Understanding multiple sclerosis: Learn from the experts

Tuesday, November 12, 2024

[4 MIN READ]

The most common symptoms of multiple sclerosis are a change in vision, vertigo and dizziness, and muscle weakness.
There is no cure for MS, but your doctor can help you find medications to manage your symptoms. Physical therapy also can help.
The best ways to manage MS at home are to eat healthy, exercise and actively work to relieve stress.

Understanding multiple sclerosis: A conversation with MS neurologists

As more and more celebrities have revealed they have multiple sclerosis (MS), the disease has come to the forefront of many conversations. It’s important to have the facts, which is why we sat down with Stanley Cohan, M.D., PhD, neurologist and medical director at Providence Multiple Sclerosis Center, and Pavle Repovic, PhD, neurologist at the Swedish Multiple Sclerosis Center and neurology research leader at Swedish Neuroscience Institute, to discuss an MS diagnosis and how it can affect those we love.

What is multiple sclerosis?

MS is an autoimmune disorder in which the immune system attacks the central nervous system, damaging the protective sheath, or myelin, that covers nerve fibers. It is a degenerative disease, which means that MS affects you more over time.

While anyone can get MS, one of the biggest risk factors is having a first-order relative (a sibling or parent) with the disease. “Keep in mind that most individuals with a first-order relative will not get multiple sclerosis, but their risk is higher than the general population,” says Dr. Cohan.

The signs and symptoms of MS can vary greatly from person to person, but some of the most common early symptoms include:

A change in vision
Numbness of the face, body, arms or legs
Vertigo and dizziness
Muscle weakness
Sensations that feel like an electric shock when making certain neck movements
Slurred speech

“It’s not unheard of for someone to experience these problems and not know what is going on,” says Dr. Repovic. “They might sit on it and then things get better, so they forget about it. If something is worsening, it needs to be investigated and not ignored.”

How is multiple sclerosis diagnosed?

“There are no definitive blood tests or diagnostic tests that say, ‘This is multiple sclerosis,’” says Dr. Cohan. “The disease is typically diagnosed after reviewing the history of symptoms, a neurological exam and an MRI scan of the brain and spinal cord. Taken together, these are the gold standards for diagnosing MS.”

When diagnosing the disorder, doctors must first rule out other potential causes of the symptoms. They also need to find damage in two or more separate areas of the central nervous system, and uncover evidence that the damage occurred at different points in time.

Once they have that evidence, they can proceed to treatment options.

Treatment options for MS

While there is no cure for MS, doctors have found success in treating many of the symptoms and delaying the disease progression. Some of those treatments include:

Medications that reduce nerve inflammation
Injectable, oral and infused medication that can modify the disease so it affects a patient’s quality of life less
Physical therapy, which includes stretching and strengthening exercises
Occupational therapy, which shows patients how to use devices for help performing daily tasks

Providence and Swedish have been at the forefront of new treatments for MS. “Until 1993, there were no medications of proven value for multiple sclerosis,” says Dr. Cohan. “Now, 30 years later, there are more than 20 medications with varying degrees of effectiveness. Medicines are selected based on the severity and pattern of the disease, as well as the potential risks from using each of these therapies.”

“Among advancing treatment options is a whole new class of medications, called Bruton tyrosine kinase (BTK) inhibitors,” Dr. Cohan continues. “There are multiple clinical trials of these agents happening worldwide, and multiple trials of these agents are being conducted at both Swedish Multiple Sclerosis Center and Providence Multiple Sclerosis Center. We hope to have data on the efficacy in the next several years.”

Living with MS: Managing symptoms

“If you’ve been diagnosed with MS, the most important thing you can do is make an appointment with an MS specialist. You don’t have to continue care with a specialist, but your ability to impact the course of this disease decreases with time,” says Dr. Repovic. “You have this window of opportunity early on to make the most impact on your course of multiple sclerosis, and starting early can make a huge difference.”

Beyond medications and other treatments, there are significant steps you can take to manage your symptoms and reduce flare-ups. They include:

Eating healthy – This can help alleviate symptoms associated with MS, such as fatigue, constipation and incontinence. Some research shows that vitamin D can help with MS.
Managing your fluid intake – You can try several different strategies to improve your bladder function, including not drinking before any outing that doesn’t involve a bathroom, and limiting your bathroom breaks to every two hours.
Exercising – Mild to moderate exercise can improve your muscle tone and strength.
Actively working to relieve stress – Stress can exacerbate MS, so try yoga, meditation, deep breathing, massage or other forms of stress relief.

There is hope for MS patients, and Providence can help you find it. Connect with the Providence Multiple Sclerosis Center to learn how you can live well with MS.

Contributing caregivers

Stanley Cohan, M.D., PhD, is a neurologist and medical director at Providence Multiple Sclerosis Center. Pavle Repovic, PhD, is a neurologist at Swedish Multiple Sclerosis Center and neurology research leader at Swedish Neuroscience Institute.

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