Multiple Sclerosis Diagnosis | Common Questions & Answers

If you’ve recently been diagnosed with MS, you probably have a lot of questions about how this happened to you, what you can expect, and the steps you can take today to feel your best now and into the future. So let’s give you some answers.

What are the Early Signs of MS?

Different people come to their MS diagnosis in different ways. Some of the most common first symptoms that people experience are vision problems (such as optic neuritis – pain, vision loss in one eye, loss of vision in a portion of the visual field, loss or dimming of color vision, and/or flashing lights; diplopia – double vision; or nystagmus – jumpy vision), and numbness and tingling in the arms or legs. However, every person’s MS is unique, which means that for some people, the initial symptoms may be different.

What are the Other Symptoms of MS?

The symptoms of MS are caused by inflammation and damage in the central nervous system, also known as the CNS (brain, spinal cord, and optic nerves.) The random episodes of inflammation can cause a very wide range of symptoms.

Fatigue is the most common, and often the most debilitating MS symptom. It is a type of fatigue that it unique to MS, but may be compounded by sleep difficulties, depression and anxiety, frequent nighttime urination, and muscle fatigue, all of which are common symptoms of MS. Weakness, balance problems, walking difficulty, changes in bladder and bowel function, pain, problems with thinking and memory, mood changes, speech and swallowing difficulties, changes in sexual feelings and responses, dizziness or vertigo, and tremor are all possible symptoms of MS. Some people will only experience a few of these symptoms while others may experience many more over the course of their disease. The wide range of possible symptoms is a major reason why comprehensive MS care requires a multidisciplinary team of healthcare professionals.

What are the Different Types of MS?

• When a person experiences a first episode of neurologic symptoms that lasts at least 24 hours and is caused by inflammation and demyelination (damage to the myelin coating around nerve fibers) in the CNS, it is referred to as a Experiencing a CIS does not necessarily mean that a person will go on to develop MS, and early treatment of a CIS has been shown to delay the onset of definite MS.
• Most people (about 85%) are initially diagnosed with relapsing-remitting MS (RRMS), which is characterized by clearly defined episodes of new or increasing neurologic symptoms. Each episode (referred to as relapses, attacks, or exacerbations) is followed by partial or complete recovery (remission), during which the symptoms may partially or completely disappear.
• Some people diagnosed with RRMS eventually develop secondary progressive MS (SPMS). When this transition happens, a person has fewer or no relapses but experiences gradually worsening disability. Early treatment with a disease-modifying therapy has been shown to delay the transition from RRMS to SPMS.
• About 15 percent of people are diagnosed with primary progressive MS (PPMS). A person with this disease course experiences a steady progression of disability with few or no relapses.

How is MS Treated?

Comprehensive MS care has 5 components which reflect the potential impact of this disease on a person’s well-being, chosen activities, productivity, and independence:

• Modifying the disease course: Early and ongoing treatment with one of the 20+ available disease-modifying therapies (DMTs) has been shown to reduce relapses and slow disease progression in many people with MS. It is usually a person’s best insurance for the future.
• Managing the symptoms: The wide range of MS symptoms are managed by a combination of interventions, including medications, mind-based strategies (e.g., cognitive behavior therapy), rehabilitation, and healthy lifestyle choices.
• Rehabilitation: Rehabilitation improves function following relapses and works to maintain a person’s mobility, safety, and independence over the lifespan. Physical and occupational therapists also recommend exercise programs and train people in the use of mobility aids. Speech/language pathologists provide remediation strategies for problems with communication, thinking, and memory.
• Managing relapses: Relapses that impact a person’s ability to function are generally treated with a short course of high-dose oral or intravenous corticosteroids, followed by rehabilitation to help restore function.
• Providing mental health services and emotional support: Mental health professionals help with the grief, depression, and anxiety that are common in MS, along with cognitive changes that impact thinking and memory.

In addition, following a healthy lifestyle can improve your quality of life and reduce the risk of developing other chronic conditions, such as heart disease and diabetes. The six tenants of a healthy lifestyle include the following:

• Regular physical activity
• A healthy diet rich in minimally processed fruits, vegetables, whole grains, legumes, nuts and seeds.
• Sufficient and restorative sleep (7-9 hours each night)
• Stress management
• Avoiding smoking, heavy alcohol use, and other dangerous substances
• Maintaining fulfilling and supportive relationships

The diagnosis of MS is hard to hear, and your path forward may not yet be clear to you, but your healthcare team and MS advocacy organizations are there to help and support you and your family along the way.