It’s estimated that at least 1 million people are living with multiple sclerosis (MS) in the United States, making it the number one non-traumatic disabling disease for young adults in America.
Even so, this is likely an underestimate because diagnosing MS is difficult.
Diagnosing multiple sclerosis
MS is generally diagnosed by exclusion. This means other conditions that cause similar symptoms need to be ruled out first. There are no medical tests that definitively diagnose MS. Neurologists use tools like MRIs and spinal fluid analysis.
“Neuropsychological testing can also be useful to establish a cognitive baseline, monitor for changes in cognitive abilities, and rule out presence of other conditions,” said Dr. James Van Hoven, neuropsychologist at Marshfield Clinic Health System.
When someone has MS, the immune system attacks myelin, which helps nerves function. This can cause:
- Inflammation of the optic nerve
- Double vision
- Trouble moving the eyes
- Trouble swallowing
- Limb weakness
- Difficulty walking
- Numbness or tingling
- Bladder problems
- Cognitive disturbance
Risk factors for multiple sclerosis
There is not one known cause of multiple sclerosis. Environmental factors, genetics and immune system responses may be risk factors. Interestingly, lack of vitamin D and distance from the equator also play into it. The further north you are from the equator, the higher your risk for MS.
Women are about three times more likely than men to get multiple sclerosis. MS primarily presents between 20 and 40 years of age, but it can occur in younger or older persons. In adult-onset multiple sclerosis, Caucasians with Northern European ancestry are the most susceptible, but the disease affects all races and ethnicities. Pediatric-onset multiple sclerosis, which is less common, may be more common among ethnically and racially diverse backgrounds.
Variations of multiple sclerosis
There are four types of MS:
- Relapsing-remitting
- Secondary-progressive
- Primary-progressive
- Progressive-relapsing
Specialists have been rethinking these categories, however. More recently, there has been increased emphasis on whether a person has active or inactive disease.
It is rare to die from MS. Most people will have an average lifespan, but this can be 5 to 10 years shorter than persons without multiple sclerosis.
Living with multiple sclerosis
People living with multiple sclerosis experience more positive outcomes today than years before.
It is a misconception that MS always causes severe disability. That is not always the case for patients who have access to early and aggressive treatments.
Between 40-65% of adults with MS experience some degree of cognitive impairment. Dr. Van Hoven said neuropsychological evaluation can help identify support resources. For example, if still in school, you might benefit from educational accommodations. Neuropsychological testing may also help your medical doctor identify medication strategies to support thinking efficiency.
Early action improves long-term outcomes
Today’s treatments do not reverse symptoms, but they can prevent new symptoms and deficits by limiting inflammatory damage.
People suffering with MS should make lifestyle modifications to decrease inflammation. Some examples include:
- Quitting smoking
- Eating whole foods
- Avoiding processed foods
- Exercising regularly
Specialized care for multiple sclerosis
Multiple sclerosis is a lifelong medical condition without a cure. However, with the right care team and a strong support system, most patients lead active and fulfilling lives.
Specialized care for MS includes:
- Neurology
- Neuropsychology
- Urology
- Physical therapy
- Physical medicine
Dr. Van Hoven recommends patients reach out to their medical and mental health providers for mental health support.
“It is not uncommon for people with MS to experience some depression, anxiety, and even mood swings. It is important to know there are resources out there that can help. In addition to medication that your doctor may consider for mood, individual counseling with a strategy like cognitive behavioral therapy and support groups may be helpful.”
Related stories from Shine365
Diet and mental health: 5 things to know
Leave a Reply