The information provided on the show is for general information purposes only. If you have a health problem, medical emergency, or a general health question, you should contact a physician or other qualified health care provider for consultation, diagnosis and/or treatment. Under no circumstances should you attempt self-diagnosis or treatment based on anything you have seen on the show.
Worldwide, more than 2.3 million people are currently living with Multiple Sclerosis, and even with celebrities like Jamie Lynn Sigler and Selma Blair opening up about their battle with the autoimmune disease, for some, it’s still unclear as to what MS is and what it affects.
Here with everything that we need to know is Dr. Sheila Wijayasinghe.
WHAT IS MS?
- MS affects 1/385 Canadians.
- Multiple sclerosis is a disease of the central nervous system (brain and spinal cord)
- The central nervous system has complex signaling system that sends important messages to all the organs in the body via nerves to control all our functions – vision, cognition (how we think/process), movement, touch and our bodily functions (urine/bowel function, sexual function.)
- Nerves are like long conducting wires, which have a protective coating, called myelin. In MS, this protective covering is damaged (why it is called the demyelinating disease) leaving the nerve exposed. Without myelin the communication between nerve cells is disrupted, and the body does not receive the instructions necessary to perform basic functions like speaking, seeing, walking and learning. As a chronic neurological disease, MS can also have a dramatic effect on energy levels, sleep and overall quality of life.
WHAT CAUSES MS?
- MS is classified as an autoimmune disease where the immune system attacks myelin, the protective covering of the nerves, causing inflammation and often damaging the myelin. Myelin is necessary for the transmission of nerve impulses through nerve fibers. If damage to myelin is slight, nerve impulses travel with minor interruptions; however, if damage is substantial and if scar tissue replaces the myelin, nerve impulses may be completely disrupted, and the nerve fibers themselves can be damaged.
- It isn’t clear why MS develops in some people and not others. It is thought to be multifactorial – likely a combination of genetic, environmental factors.
WHAT ARE THE SYMPTOMS?
The symptoms of MS are unique to each individual depending on where in the nervous system the changes have taken plan (because different parts of the brain/spinal cord are responsible for different functions.)
Symptoms of MS are unpredictable and can include:
- Numbness or weakness in one or more of your limbs
- Loss of vision: Optic neuritis, inflammation of the optic nerve, presents as sudden onset of visual blurring or loss of vision in one eye, particularly in the central visual field.
- Having double vision or blurry vision
- Feeling tingling or pain in one or more parts of your body
- Feeling electric-shock sensations when you move your head in certain ways
- Feeling unsteady or losing coordination while walking or standing/vertigo
- Cognitive impairment/mood (40-70% of people with MS have this, short term memory)
- Having stiff muscles or muscle spasms
- Bladder symptoms – incontinence
- Extreme fatigue (90% of people with MS. Fatigue can be a primary symptom (due to active inflammatory disease) or a secondary symptom (the result of other symptoms or conditions such as sleep disorders, depression, or muscle weakness).
WHO IS MOST COMMONLY AFFECTED?
- MS can occur at any age, but usually affects people somewhere between the ages of 16 and 55.
- Women are more than two to three times as likely as men are to have relapsing-remitting MS.
- If one of your parents or siblings has had MS, you are at higher risk of developing the disease. While the average person has about a 1 in 750 chance of developing MS, someone who has a parent or sibling with MS has a 1 in 40 chance of developing MS. However, the connection isn’t clear, and doctors do know that one doesn’t develop MS because of genetics alone.
- White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.
- MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe.
- Having low levels of vitamin D and low exposure to sunlight is associated with a greater risk of MS.
- You have a slightly higher risk of developing MS if you have thyroid disease, type 1 diabetes or inflammatory bowel disease.
Smokers who experience an initial event of symptoms that may signal MS are more likely than non-smokers to develop a second event that confirms relapsing-remitting MS.
HOW IS IT DIAGNOSED?
As a family doctor – MS can be a difficult diagnosis to make and it can take months-years for some to be diagnosed:
- Symptoms come and go and tend to be triggered by stress or an increase in body temperature. Because people with MS experience so many different types of symptoms, in unpredictable patterns, makes it very hard to diagnose. Doctors may mistake the symptoms of MS for other diseases, and because there is no definitive test for MS, it very hard to confirm that someone who may present with MS symptoms actually has MS.
- If you are having symptoms that may be related to your nervous system, it’s important to be seen. There are other causes of these symptoms that should be investigated, as MS does not have a specific test that can be done to test for it.
- If you have these symptoms, your doctor will review, consider bloodwork to rule out other causes (thyroid b12, etc.) and consider imaging such as an MRI of the head, which can look for abnormalities that are seen in MS. If ongoing, a referral to a neurologist is warranted.
HOW IS MS MANAGED?
- Get plenty of rest. Look at your sleep habits to make sure you’re getting the best possible sleep. To make sure you’re getting enough sleep, you may need to be evaluated — and possibly treated — for sleep disorders such as obstructive sleep apnea.
- Regular exercise can help improve your strength, muscle tone, balance and coordination, if you have mild to moderate MS. Swimming or other water exercises are good options if you’re bothered by heat. Other types of mild to moderate exercise recommended for people with MS include walking, stretching, low-impact aerobics, stationary bicycling, yoga and tai chi.
- Physical and occupational therapy can be most helpful in assessing gait and recommending strategies, aids, and home modifications to promote better gait and safety in activities of daily living that are compromised by gait disturbance.
- Cool down. MS symptoms often worsen when the body temperature rises in some people with MS. Avoiding exposure to heat and using devices such as cooling scarves or vests can be helpful.
- Eat a balanced diet. Since there’s little evidence to support a particular diet, experts recommend a generally healthy diet. Some research suggests that vitamin D may have potential benefit for people with MS.
- Relieve stress. Stress may trigger or worsen your signs and symptoms. Yoga, tai chi, massage, meditation or deep breathing may help.
- General support to cope with illness, connection, counselling, and support groups.