Spotlight on... multiple sclerosis (MS)

In our central nervous system disorders focus month, Andrea Lisher provides us with an overview of multiple sclerosis (MS), which currently affects around 100,000 people in the UK and 2 million people around the world.

What is MS?

Multiple sclerosis (MS) is a condition of the central nervous system. In MS, the coating around nerve fibres (called myelin) is damaged, causing a range of symptoms.

Approximately 100,000 people in the UK live with multiple sclerosis and 2 million around the world. Every one of them shares the uncertainty of life with MS.

Once diagnosed, MS stays with people for life, but treatments and specialists can help them manage their condition and its symptoms.

We currently don't know the cause of MS and as yet, there's no cure. However, important breakthroughs have already been made and we're now at the start of a generation of MS research that holds incredible promise.

There are several different types of MS, it's a fluctuating condition and affects everyone differently:

• Relapsing remitting MS – around 85 percent of people diagnosed with MS have this form of the condition. It means that symptoms appear with a relapse and then fade away, either partially or completely. It could be the appearance of new symptoms or the return of old ones. They usually come on over a short period of time – say hours or days – and could last for days, weeks or even months. This form of MS affects more women than men.

• Primary progressive MS – this form affects about 10 to 15 percent of people diagnosed with MS. Symptoms get gradually worse over time, rather than appearing as sudden attacks (relapses). This type of MS is usually diagnosed in people in their 40s and 50s and affects equal numbers of men and women.

"...we're now at the start of a generation of MS research that holds incredible promise."

• Secondary progressive MS – this is the stage which often comes after relapsing remitting MS. It's often described as a "sustained build up of disability, independent of any relapses".

• Childhood MS – MS in children is rare, although it's thought that around five to ten percent of people with the condition experience its onset before the age of 16. Childhood MS isn't always recognised, either because symptoms are mild and pass quickly or because they're put down to other conditions that are more common in children. Neurologists are starting to recognise that children can get MS.

Who is at risk?

MS affects almost three times as many women and men and people are usually diagnosed in their 20s and 30s.

What are the symptoms to look out for?

MS can get steadily worse, or remain unpredictable – one day a person with MS might be fine, the next day they might lose their sight or be unable to move.

The damage to myelin (the nerve fibre coating) can lead to a range of symptoms including loss of sight and mobility, muscle spasms, slurred speech, pain, incontinence, cognitive problems, fatigue and depression.

The course of the condition and its impact on different people is very difficult to predict.

Diagnosis – because MS is complex and can cause many different symptoms it's not an easy condition to diagnose. It can often take months for people to get a diagnosis and sometimes might be longer. Tests for MS can include MRI scans and a lumbar puncture.

What treatment is available?

There are lots of different ways to manage MS: they can include drug treatments for individual symptoms or relapses, such as steroids, exercise and alternative therapies.

Disease modifying drugs – clinical trials have shown that disease modifying treatments can reduce the number of relapses people have by around a third over two years. They can cause side effects and have criteria for who can access them (e.g they're only for people with the relapsing remitting form of MS).

"...clinical trials have shown that disease modifying treatments can reduce the number of relapses people have by around a third over two years."

People can also treat and manage specific symptoms using a variety of treatment tools and techniques:

• Steroids – steroids can be used to treat relapses in MS. Steroids can shorten the duration and speed up recovery from a relapse.

• Exercise – because MS can be so unpredictable, what's suitable will vary for different people. It can often help with symptoms such as fatigue, balance and muscle spasms.

• Physiotherapy – physio is often recommended when people have a specific problem or ongoing symptom that affects their mobility and independence.

• Botox – botox is most commonly known for its use in cosmetic procedures, but has also been shown to be beneficial for people with MS that have symptoms of overactive bladder. It can also be used in MS to treat muscle tension and spasticity.

• Cognitive behavioural therapy (CBT) to improve fatigue management – most people with MS will experience fatigue at some point, and we know that CBT with a psychologist can help with it. Researchers have also been trying to make it more accessible by designing it to be internet based and self-manageable.

• Functional electrical stimulation (FES) – this device can help some people with MS to walk by using electrical current to stimulate nerves and move parts of the body.

Any of these tools or techniques combined with a healthy lifestyle can help people to best manage their MS.

"At the moment, the MS Society is funding around 70 research projects costing over £15 million."

What does the future look like for patients with MS?

The MS Society is working with partners around the world to fund research that we believe will beat MS for good.

At the moment, the MS Society is funding around 70 research projects costing over £15 million.

We fund biomedical research into the causes of MS as well as better treatments for the condition. We're also committed to improving the day-to-day lives of the people it affects so our research now includes projects looking at symptom relief and MS services.

More and more research is also now being done with the hopes of finding new treatments for progressive MS.

About the author:

Andrea Lisher is Press and PR Officer at the MS Society and joined the charity in summer 2012 after working as a journalist for almost ten years. Andrea spent more than three years working for BBC Radio 5 live and also freelanced for a variety of other radio stations including Capital Radio in London, Sky News Radio and the Jeremy Vine show at BBC Radio 2. Andrea now focuses on fundraising and case study press work at the MS Society but also works with colleagues on research and policy stories.

You can contact Andrea at andrea.lisher@mssociety.org.uk

To find out more about MS and the work of the MS Society go to: www.mssociety.org.uk

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