What is multiple sclerosis?

What causes MS?

Is it fatal?

How do I know that I have MS?

Who can tell me that I have MS?

Who gets MS?

Is it safe to get pregnant?

Can I inherit MS?

Will I be confined to a wheel chair?

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Individuals with MS may have symptoms that include visual changes, overwhelming fatigue, bladder and bowel dysfunction, numbness, dizziness, impaired mobility, chronic aching pain, and other physical, mental, and emotional difficulties. Heat intolerance is a classic MS tendency, where a rise in temperature (internally or externally) may temporarily increase symptoms.

What causes MS?
Most researchers believe MS is an autoimmune disease – one in which white blood cells, meant to fight infection or disease, are misguided to target and attack the body’s own cells. This attack causes inflammation in the CNS, which may damage the myelin and ultimately injure the axons as well.

Is it fatal?
Most people with MS will have a normal life expectancy. The majority of individuals with MS may continue a fulfilling and productive lifestyle.

How do I know that I have MS?
The diagnosis of MS is a clinical one, based on the individual's medical history and symptoms. A proper diagnosis requires an examination by a physician, preferably a neurologist.

Symptoms can vary significantly from one person to another. Examples of symptoms that are commonly reported by people with MS include problems with vision, difficulty walking, fatigue, numbness or the sensation of feeling "pins and needles." Additional common symptoms may include bowel or bladder problems, memory loss, headaches, and vertigo.

The occurrence of symptoms which appear briefly (lasting days or weeks) and then disappear completely or become less noticeable may be an early indication that MS is present. This pattern often corresponds to the attack and remission cycle of MS. It is important to note, however, that these symptoms can be caused by other disorders or conditions.

Who can tell me that I have MS?
A neurologist is the medical specialist who is trained to evaluate the symptoms of MS.

Ideally, it may be helpful if the neurologist is affiliated with an MS center, research facility, or a teaching hospital. The initial visit to the neurologist will include a series of questions about the medical history of the patient and his or her birth family, and a neurological exam which may include balance testing, sensory evaluation, and reflex eye movement.

The next step in the process of confirming a diagnosis is the MRI (magnetic resonance imaging) of the brain. Repeat MRI scans may show contrast and permit the neurologist to estimate the evolution of lesions (inflamed areas). Other tests to support the physicians' diagnosis are evoked potentials (visual and somatosensory) and analysis of spinal fluid.

Please note that lesions can occur throughout the disease process even though there are no apparent symptoms present.

Who gets MS?
Most people with MS experience their first symptoms and are diagnosed between the ages of 15 and 50.

The distribution of the disease is not totally random. On average, women are three times as likely than men to develop MS. Additionally, the occurrence of this disorder is positively correlated with latitude. People living beyond the 40-degree mark north or south of the equator are far more likely to develop MS than those living in the warmer climates near the equator. This is especially true for people in North America, Europe, and southern Australia, while Asia continues to have a low incidence of MS. More prevalent among those of northern European or Scandinavian ancestry, Caucasians are far more likely than those of African heritage to develop this disease.

Is it safe to get pregnant?
You certainly can have a baby. Multiple sclerosis does not affect your fertility. Your pregnancy will progress normally, and MS symptoms usually stabilize or improve during pregnancy. If your muscles are weakened, you may not be able to push sufficiently during delivery, and you may need help from instruments or suction. Between 20 and 40 percent of women have a relapse following delivery, so you may need to plan for more rest and assistance during the first few months. Your long-term chance of a relapse is not affected by pregnancy.

You should not take interferons or steroids during pregnancy or while breast-feeding. Interferons increase the possibility of miscarriage and are transmitted in breast milk. Steroids can be passed to the fetus through blood and breast milk. The effect of Copaxone is not known, but it is generally advised to avoid it as well. You will probably want to discuss with your neurologist stopping your medications two to three months before attempting to become pregnant. You should also discuss any other medications you are taking at that time.

Whether or not to have a baby is an important decision for any person or couple. You will be responsible not only for a baby, but for this child as he or she grows and changes over the years. You will need to consider how a child will change your relationship with your partner; and how a child, coupled with the fatigue and other symptoms possible with MS, will impact on your life together. At times, you may need outside help. Many women, with or without a disability, must learn to ask for help instead of trying to do everything themselves. There may even be periods during which you will be physically unable to care for your child, and you will need to have someone identified who is able to step in. You and your partner, together with your doctor, should have some thorough discussions before making this commitment.

Can I inherit MS?
Although the cause of MS is not completely understood, researchers believe there may be some genetic link. The average risk of developing MS in the United States is one in 1,000, or one tenth of one percent. For first-degree relatives (such as a child or sibling), the risk increases to three or four percent. This is not true for adopted children or half siblings (who do not share the same parent who has MS), whose risk is the same as unrelated individuals. In instances where one identical twin has been diagnosed with MS, the other twin has a 31 percent risk of developing the disease. The risk for twins who are not identical is five percent – similar to that of other siblings.

Will I be confined to a wheel chair?
Seventy-five percent of individuals with MS will not need to use a wheelchair.

Scientists continue to research MS. A great deal has been learned in recent years and the future looks positive.