Understanding Multiple Sclerosis (MS)

Medically reviewed by Sharon Stoll, DO, MSWritten by Ann Pietrangelo on May 15, 2020
. The immune system attacks myelin, which is the protective layer around nerve fibers.

This causes inflammation and scar tissue, or lesions. This can make it hard for your to send signals to the rest of your body.

and .


of people with MS report having fatigue. Fatigue that occurs with MS can become debilitating, affecting your ability to work and perform everyday tasks.

Difficulty walking

Difficulty walking can occur with MS for a number of reasons:

  • numbness in your legs or feet
  • difficulty balancing
  • muscle spasticity

Difficulty walking can also lead to injuries due to falling.

Other symptoms

Other fairly common symptoms of MS include:

  • acute or chronic pain
  • tremor
  • cognitive issues involving concentration, memory, and word-finding difficulty

The condition can also lead to speech disorders.

体育投注网址Your doctor will need to perform a neurological exam, request a clinical history, and order a series of other tests to determine if you have MS.

体育投注网址Diagnostic testing may include the following:

  • Magnetic resonance imaging (MRI) scan. Using a contrast dye with the MRI allows your doctor to detect active and inactive lesions throughout your brain and .
  • Optical coherence tomography (OCT). OCT is a test that takes a picture of the nerve layers in the back of your eye and can assess thinning of the optic nerve.
  • Spinal tap (lumbar puncture). Your doctor may order a to find abnormalities in your spinal fluid. This test can help rule out infectious diseases and can also be used to look for oligoclonal bands (OCBs), which can be used to make an early diagnosis of MS.
  • Blood tests. Doctors order to help eliminate other conditions with similar symptoms.
  • Visual evoked potentials (VEP) test. This test requires the stimulation of nerve pathways to analyze electrical activity in your brain. In the past, and sensory-evoked potential tests were also used to diagnose MS.

An MS diagnosis requires evidence of demyelination occurring at different times in more than one area of your brain, spinal cord, or .

A diagnosis also requires ruling out other conditions that have similar symptoms. , , and are just a few examples.

are similar to the pins-and-needles feeling you get when your foot falls asleep. However, they occur for no apparent reason.
  • Uneven balance and weak legs. You may find yourself tripping easily while walking or doing some other type of physical activity.
  • Double vision, blurry vision in one eye, or partial vision loss. These can be an early indicator of MS. You may also have some eye pain.
  • It isn’t uncommon for these early symptoms to go away only to return later. You may go weeks, months, or even years between .

    These symptoms can have many different causes. Even if you have these symptoms, it doesn’t necessarily mean that you have MS.

    RRMS is more common in women, whereas PPMS is equally common in women and men. believe that MS in men tends to be more aggressive and recovery from relapses is often incomplete.

    with MS raises your risk slightly. Scientists have identified some genes that seem to increase susceptibility to developing MS.

    体育投注网址 is a pre-MS condition involving one episode of symptoms lasting at least 24 hours. These symptoms are due to in your CNS.

    体育投注网址Although this episode is characteristic of MS, it’s not enough to prompt a diagnosis.

    If there are more than one lesion or positive oligoclonal bands (OCB) in your spinal fluid at the time of a spinal tap, you’re more likely to receive a diagnosis of relapsing-remitting MS (RRMS).

    If these lesions aren’t present, or your spinal fluid doesn’t show OCBs, you’re less likely to receive an MS diagnosis.

    Relapsing-remitting MS (RRMS)

    involves clear relapses of disease activity followed by remissions. During remission periods, symptoms are mild or absent, and there’s no disease progression.

    体育投注网址RRMS is the most common form of MS at onset and accounts for of all cases.

    Primary progressive MS (PPMS)

    If you have , neurological function becomes progressively worse from the onset of your symptoms.

    However, short periods of stability can occur. The terms “active” and “not active” are used to describe disease activity with new or enhancing brain lesions.

    Secondary progressive MS (SPMS)

    体育投注网址 occurs when RRMS transitions into the progressive form. You may still have noticeable relapses in addition to disability or gradual worsening of function.

    The bottom line

    体育投注网址Your MS may change and evolve, for example, going from RRMS to SPMS.

    体育投注网址You can only have one type of MS at a time, but knowing when you transition to a progressive form of MS may be difficult to pinpoint.


    体育投注网址It’s almost impossible to predict how MS will progress in any one person.

    体育投注网址 of people with MS have only rare attacks and minimal disability 10 years after diagnosis. It’s generally presumed they’re not on treatment or injectables. This is sometimes called .

    体育投注网址With the development of disease-modifying therapies (DMTs), studies show promising results that the progression of the disease can be slowed.

