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Overview of multiple sclerosis (MS)

Tirohanga whānui ki te wharanga uwhi iaia

Multiple sclerosis (MS) affects the central nervous system. Your central nervous system is made up of your brain, spinal cord and optic nerves (the nerves that carry images from your eyes to your brain).

Your nerves have a protective coating around them called myelin. An MS attack causes inflammation of myelin (demyelination) leading to scarring (sclerosis) on your nerves. This process interferes with impulses travelling along the nerves causing a range of neurological symptoms.

Everyone with MS has slightly different symptoms depending on the location, size and number of demyelinated areas. The areas can heal over time, and symptoms can go away or become permanent.

Multiple sclerosis affects around one in 1,000 New Zealanders. The chances of having MS increase to 30 in 1,000 people if you have a near relative (mother, father, brother or sister) with MS. But most people with a near relative with MS do not get it. Women are three times more likely to get MS than men.

Multiple sclerosis usually develops between the ages of 20 and 50, and most commonly in the early 30s. Most people with MS will live to a similar age to others around them.

Being diagnosed with MS can be a difficult and worrying time. Being well-informed and getting support can help and prepare you for the future. Many people with MS are able to live normal lives with some or no disability.

Symptoms of MS

Multiple sclerosis symptoms typically get worse for several days, then stay the same for a few days or weeks, then improve over the next month.

The most common symptoms of MS that people complain about are:

• reduced vision in one eye, usually with pain when you move your eye
• double vision
• weakness in an arm or leg
• numbness in an arm or a leg
• vertigo (where you feel that you, or the world around you are moving or spinning)
• poor coordination and lack of balance
• bladder or bowel problems.

People with MS may also have fatigue and be sensitive to heat.

Causes of MS

Doctors think MS is an autoimmune disease, possibly triggered by an infection. In autoimmune conditions, your immune system starts to attack parts of your own body. MS is not contagious or infectious so you cannot catch it from someone who has it.

There are different types of MS.

• Relapsing MS, where relapses (periods with symptoms) are followed by remissions (when you have no symptoms or only minor symptoms). This is the most common type, affecting about 85% of people with MS.
• Primary progressive MS, where your symptoms gradually get worse. This affects about 15% of people with MS.
• Secondary progressive MS happens in people with previous relapsing MS who later develop progressive symptoms unrelated to relapses. Around 65% of people with relapsing MS will develop secondary progressive MS around 15 years after being diagnosed.

Diagnosing MS

A neurologist will ask you about your symptoms and examine you. Often, they will need to watch you and wait to see if new symptoms appear, or previous symptoms come back. This can be frustrating, and the process can take months or even years.

MS is diagnosed from the symptoms you have being typical of demyelination supported by tests such as an MRI scan of your spinal cord or brain and a lumbar puncture.

You'll also have blood tests to rule out other conditions that cause similar symptoms to MS.

While your current symptoms and the neurologist's investigation can confirm that you have MS, they cannot predict how bad your MS will be, how fast it will progress or what other symptoms you'll get.

Treating MS

Several medications can help reduce the frequency and severity of relapses and help prevent disability in relapsing MS. Your neurologist will recommend the best options for you.

Other medications may be used to treat a flare-up of MS or to manage particular symptoms.

Multiple Sclerosis New Zealand has detailed information about treatment options.

Long-term effects of MS

Most people with MS have a normal or near-normal lifespan, but MS symptoms can impact your quality of life.

Because MS affects people in different ways, it's difficult to predict the outlook for an individual. There are currently no tests to predict how MS will progress, but here are some statistics:

• most people with MS can continue to walk and function at their work for many years after their diagnosis
• about one in five people with MS have no symptoms or only develop mild symptoms after an initial event
• another one in five people have symptoms that rapidly get worse
• after 20 years, two out of three people with MS do not need to use a wheelchair.

  HealthInfo recommends the following videos

• Healthify He Puna Wairoa – Multiple sclerosis videos

  For a series of videos with people discussing their MS, follow the link, scroll down the page and open the Personal stories block.

  HealthInfo recommends the following pages

• Healthify He Puna Wairoa – Multiple sclerosis

  Information about MS.

• Multiple Sclerosis New Zealand – What is MS?

  This website has information about MS including diagnosis, symptoms and treatments.

On the next page: Self-care for multiple sclerosis

Written by HealthInfo clinical advisers. Last reviewed November 2022.

Sources

Page reference: 421855

Review key: HIMSC-58142