What Is Multiple Sclerosis?

Multiple sclerosis is an autoimmune disease that damages nerve fibers. The exact triggers are unknown. Here's what you should know about MS and its effects.

In the television show “West Wing,” Jed Bartlett, played by Martin Sheen, runs for president and wins, without telling voters that he suffers from multiple sclerosis. He’s censured by Congress for keeping an important secret.

Why might voters decide to vote against someone just because he has this disease?

The short answer is that multiple sclerosis (MS) is a disease of the nervous system that usually comes in episodes. You have an attack — and then you’re fine. Bartlett can meet the demands of the presidency, but at any moment he could be temporarily disabled.

In a show full of cliff-hangers, multiple sclerosis adds to the tension. We know Bartlett could suddenly lose his vision or be unable to concentrate for a day or more.

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What is multiple sclerosis?

The number of people with an autoimmune illness has risen dramatically. The common illnesses in this group include lupus, celiac disease, type 1 diabetes, and multiple sclerosis.

Your immune system developed to protect you from bacteria and viruses. To do so, it needs to identify foreign proteins. In an autoimmune illness, your immune system misidentifies part of your body as foreign and attacks it.

It’s not known what triggers MS, but scientists believe that changes in the environment have led to the increase in autoimmune illnesses. People with MS most likely are more vulnerable than the general population because of their genes.

When you have MS, your immune system creates inflammation that damages nerve fibers, fat insulating nerve fibers called myelin, and cells that make myelin. The damaged areas develop scars, known as sclerosis. You end up with many scars. The scars interfere with your central nervous system, which includes your brain, spinal cord, and optical nerves. Messages within the system may be garbled or stop entirely.

Multiple sclerosis symptoms

Multiple sclerosis symptoms vary from one person to the next. Some people have flare-ups but are symptom-free in between episodes for most of their lives; others have severe chronic symptoms.

The first symptoms often occur in your eyes:

• Suddenly blurred vision
• Not being able to see contrast or colors
• Pain when you move an eye

Another early symptom is tingling in your face or arms and legs. About 80 percent of patients battle fatigue.

Many people become depressed. It is also common to develop chronic pain. You might have spasms, especially in your legs, and might develop problems walking. Trouble with your bladder and constipation are common. You might notice sexual functioning problems.

Many MS patients lose some cognitive function over time.

About a quarter of all patients lose some of their sense of taste.

Less common multiple sclerosis symptoms include:

• Tremors
• Slurred speech
• Seizures
• Hearing loss
• Breathing and swallowing symptoms

Treatment for multiple sclerosis

There is no cure for MS. Physical therapy and medications that suppress your immune system can help with symptoms and slow disease progression.

Your doctor might prescribe corticosteroids, plasma exchange, and disease-modifying medications, both injectable and infused.

Life with MS

About 15 percent of patients have primary progressive MS (or PPMS), meaning they suffer from increasing disability from day one.

About 85 percent of patients begin with a relapsing-remitting MS (RRMS). Like Bartlett, they have noticeable attacks (relapses) that go away (remit). During the remissions, you function normally. You’ve had an attack, if, after at least 30 days without a particular symptom, it comes on without any obvious trigger and lasts at least 24 hours.

Most people with RRMS eventually develop secondary progressive MS (SPMS). In this stage, you become increasingly disabled over time but still have flare ups and quiet periods as before.

More than half of all MS patients eventually see changes in their thinking. You might be slower to learn and remember new information, organize, solve problems, focus attention, and accurately perceive your environment. In the TV show, Bartlett plays chess every week with a colleague to monitor any cognitive declines.

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