    MS type

    Progressive MS generally advances faster than RRMS. People with RRMS can be in remission for many years. A lack of disability after 5 years is usually a good indicator for the future.

    Age and sex

    The disease tends to be more severe and debilitating in men and older adults. The same prognosis is also seen in African Americans and those who have a high relapse rate.

    The bottom line

    Your quality of life with MS will depend on your symptoms and how well you respond to treatment. This rarely fatal, but unpredictable, disease can change course without warning.

    体育投注网址Most people with MS don’t become severely disabled and continue to lead full lives.

    are designed to slow disease progression and lower your relapse rate.

    Self-injectable disease-modifying medications for RRMS include and beta interferons, such as:

    Oral medications for RRMS include:

    体育投注网址 for RRMS include:

    • alemtuzumab (Lemtrada)
    • natalizumab (Tysabri)
    • mitoxantrone (Novantrone)
    • Ocrelizumab (Ocrevus)

    In 2017, the Food and Drug Administration (FDA) approved the first DMT for people with PPMS. This infusion drug is called ocrelizumab (Ocrevus), and it can also be used to treat RRMS.

    Another drug, ozanimod (Zeposia), has recently been approved for treating CIS, RRMS, and SPMS, but it isn’t yet marketed due to the COVID-19 pandemic.

    Not all will be available or appropriate for every person. Talk to your doctor about which drugs are most appropriate for you and the risks and benefits of each one.

    Other drugs

    Your doctor can prescribe corticosteroids, such as methylprednisolone (Medrol) or Acthar Gel (ACTH), to treat relapses.

    Other treatments may also ease your symptoms and improve your quality of life.

    体育投注网址Because MS is different for everyone, treatment depends on your specific symptoms. For most, a flexible approach is necessary.


    体育投注网址If you take one of the DMTs, you’ll need to adhere to the recommended schedule. Your doctor may prescribe other medications to treat specific symptoms.

    Diet and exercise

    体育投注网址 is important for physical and mental health, even if you have disabilities.

    If physical movement is difficult, swimming or can help. Some are designed just for people with MS.

    A , low in and high in and , will help you manage your overall health.

    Your diet should mainly consist of:

    • a variety of and
    • lean sources of , such as and
    • and
    • adequate amounts of and other fluids

    The better your diet, the better your overall health. You’ll not only feel better in the short term, but you’ll also be laying the foundation for a healthier future.

    Explore the relationship between diet and MS.

    体育投注网址You should :

    体育投注网址If you have other medical conditions, ask your doctor if you should follow a special diet or take any dietary supplements.

    Specialized diets such as the keto, paleo体育投注网址, or diet may help with some of the challenges people with MS face.

    Foods that are high in calories but low in nutrients won’t help you feel better or maintain a healthy weight.

    Check out these additional tips for eating an MS-friendly diet.

    Other complementary therapies

    Studies regarding the effectiveness of are scarce, but that doesn’t mean they can’t help in some way.

    The following therapies may help you feel less stressed and more relaxed:

    have MS.

    Other things you should know:

    • MS is neurological condition disabling young adults worldwide.
    • Most people diagnosed with RRMS are at the time of their diagnosis.
    • Overall, MS is more common in women than men. According to the , RRMS is two to three times more common in women than men. PPMS rates in women and men are roughly equal.
    • Rates of MS tend to be lower in places that are closer to the equator. This may have to do with and exposure. People who relocate to a new location generally acquire the risk factors associated with the new location.
    • Data from 1999 to 2008 showed that direct and indirect costs of MS were between per year. Current DMTs for RRMS can cost a year. Ocrelizumab (Ocrevus) costs a year.

    体育投注网址Canadians have the highest rate of MS in the world.

    The lesions MS causes can appear anywhere in your CNS and affect any part of your body.

    Mobility issues

    As you age, some disabilities MS causes may become more pronounced.

    If you have mobility issues, falling may put you at an increased risk for bone fractures. Having other conditions, such as and , can complicate matters.

    Other issues

    体育投注网址One of the most common symptoms of MS is fatigue, but it’s not uncommon for people with MS to also have:

    • anxiety
    • some degree of cognitive impairment

    The bottom line

    体育投注网址Mobility issues can lead to a lack of physical activity, which can cause other health problems. Fatigue and mobility issues may also have an effect on sexual function.

    体育投注网址 support groups.

    See what 11 public figures have to say about navigating life with MS.

    You can also try our free MS Buddy app to share advice and support in an open environment. Download for or .

    Last medically reviewed on May 15, 2020

    Medically reviewed by Sharon Stoll, DO, MSWritten by Ann Pietrangelo on May 15, 2020