-brain barrier and enter the CSF. A CSF analysis can provide information about the presence of immune cells and proteins in the CFS and support the diagnosis.

 

The treatment of MS relies on disease-modifying treatments which are specific to MS and symptomatic treatments which are not specific and treat the symptoms. Disease-modifying treatments act on the abnormal mechanism of the disease and reduce the number and severity of relapses. Immunomodulating medications alter the activity of the immune system and anti-inflammatory drugs reduce the inflammation in the brain and spinal cord. These drugs slow the progression of MS but do not stop it.

Acute relapses of MS are commonly treated by corticosteroids. These drugs reduce inflammation and inhibit the proliferation of the immune cells. A group of drugs called beta interferons can also be used to reduce inflammation in relapsing MS. Beta interferons are substances that are naturally produced by the body to reduce inflammation. Other drugs share structural similarities with myelin and alter the immune response to myelin.

A more novel treatment involved monoclonal antibodies. Antibodies are proteins made by immune cells that can recognize and neutralize foreign particles and molecules in the body. Monoclonal antibodies are antibodies produced by identical cells that can identify the desired cell type and destroy it. The exact mechanism of action of monoclonal antibodies in MS is not known. However, they likely inhibit the immune cells from attacking the myelin sheath and have shown to be effective in relapses.

Progressive forms of MS are more difficult to treat and fewer drugs have been found. A cancer chemotherapeutic drug which alters the activity of the immune system appears to be effective in reducing the progression of progressive MS subtypes.

While disease-modifying drugs change the activity of the immune system, symptomatic treatments target the symptoms that occur as a result of damage to the brain and the spinal cord.

Multiple sclerosis is often not fatal and life expectancy is shortened by only a few months. However, quality of life might be affected as a result of neurological deficits. About one-third of all patients with MS go through life without any persistent disability and suffer only intermittent, transient episodes of symptoms.

Tips or Suggestions of Multiple Sclerosis has not been added yet.

Goldenberg MM. Multiple sclerosis review. P T. 2012;37(3):175–184. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3351877/

Loma I, Heyman R. Multiple sclerosis: pathogenesis and treatment. Current Neuropharmacology. 2011;9(3):409–416. doi:10.2174/157015911796557911

Huang WJ, Chen WW, Zhang X. Multiple sclerosis: Pathology, diagnosis and treatments. Experimental and Therapeutic Medicine. 2017;13(6):3163–3166. doi:10.3892/etm.2017.4410

Dobson R, Giovannonib G. Multiple sclerosis – a review. European Journal of Neurology. 2019;26:27–40. doi:10.1111/ene.13819

Baecher-Allan C, Kaskow B, Weiner H. Multiple Sclerosis: Mechanisms and Immunotherapy. Neuron. 2018; 97: 742-768. https://doi.org/10.1016/j.neuron.2018.01.021

Lemus H, Warrington A, Rodriquez M. Multiple Sclerosis Mechanisms of Disease and Strategies for Myelin and Axonal Repair.Neurologic Clinics. 2018; 36(1):1-11. https://doi.org/10.1016/j.ncl.2017.08.002

Rolak LA. Multiple sclerosis: it's not the disease you thought it was. Clinical Medical Research. 2003;1(1):57–60.DOI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069023/

Ghasemi N, Razavi S, Nikzad E. Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy. Cell J. 2016;19(1):1–10. doi:10.22074/cellj.2016.4867

Treatment Success - Adult Stem Cells Created by skinny13
Last updated 18 Feb 2016, 04:20 PM

Posted by mdavis
18 Feb 2016, 04:20 PM

Has anyone heard or had success with Stemgenex in California? https://stemgenex.com/

Posted by skinny13
16 Mar 2009, 07:00 AM

There appears to be much success with Adult Stem Cell Therapy. http://donmargolis.com/blog/2009/03/adult-stem-cell-research-a-miracle-for-multiple-sclerosis-patient/ An alternative to invasive is increasing our natural release of our Adult Stem Cells from bone marrow using natural botanicals, such as AFA. AFA used in a concentrate form, has been proven to increase your natural release 25%, or 2-5 million more adult stem cells for repair in 30-60 minutes. Maureen

