- 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.
- Viral or other infection
- Genetic factors (heredity)
- Environmental factors
- Breaking down of parts of the nervous system
|Abnormal Immune Responses Cause Nerve Damage|
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- Exposure to certain viruses
- Family members who have MS or other autoimmune disorders, such as systemic lupus erythematosus
- Being of Northern European descent
- Growing up in a colder climate, as opposed to a tropical climate
- Having certain immune system genes
- Having inflammation of the optic nerve
- Having low vitamin D levels
- 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
- Blood tests—to rule out other diseases that may mimic MS
- MRI scan
- Lumbar puncture—to check the fluid around the brain and spinal cord, which may rule out other diseases
- 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
- Optical coherence tomography (OCT)—to look at the retina and the optic nerve
- Interferon betas
- Muscle relaxants—to reduce muscle spasms
- Potassium channel blockers—to help improve vision, motor skills, and relieve fatigue
- Botox injections —to reduce tremor and muscle tone
- Pain relievers
- Medications to help with bladder or bowel problems
- 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
- Occupational therapy to help with assisted devices and daily living activities
- Speech and/or swallowing therapy
- Cognitive therapy to address specific neuropsychiatric problems
- Stress reduction techniques
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, especially when washing your hands
- Staying away from people who are sick
- Thoroughly cooking food
- Practicing safe sex
- Quitting smoking —smoking may worsen MS, causing the condition to progress to a more severe form
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
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1/4/2011 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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 http://www.ebscohost.com/dynamed: 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 August 28, 2015.
1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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):188-192.
4/25/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Rosti-Otajärvi EM, Hämäläinen PI. Neuropsychological rehabilitation for multiple sclerosis. Cochrane Database Syst Rev. 2014;2:CD009131.
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- Reviewer: Rimas Lukas, MD
- Review Date: 08/2015 -
- Update Date: 11/09/2015 -