Determining The Type Of Ms
Once a diagnosis of MS has been made, your neurologist may be able to identify which type of MS you have.
This will largely be based on:
- the pattern of your symptoms such as whether you experience periods when your symptoms get worse then improve , or whether they get steadily worse
- the results of an MRI scan such as whether theres evidence that lesions in your nervous system have developed at different times and at different places in your body
However, the type of MS you have often only becomes clear over time because the symptoms of MS are so varied and unpredictable. It can take a few years to make an accurate diagnosis of progressive MS, as the condition usually worsens slowly.
Demographic And Clinical Participant Characteristics
Twenty-two of thirty-six patients and 13 of 21 controls were female . Twenty-one of thirty-six patients and 16 of 21 controls had at least a high school diploma . The mean age of patients was 47.4 y and of controls was 49.1 y . Eight of 36 patients were treated with fumarate, 7 with -interferons, 7 with glatiramer acetate, 6 with fingolimod, and finally 2 with teriflunomide. For a subgroup of 22 patients, a T2-weighted brain MRI scan acquired within a time period of roughly 1 y before participation in our study was available . Comparing these images with T2w images acquired during study participation revealed that only 7 of 22 patients had developed new lesions in this period . Consistently, the median number of days since the end of the last relapse across all 36 patients was 654 d . Together, these findings suggest that disease activity at or around the time of our study was fairly small. See and for further patient characteristics.
The association between fast neural stress responses and brain volume. The brain slices depict coordinates with a positive link of stress-induced brain activity and GMF in patients surrounding the peak coordinate identified in fMRI analysis 4a . The scatterplot illustrates the association of GMF and stress-induced brain activity at MNI coordinates 42, 61, 22 for patients and the association between activity and GMF at MNI coordinates 45, 61, 22 in controls. The corresponding results for WMF identified in fMRI analysis 4b.
Avoid These Potential Relapse Triggers
When you have relapsing-remitting multiple sclerosis , months of symptom-free bliss can be ruined by a sudden and often unexplained relapse of symptoms pain, fatigue, weakness, problems with balance, and more. There is no clear cause of MS or definite triggers for its symptoms, which makes general recommendations on how to prevent the disease impossible, says Le Hua, MD, an MS specialist at the Cleveland Clinics Lou Ruvo Center for Brain Health in Las Vegas, Nevada.
What triggers a relapse varies widely from person to person. Relapse can also occur for no apparent reason, just by the nature of the disease,” she says. That being said, avoiding some potential triggers whenever possible may help you prevent a relapse.
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Multiple Sclerosis And Mental Health: 3 Common Challenges
Multiple sclerosis affects everyone differently. If you or your loved one has MS, you areprobably familiar with symptoms such as difficulty walking, fatigue, andnumbness or tingling. These and other physical symptoms can be severe andlimiting. However, emotional changes and mental health challenges can bejust as disabling.
Rehabilitation neuropsychologist Meghan Beier, Ph.D., discusses three common mood and mental health concerns for people with MSand how to address them.
How Nerve Damage Can Impact Organs

And because the brain sends messages to the sexual organs through the spinal cord and vice versa, Dr. Scherz says damage anywhere along that path may cause sexual problems, including difficulty getting aroused, reduced sensation and trouble achieving orgasm.
Lesions in the parts of the brain responsible for coordinationoften lead to balance and coordination problems, which tend to begin in the legs and move to other parts of the body as the disease progresses. Muscle spasticity and weakness, stemming from fatigue or other symptoms, may also be to blame.
People with MS may have difficulty walking, and in advanced stages, need a cane or wheelchair or to be bedridden, Dr. Scherz says.
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Stress At Home And Work
In the study, published in Neurology, researchers looked at the relationship between stress and the risk of developing multiple sclerosis in more than 237,000 women who participated in the Nurses Health Studies.
The participants reported the level of general stress at home and at work, including physical and sexual abuse in childhood and adolescence.
After taking into consideration other risk factors for multiple sclerosis, including age, ethnicity, latitude of birth, body mass at age 18, and smoking status, the researchers found severe stress at home or at work was not associated with any increase in MS risk.
In addition, there was no increase in multiple sclerosis risk among the women who reported severe physical or sexual abuse during childhood or adolescence.
The researchers say the results suggest that stress does not play a major role in the development of MS, but future studies are needed to fully exclude stress as a risk factor for multiple sclerosis.
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Why Do People Get Ms
It’s not clear what causes the immune system to attack the myelin sheath.
It seems likely that it’s partly caused by genes you inherit from your parents and partly by outside factors that may trigger the condition.
