- Relapsing-remitting MS —Symptoms suddenly reappear periodically. They last for a few weeks or months, then go back into remission (a period with no symptoms). Symptoms may get worse with each occurrence.
- Primary progressive MS —Symptoms gradually worsen after symptoms first appear. Relapses and remissions usually do not occur.
- Secondary progressive MS —After years of relapses and remissions, symptoms suddenly begin to progressively worsen.
- Progressive relapsing MS —Symptoms gradually worsen after symptoms first appear. One or more relapses may also occur.
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- Viral or other infection
- Genetic factors (heredity)
- Environmental factors
- Breaking down of parts of the nervous system
- Numbness or tingling in the face or limbs
Impaired vision in one or both eyes, including:
- Blurred vision
- Double vision
- Loss of vision
- Eye pain
- Muscle stiffness
- Muscle spasms
- Muscle weakness
- Incoordination or falling
- Trouble walking or maintaining balance
- Weakness in one or more limbs
Bladder problems including:
- Incomplete emptying
- Bowel problems, including constipation
- Sexual dysfunction
- Slurred speech
- Difficulty swallowing
- Forgetfulness, memory loss, and confusion
- Difficulty concentrating or solving problems
- Hot weather
- Hot baths or showers
- Overexertion—intense physical activity
- MRI to take pictures of internal structures around the brain and spinal cord
- Sensory evoked potentials to record the electrical responses evoked after a sensory stimulus
- Visual evoked potential test to look for problems in the brain that affect vision
- Lumbar puncture to check the fluid around the brain and spinal cord, which may rule out other diseases
- Blood tests to rule out other diseases that may mimic MS
- Interferon betas
- Muscle relaxants
- Potassium channel blockers
- Botox injections
- Bladder or bowel problems
Physical Therapies and Lifestyle Changes
- Regular moderate exercise with your doctor's permission—swimming may be especially beneficial
- Physical therapy to help maintain muscle strength and tone, dexterity, and walking ability
- High-fiber diet to prevent constipation
- Stress reduction techniques
- Quitting smoking —smoking may worsen MS, causing the condition to progress to a more severe form
Avoiding Periods of Relapse
- Adhere to the treatment plan you worked out with your doctor
- Get adequate rest
- Avoid hot weather
- Stay in air-conditioned places during periods of hot weather
- Avoid hot showers or baths
- Avoid overexertion and stress
Avoid infection by:
- Using proper hygiene
- Staying away from people who are sick
- Thoroughly cooking food
- Practicing safe sex
Multiple Sclerosis Association of America http://www.mymsaa.org
National Multiple Sclerosis Society http://www.nationalmssociety.org
Health Canada http://www.hc-sc.gc.ca
Multiple Sclerosis Society of Canada http://mssociety.ca
About MS. National Multiple Sclerosis Society website. Available at: http://nationalmssociety.org/about-multiple-sclerosis/index.aspx . Accessed September 5, 2013.
Ascherio A, et al. Vitamin D and multiple sclerosis. Lancet Neurol. 2010;9(6):599-612.
Cohen JA, Barkhof F, et al. Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis. N Engl J Med. 2010;362(5):402-415.
FDA approves Ampyra to improve walking in adults with multiple sclerosis. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm198463.htm . Updated April 25, 2013. Accessed September 5, 2013.
International Multiple Sclerosis Genetics Consortium. Risk alleles for multiple sclerosis identified by a genomewide study. NEJM. 2007;357(9):851-862.
Kasper DL, Braunwald E, et al. Harrison’s Principles of Internal Medicine . 16th ed. The McGraw-Hill Companies; 2006.
Kappos L, Radue EW. A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. N Eng J Med. 2010;362(5):387-401.
Multiple sclerosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated August 5, 2013. Accessed September 5, 2013.
NINDS multiple sclerosis information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/multiple%5Fsclerosis/multiple%5Fsclerosis.htm . Updated July 5, 2013. Accessed September 5, 2013.
Rose JW, Carlson NG. Pathogenesis of multiple sclerosis. Continuum Lifelong Learning Neurol. 2007;13:35-62.
Treatments. National Multiple Sclerosis Society. Available at http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/treatments/index.aspx . Accessed September 5, 2013.
Van der Mae IA, et al. Individual and joint action of environmental risk factors and MS. Neurol Clin. 2011;29:233-55.
1/4/2011 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Healy B, Ali E, Guttmann C, et al. Smoking and disease progression in multiple sclerosis. Arch Neurol. 2009;66(7):858-864.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : US Food and Drug Administration. FDA approves first oral drug to reduce MS relapses. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm226755.htm . Updated April 19, 2013. Accessed September 5, 2013.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Kang JH, Sheu JJ, Kao S, Lin HC. Increased risk of multiple sclerosis following herpes zoster: a nationwide, population-based study. J Infect Dis. 2011;204(2):188-92.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -