ms.about.comMultiple Sclerosis: Symptoms, Causes, Diagnosis, Treatment, Coping

-- Menu Verywell Health An Overview of Multiple Sclerosis Share Flip Email Search Search Clear GO More in Multiple Sclerosis Symptoms Diagnosis Treatment Living With Support & Coping Complementary Therapies Primary Progressive MS Secondary Progressive MS Relapsing-Remitting MS Clinically Isolated Syndrome View More Tools & Resources Thyroid Test Analyzer Doctor Discussion Guides Hemoglobin A1c Test Analyzer Lipid Test Analyzer Complete Blood Count (CBC) Analyzer Healthy Conversations Coach Renal Test Analyzer When Does an Epidemic Become a Pandemic? Juul Pod Ingredients Tobacco: New Legal Minimum Age Best OTC Flu Meds Intermittent Fasting and Cancer Causes of Lyme Disease Health A-Z Arthritis Type 2 Diabetes Heart Disease Digestive Health Lung Cancer Multiple Sclerosis View All Prevention & Treatment Vaccines First Aid Surgery Herbal Medicine Supplements Healthy Aging View All Health Care Health Insurance Public Health Patient Rights Health Technology For Caregivers & Loved Ones For Healthcare Professionals View All About Us Editorial Policy Privacy Policy Contact Us Visit our other Verywell sites: Verywell Fit Verywell Mind Verywell Family Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved Brain & Nervous System Multiple Sclerosis Print An Overview of Multiple Sclerosis By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial policy Colleen Doherty, MD Medically reviewed by Medically reviewed by Nicholas R. Metrus, MD on January 07, 2020 linkedin Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey. Learn about our Medical Review Board Nicholas R. Metrus, MD on January 07, 2020 Multiple Sclerosis Overview Symptoms Causes Diagnosis Treatment Living With In This Article Table of Contents Expand Types Symptoms Causes Diagnosis Treatment Coping View All Multiple sclerosis is an autoimmune disease in which the immune system attacks and destroys the protective covering of nerve cells (myelin) of the brain, spinal cord, and/or eyes.   As a result of this, nerve signaling is impaired, causing a wide variety of potential symptoms, such as muscle weakness, spasticity, pain, and cognitive issues. The precise cause of MS is unknown.   The disease is often diagnosed with the help of an MRI and/or spinal tap. Unfortunately, there's no cure. However, there are several treatment options and ways to cope that can help you manage your disease. Verywell / Joyce Chan Types There are three main types of MS.   They vary in their symptoms, disease course, and how they are treated. Relapsing-remitting MS : About 85 to 90 percent of people with MS are first diagnosed with this form. During relapses , you'll experience neurological symptoms and functionality will decline. During remissions, symptoms may disappear or just become milder. Remission may last weeks or months. Secondary-progressive MS : Some people with relapsing-remitting MS eventually develop secondary-progressive MS. It has a more progressive disease course in which symptoms become chronic and irreversible. Primary-progressive MS : Symptoms slowly, but steadily get worse over time. Relapses don't occur, and the rate of worsening varies greatly. This is a less common type, accounting for about ten percent of cases. It tends to affect the spinal cord more than the brain. You may also hear about clinically isolated syndrome (CIS) .   This is when a person has experienced a single episode that looks like an MS relapse but doesn't meet the criteria for a proper MS diagnosis . Some people with CIS go on to develop MS while others don't. In the past, when specific treatments weren't available, the vast majority of patients with relapsing-remitting MS developed secondary progressive MS within 15 to 20 years of their diagnoses.   However, since the development of disease-modifying medications , that has changed. The prognosis for MS patients continues to improve. Symptoms In the central nervous system of a healthy person, nerve cells in the brain and spinal cord rapidly send signals to each other and to the rest of the body. But in a person with MS, this signaling is impaired due to damage to the myelin.   Nerve impulses are either slow or not transmitted at all, and that causes a vast array of consequences. Which MS symptoms each person with MS experiences is unique to them, but some are more common than others because the disease tends to affect certain locations within the central nervous system. For example, because the brainstem and the nearby cerebellum are commonly affected, vertigo , speech problems , tremor , ataxia, and double vision   often result. Fatigue is also very common with MS as well as visual problems due to the involvement of the optic nerves.   Other common symptoms of MS include: Abnormal sensations (e.g., numbness and tingling , itching, feeling cold , tightness, burning )   Muscle weakness Pain Spasticity   Cognitive problems Depression MS symptoms depend on the location and severity of the damage. Some people are inconvenienced by them, while others become seriously disabled.   In people who experience remission, symptoms might go away entirely. In others, they may become milder. Some people, however, have no periods of improvement. Symptoms of Multiple Sclerosis Causes Scientists are still scratching their heads about the exact cause of MS, but they've formed several theories. Those with the most scientific backing include: Infectious diseases   Genes Vitamin D levels   It's likely that a complicated interaction between your genes and your environment is what ultimately triggers MS. As with symptoms, causal factors can be different for different people. Right now, there's no specific gene(s) that doctors can test to determine whether you'll develop MS, but certain risk factors may increase the odds of you have the disease.   Some of these include: Being between ages 20 and 50 Being female Living in a northern climate Smoking Some dietary habits may increase or decrease risk as well, but there's no strong evidence to that end yet. Causes and Risk Factors of Multiple Sclerosis Diagnosis Diagnosing MS can be difficult at times, and it's especially hard to confirm it based on symptoms alone given that they can come and go and be rather nebulous.   A medical history, physical examination, tests such as blood tests and magnetic resonance imaging (MRI) of your brain and/or spinal cord are usually needed to determine if you do, in fact, have MS. Since a lot of MS symptoms are common in other conditions, doctors need to rule them out during the diagnostic process. For instance, nerve pain, fatigue, and cognitive dysfunction are common in fibromyalgia and systemic lupus erythematosus .   Numbness, tingling, and muscle weakness can stem from a vitamin B12 deficiency or herniated disc . Before their diagnosis, it's fairly common for people with MS to say they first attributed their symptoms to a passing illness, like the flu. Doctors, too, sometimes miss MS because the symptoms are so subtle and transient. Some people go years without a diagnosis. If you're having new symptoms that could point to MS, see your doctor. He or she will likely refer you to a neurologist if the disease is suspected. How Multiple Sclerosis Is Diagnosed Treatment You've got a lot of treatment options for combatting MS.   Disease-modifying medications include: Injectable drugs such as Avonex , Betaseron , Rebif , and Plegridy Pills such as Gilenya (fingolimod) , Tecfidera (dimethyl fumarate), and Aubagio (teriflunomide) Infusions such as Lemtrada (alemtuzumab), Novantrone (mitoxantrone), Tysabri (natalizumab) , and Ocrevus (ocrelizumab) Most of them are for relapsing types of the disease, but evolving research on treatments for progressive MS are improving that picture. Ocrevus   is the first FDA-ap...