Some of the factors that have been suggested as possible causes of MS include:
- your genes MS isn’t directly inherited, but people who are related to someone with the condition are more likely to develop it the chance of a sibling or child of someone with MS also developing it is estimated to be around 2-3%
- lack of sunlight and vitamin D MS is more common in countries far from the equator, which could mean that a lack of sunlight and low vitamin D levels may play a role in the condition, although it’s not clear whether vitamin D supplements can help prevent MS
- smoking people who smoke are about twice as likely to develop MS compared to those who don’t smoke
- viral infections it has been suggested that infections, particularly those caused by Epstein-Barr virus , might trigger the immune system, leading to MS in some people
More research is needed to further understand why MS occurs and whether anything can be done to prevent it.
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What Happens In Ms
MS is an autoimmune condition, which means your immune system mistakes part of your body for a foreign substance and attacks it.
In the case of MS, it attacks the myelin sheath in the brain and/or spinal cord. This is the layer that surrounds your nerves, protecting them and helping electrical signals travel from the brain to the rest of the body.
The attacks cause the myelin sheath to become inflamed in small patches , which can be seen on a magnetic resonance imaging scan.
These patches of inflammation can disrupt the messages travelling along the nerves. It can slow them down, jumble them, send them the wrong way, or stop them from getting through completely. This disruption leads to the symptoms and signs of MS.
When the inflammation goes away, it can leave behind scarring of the myelin sheath . These attacks, particularly if frequent and repeated, can eventually lead to permanent damage to the underlying nerves.
What Is The Prognosis For Ms
Most people think that MS is a rapidly disabling disorder. This is not true for most people with MS. A recent study of people with MS in the Olmstead county area near the Mayo clinic showed that most people did well even without treatment. An older study showed that after 25 years without treatment most people were still able to walk. However, only a small percentage of people followed for years do not show some measurable signs of MS on examination.
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The Stress Of Living With Ms
Living with MS means that you may have to face health limitations, such as problems with mobility, bladder issues, and impaired vision, which can cause frustration and stress. But there are many other concerns those with MS face that factor into the stress of living with this disease as well:
- The unpredictable nature of MS
- Adapting to new symptoms
- Concerns about your job
What Is An Ms Relapse
An MS relapse is caused by acute inflammation in the central nervous system damaging the protective myelin. As a result, new MS symptoms occur or old symptoms worsen, but to be defined as a relapse they must be separated from the previous flare-up by at least 30 days and last for at least 24 hours. There must also be no other explanation for the symptoms for example fever, acute infection or acute stress in such cases the new symptoms would be classified as a pseudo-relapse.
Symptoms will vary from person to person and can range from mild sensory disturbance to severe new disability. For example, in some cases it can be just one symptom while others may experience several new symptoms at the same time.
MS relapses can last from several days, to weeks or even months. In relapsing-remitting MS, exacerbations are followed by remissions. Some people will find that they go back to how they were feeling before the exacerbation but going into remission doesnt mean that symptoms always disappear.
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Dont Be Afraid To Talk To Your Doctor
If you have MS and think you may have depression, anxiety or pseudobulbar affect, talk to your primary care physician about your symptoms. They can refer you to a rehabilitation psychologist specializing in MS or another specialist who can help.
If you are a support partner of someone with MS, watch for signs of depression and anxiety both in your loved one and in yourself. They may not always be obvious and can often look like irritability, anger or a growing detachment from social life.
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The Danger Of Anxiety: Avoidance Behaviors

If youve ever experienced anxiety, you know it can make daily life difficult. One way some people deal with anxiety is by avoiding its source. When you get anxious about getting dizzy while driving, your instinct may be to avoid getting in the car. Or if you are afraid of having a bowel accident in public, not leaving the house may seem like a good solution. These avoidance behaviors could make you skip a doctors appointment, reduce your time with friends or stop you from doing what you enjoy.
People who have both MS and anxiety are more likely to have suicidal thoughts, adds Beier. Although data varies, it is estimated that up to 15 percent of people with MS die of suicide. If you notice avoidance behaviors, or anxiety that is impacting daily life, its important to start a conversation with a doctor.
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What Do We Know About Multiple Sclerosis
There has been widespread research about MS over the past 50 years. We do not know the cause of MS, but do know that it is an inflammatory disorder of the central nervous system that occurs in people with a tendency to such a problem. We know that about 350,000 people in the United States have MS, about 1 in 1,000 people. We know that it is more common further north and south of the equator. Although we are still unsure exactly why this is. Females tend to get MS about three times as often as males, a rate similar to other immune diseases. MS is more common in Caucasians, but can occur in other populations. It is not contagious, nor is it infectious.
What Are The Main Risk Factors For Multiple Sclerosis
Multiple sclerosis results when your immune system attacks the cells of the brain and spinal cord. It is an autoimmune disease, a condition in which the bodys immune system is misdirected and attacks its own cells.
