Multiple Sclerosis (MS)

Overview

Multiple Sclerosis (MS) is an autoimmune disorder in which the immune system attacks cells in parts of the central nervous system – particularly the brain and spine – causing them to work less efficiently, or not at all. There are four main types:

  • Relapse-Remitting MS, in which a person has “attacks” or relapses of symptoms, followed by periods of remission or complete recovery of symptoms.
  • Secondary Progressive. Most individuals with this type initially had Relapse- Remitting which progressed to include neurologic decline between attacks without periods of remission.
  • Primary Progressive which includes continuous decline without clear attacks or remission. This subtype occurs in a minority of individuals and tends to occur with later age of onset. The last and most rare type of MS is
  • Progressive Relapsing. This is the rarest type of MS. which includes continuous decline with clear acute attacks superimposed.

Causes/Symptoms

No definitive cause has been found; however, common theories suggest that an infection may prime the immune system to have an abnormal reaction later on, or that chronic infections may lead to an abnormal reaction in the immune system. Genetics may also play a role.

MS can produce motor, sensory, and cognitive symptoms, as well as significant fatigue. Motor symptoms can include weakness or numbness/tingling in parts of the body. Sensory symptoms can include loss of vision or blurred vision. Cognitive symptoms include slowed thinking speed, difficulties paying attention, reduced recent memory, word finding, and trouble with problem solving. Visuospatial skills can be affected at times too. Emotional symptoms can also occur. Symptoms generally onset between the ages of 20 and 40.

When to see a doctor

If you notice any of the symptoms mentioned above, such as increased fatigue, motor changes, sensory symptoms, cognitive declines, and mood changes, consult with your doctor, particularly if symptoms are unexplained.

Evaluation

An evaluation for MS is generally conducted by a neurologist and often includes a neurologic exam, blood work, and imaging of the brain and spine.

If you are experiencing cognitive difficulties, your neurologist may recommend a neuropsychological evaluation as well, to assess a person’s cognitive abilities and mood.

Physical or occupational therapy evaluations may also be recommended for changes in motor or sensory functioning. Consultation with a vision specialist, such as a neuro-opthamologist, may also be recommended.

Treatment

Medications such as immunomodulatory and immunosuppressant agents can be prescribed to treat MS and its symptoms. These are generally prescribed and managed by the treating neurologist or physician.

Other therapies may be beneficial, as well, depending on the person’s presenting symptoms.

  • Physical therapy may benefit someone with motor or balance difficulties.
  • Occupational therapy may help those with motor difficulties in their hands, or visual difficulties. OT can also improve a patient’s ability to continue driving or performing other daily activities such as managing finances and medications.
  • Cognitive Rehabilitation Therapy can address cognitive deficits.
  • Psychotherapy can help a patient manage mood-related symptoms. There are many support groups for MS in the area, as well.
  • Vocational rehabilitation may be beneficial for those who are still working, to provide support and accommodations for continued success.

Bancroft NeuroRehab offers all of these therapies, including physical, occupational, speech, vocational and psychotherapy, as well as neuropsychological evaluations in one location. This also facilitates communication among treating therapists to help ensure the best level of care and ease of receiving needed services.