Balos Disease or Balos Concentric Sclerosis Created by marilynejanson
Last updated 24 Aug 2014, 12:32 AM

Posted by marilynejanson
24 Aug 2014, 12:32 AM

I am trying to find anyone out there who's loved one or family member has Balos. It is amazing to me the lack of information on this disease in this age of information overload.

balo concentric sclerosis Created by tortis
Last updated 24 Jun 2011, 04:09 PM

Posted by tortis
24 Jun 2011, 04:09 PM

Hi, I need to know if anyone has this form and if tysabri would be the right treatment for it. My eyes are hurting and not typing real well, any info on it would be really welcome! very scary the little I have found says usually fatal. Tortis

Community External News Link
Title Date Link
Community Resources
Title Description Date Link

Clinical Trials


Cords registry

CoRDS, or the Coordination of Rare Diseases at Sanford, is based at Sanford Research in Sioux Falls, South Dakota. It provides researchers with a centralized, international patient registry for all rare diseases. This program allows patients and researchers to connect as easily as possible to help advance treatments and cures for rare diseases. The CoRDS team works with patient advocacy groups, individuals and researchers to help in the advancement of research in over 7,000 rare diseases. The registry is free for patients to enroll and researchers to access.

Enrolling is easy.

  1. Complete the screening form.
  2. Review the informed consent.
  3. Answer the permission and data sharing questions.

After these steps, the enrollment process is complete. All other questions are voluntary. However, these questions are important to patients and their families to create awareness as well as to researchers to study rare diseases. This is why we ask our participants to update their information annually or anytime changes to their information occur.

Researchers can contact CoRDS to determine if the registry contains participants with the rare disease they are researching. If the researcher determines there is a sufficient number of participants or data on the rare disease of interest within the registry, the researcher can apply for access. Upon approval from the CoRDS Scientific Advisory Board, CoRDS staff will reach out to participants on behalf of the researcher. It is then up to the participant to determine if they would like to join the study.

Visit sanfordresearch.org/CoRDS to enroll.

Community Leaders

 

Expert Questions

Ask a question

Community User List

<p>Sjogren&#39;s and Essent...
<p>MS Diagnosis 2012 @ 50 Y...
<p>My daughter is 1,5 year ...
I have been recently dx wit...
My sister has been diagnose...
I am the partner of someone...
I have MS daughter having s...
Mother of daughter with 'Ce...
I am 47 years young and suf...
Diagnosed with Myasthenia G...
I was diagnosed with M.S. i...
I am involved in research a...
I'm a Private Caregiver wit...
I've had relapsing-remittin...
Dxd 1995 after a year of lo...
I was diagnosed with Multip...
Have had MS about 20 years ...

Start a Community


Don't See Your Condition On Rareshare?

Start your own! With a worldwide network of 8,000 users, you won't be the only member of your community for long.

FAQ


Have questions about rareshare?

Visit our Frequently Asked Questions page to find the answers to some of the most commonly asked questions.

Discussion Forum

Treatment Success - Adult Stem Cells

Created by skinny13 | Last updated 18 Feb 2016, 04:20 PM

Balos Disease or Balos Concentric Sclerosis

Created by marilynejanson | Last updated 24 Aug 2014, 12:32 AM

balo concentric sclerosis

Created by tortis | Last updated 24 Jun 2011, 04:09 PM


Communities

Our Communities

Join Rareshare to meet other people that have been touched by rare diseases. Learn, engage, and grow with our communities.

FIND YOUR COMMUNITY
Physicians

Our Resources

Our rare disease resources include e-books and podcasts

VIEW OUR EBOOKS

LISTEN TO OUR PODCASTS

VIEW OUR GUIDES

Leaders

Our Community Leaders

Community leaders are active users that have been touched by the rare disease that they are a part of. Not only are they there to help facilitate conversations and provide new information that is relevant for the group, but they are there for you and to let you know you have a support system on Rareshare.