Multiple Sclerosis Symptoms (MS) is the leading cause of irreversible neurological disability in women in the U.S. According to the National Multiple Sclerosis Society, it’s is at least two to three times more common in women than in men. The reason? That still remains one of the major mysteries of the disease.
Multiple sclerosis is a condition where the immune system attacks nerves in the brain and spinal cord. Typically, MS follows a classic relapse/remission pattern. “You get this burst of inflammation in a spot in the brain, and the inflammation runs its course for about two months,” Vollmer explains. After this “attack,” you then “recover,” and the disease and symptoms retreat for a time period until the next attack. If left untreated, this type of MS will eventually enter a progressive phase, where the disease advances and symptoms continually worsen. “We can’t stop the progressive stage once it starts,” Vollmer.
The cause of MS is tough to pinpoint, though environmental factors seem to play a big role. Family history (especially your mother) of multiple sclerosis makes you more susceptible to it, Vollmer says. “One out of 20 children born into a family with MS will develop it.” Researchers have identified 55 genes that are associated with either an increased or decreased risk of developing MS, Vollmer says, but what that can reveal is relatively small. There seem to be genetic, hormonal, and environmental factors at play. MS occurs in all ethnic groups, but it’s more common in Caucasians of northern European ancestry, according to the National MS Society. Vollmer says that there’s a powerful association between MS risk and low vitamin D exposure in utero and early in life.
Multiple Sclerosis Symptoms can be managed if it’s caught early, which is why it’s important to recognize its symptoms. Vollmer calls MS a relatively invisible disease, since many of the symptoms can only be felt by the patient. “Oftentimes, family member and friends may not know what they’re going through.” The symptoms of the disease are common symptoms of many other less serious ailments, which makes MS difficult to spot. “They’re often subtle enough that healthcare providers miss it,” Vollmer adds.
He also notes that when patients present with their first symptoms, it’s very likely they’ve had the condition for a decade already and have already suffered significant brain volume loss—this atrophy is the strongest predictor of disability, so it’s key to catch it early. Where in the brain the attacks occur can drastically change when symptoms pop up and how debilitating they are.
Multiple Sclerosis Symptoms is treatable, but there’s some debate in the medical community on the best way to approach it. There’s a big debate among neurologists about whether to approach treatment by using the most effective, often riskier drugs right off the bat (early effective therapy), or starting with the less effective, yet safer ones, and working up if there’s no progress (escalation therapy). “Most of the world does escalation therapy, seeing if patients fail on old drugs before considering using newer drugs,” Vollmer explains. “Most MS centers in this country do the opposite—we select the most effective therapy and intervene as early as we can.” The problem is that newer drugs are more complicated, riskier, more expensive, and often have insurance limitations. “Bottom line is, try to get at least one second opinion to make sure you understand your options,” Vollmer says.