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What is Multiple Sclerosis (MS)?

MS is a condition that affects the central nervous system, causing a wide range of potential symptoms.The exact cause of MS is unknown but we do know that something triggers the immune system to attack the brain and spinal cord. These attacks result in loss of myelin (the protective layer insulating wire-like nerve fibres) and axons (the wire-like nerve fibres), which disrupts signals to and from the brain. This disruption of signal conduction causes unpredictable symptoms which vary from person to person. Once diagnosed, MS stays with you for life, but treatments can help to mitigate the condition and its symptoms.

Types of MS

Four disease courses have been classified in multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), primary progressive MS (PPMS), and secondary progressive MS (SPMS). Some of them can also be categorised as active/not active and progressive/not progressive.

Clinically Isolated Syndrome of multiple sclerosis (CIS)

CIS is a first episode of neurologic symptoms caused by inflammation and demyelination in the central nervous system. This type of episode is characteristic of multiple sclerosis but does not yet meet the criteria for a diagnosis of MS, in the absence of new relapses (or test results indicating ongoing new disease activity).

Relapsing Remitting MS (RRMS)

RRMS is characterised by clearly defined attacks of new or increasing neurologic symptoms. These attacks – also called relapses are followed by periods of partial or complete recovery and remissions. A relapse is the occurrence of new symptoms or sometimes a significant worsening of old symptoms. It can be very mild, or severe enough to interfere with a person’s ability to function.

Secondary Progressive MS (SPMS)

Some people with RRMS may eventually transition to a secondary progressive course, in which there is a gradual worsening of neurologic function (accumulation of disability) year-on-year, even in the absence of relapses.

Primary Progressive MS (PPMS)

PPMS is characterised by gradually worsening neurologic function (accumulation of disability) from the onset of symptoms, without preceding relapses (but there can still be relapses superimposed on the gradual progression).

Some types of MS can also be described as active, not active, progressive or not progressive. Both PPMS and SPMS can be further characterised as either active (with relapses and/or evidence of new MRI activity over a specified period of time) or not active, as well as with progression (evidence of disability accumulation over time, with or without relapse or new MRI activity) or without progression.

The diagnosis process

It can be hard to tell whether your symptoms might be caused by MS at first, as some of the symptoms can be quite vague or similar to other conditions, and there is no single test which is diagnostic for MS (so usually a specialist is required to clinically confirm the diagnosis).

However, it’s important to book an appointment with your GP if you do have any symptoms of MS. Common symptoms include:

  • Numbness
  • Difficulty walking
  • Spasticity
  • Vision problems
  • Weakness
  • Fatigue
  • Cognitive changes
  • And more!

As soon as you start to notice symptoms, make sure you make a written note. It’s easy to forget what symptoms you experienced and how badly they affected you once you’re feeling better. Plus, letting your GP know as much information as possible about the type, duration and pattern of symptoms you’ve experienced will help them determine whether you might have the condition and how best to treat you. If the GP thinks you could have MS you should be sent for tests and also to see a neurologist for an assessment.

Tests & Treatments