The exact cause for MS is not known, however, and several factors can put you at risk of getting MS:
- Age: MS can occur at any age, but the most common age group is 15 to 60 years.
- Sex: MS is more common in women than in men.
- Genes: Although MS is not hereditary, you are more likely to get MS if you have a family history of MS.
- Smoking
The factors listed above often act interdependently to cause MS rather acting in isolation. For example, female individuals with a family history of MS are more likely to get MS compared with those females who have no family history of MS.
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Worried About Ms 4 Triggers That Can Cause Flares
Periods of relapse and remission are common with the chronic disease multiple sclerosis. Find out about factors that might trigger MS symptoms.
For Americans living with multiple sclerosis , the majority are initially diagnosed with relapsing-remitting MS, or when the symptoms ebb and flow. Although the flares of numbness, pain, dizziness, and imbalance can be unpredictable, there are certain triggers that cause the flare ups for many people.
“When a new neurological symptom develops in multiple sclerosis, one that isnt related to an infection, and lasts for more than 24 hours, it is considered to be an MS relapse,” explains Devon Conway, MD, a neurologist at the Cleveland Clinic. While a relapse that causes serious symptoms usually needs to be treated, old symptoms that reappear are not as serious and often go away without needing treatment.
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Does Stress Cause Ms Lesions
MS lesions are areas of damage in the nervous system. They can be seen using magnetic resonance imaging . New lesions look different than older ones. Researchers have been studying how different factors may influence the formation of new lesions.
One studyTrusted Source explored the effects of both positive and negative stressful events. Negative stress was defined as a threat to the person or their family. The study found that periods of negative stress resulted in more brain lesions. Positive stress events did not.
Another study found that stress management counseling reducedTrusted Source the number of new MS brain lesions. However, the effects did not last. There was no significant difference in lesions at the 24 week follow-up.
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The Treatment Of Spinal Ms
Unfortunately, scientists have yet to develop a cure for Multiple Sclerosis. The good news: MS researchers have celebrated successes in developing more effective treatments for symptom management. Oral and injectable medications have proven to slow or even halt the progression of the disease.
In particular, many clinicians now offer an integrated approach to MS treatment. By combining a spectrum of wellness strategies, individuals with MS can lead healthier, happier, and longer lives. Components of this integrative approach include:
Experiencing unusual neurological symptoms with your lower back or neck pain? Have your symptoms checked out today. Already living with MS? Keep on your treatment path and maybe add some new interventions from the list above. Individuals with spinal multiple sclerosis are now living longer and fuller lives and so can you too.
Is Fatigue Part Of Ms
Fatigue, a sensation of being tired all the time, is very common in MS. Most patients with MS feel tired more than they used to, despite getting sleep at night. While fatigue in MS can be due to a lack of sleep or poor sleep, it is often just one of the symptoms of MS. It may be due to activation of the immune system, like fighting off an infection. It may be due to having to work harder to re-route information in the brain because of the MS. In any case, it can be treated. Taking naps helps with afternoon fatigue.
Regular exercise actually improves fatigue symptoms. Avoiding very heavy meals may help. Making sure that night-time sleep is good is also useful. There are medications that have been shown to be helpful in MS-related fatigue.
Last reviewed by a Cleveland Clinic medical professional on 01/28/2019.
References
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What Is Demyelination
In MS, patients develop various areas in the brain and spinal cord where the myelin is stripped off of the nerves. These areas are called plaques or sometimes lesions. When the myelin is off, the electrical conduction of these nerves is altered. It is like getting a fuzzy signal on a television set. This event may affect any aspect of central nervous system functioning, causing symptoms. The symptoms may vary over time depending on how extensive the demyelination is and on factors such as fatigue and heat.
Does Stress Affect Ms

MS is an autoimmune disease. The immune system is designed to attack harmful invaders like viruses or bacteria. In MS, the immune system mistakenly attacks myelin, the protective coating on the nerves. This results in damage to the myelin.
There may be a link between stress and autoimmune diseases like MS. Researchers have found that people who have been diagnosed with stress-related conditions are more likely to develop an autoimmune disease. However, more research is needed to understand this connection.
Science hasnt been able to draw a conclusive link between stress and MS flares. Stress can cause a variety of emotional and physical symptoms that can affect how you feel. If youre already dealing with symptoms of MS or its treatments, the extra toll of stress can make you feel worse.
MS lesions are areas of damage in the nervous system. They can be seen using magnetic resonance imaging . New lesions look different than older ones. Researchers have been studying how different factors may influence the formation of new lesions.
One study explored the effects of both positive and negative stressful events. Negative stress was defined as a threat to the person or their family. The study found that periods of negative stress resulted in more brain lesions. Positive stress events did not.
Another study found that stress management counseling
Here are some stress management strategies to try:
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