Multiple Sclerosis Overview

Multiple Sclerosis Symptoms and Treatment

Cheryl Miller, severely disabled by multiple sclerosis, is given marijuana to chew by her husband Jim as they participate in a protest against anti-medicinal marijuana legislation in Washington, D.C.
Cheryl Miller, severely disabled by multiple sclerosis, is given marijuana to chew by her husband Jim as they participate in a protest against anti-medicinal marijuana legislation in Washington, D.C.

One of the most difficult things about living with multiple sclerosis is its wide range of varying symptoms. Some patients experience every symptom known to be associated with MS; some only experience a few. Some symptoms are chronic and result in permanent damage, while others come and go. While there is no cure, many of the symptoms can be managed through medication and different types of therapy. We'll look at some of the most common symptoms and their typical course of treatment.

Most MS patients experience some degree of fatigue. It tends to get worse over the course of a day and comes on suddenly. Doctors don't currently know why MS causes fatigue. Patients are often prescribed medications such as amantadine, as well as relaxation therapy, stress therapy, and physical therapy to learn energy-saving techniques for tasks like walking.

Vision problems are also very common; a patient may have blurry vision, double vision, tunnel vision, temporary episodes of blindness or severe eye pain. This can be the result of optic neuritis, or lesions on the optic nerves. Steroids can help the patient recover, and these vision problems tend to come and go on their own. MS patients don't usually go completely blind.

Many MS patients also experience numbness and tingling in different parts of the body, such as the arms and legs. If patients have facial numbness, they're advised to be very careful when eating because they can accidentally bite their cheeks or tongue. Doctors sometimes prescribe steroids for numbness as well, but it's another symptom that comes and goes. Some people with MS also experience dizziness and feel off-balance. To help with these symptoms, patients can take drugs for motion sickness, like Dramamine, or antinausea drugs, like Zofran.

MS can be physically painful. Patients can suffer from a number of different types of chronic and acute pain. One chronic type of pain is dysesthesia, which can be burning, itching, tingling and aching pain that some describe as feeling like an electric shock or acid on the skin. It can be treated with antidepressants, which change the central nervous system's reaction to pain. Dysesthesia can also be treated with anticonvulsant medication or nonmedicinal therapies like wearing a body stocking, which can make the pain feel more like pressure. Some patients experience acute pain such as stabbing facial pain, known as trigeminal neuralgia, which can also be treated with anticonvulsants.

Patients who have MS might also have difficulty walking, which can be caused by other common symptoms, such as fatigue, numbness and vertigo. Walking problems can also result from weak muscles or spasticity, which occurs when the muscles stiffen and contract involuntarily. Depending on the cause, medications can help. Some patients who have problems walking use canes or walkers, or must progress to scooters or wheelchairs as the disease worsens. Physical therapy can also help to stretch spastic muscles and teach ways of walking that compensate for the weakness.

Since MS originates in the central nervous system, it can also affect brain functions such as memory, organization, problem-solving and speech. While half of MS patients will develop some kind of problem with higher brain function, only 5 to 10 percent have severe impairment. [source: NMSS]. MS also affects the brain in other ways. Many patients become clinically depressed, either as a reaction to the disease or from the demyelinization. Depression can also be a side effect of some of the drugs prescribed to treat other symptoms.

In addition to treating the symptoms of MS, doctors also prescribe drugs to help slow the progress of relapsing forms of the disease and decrease its activity. These are known as disease-modifying agents. The FDA has currently approved five different drugs for this purpose: Avonex, Betaseron, Caopaxone, Novantroe, Rebif and Tysabri. These drugs either suppress or alter the immune system in some way, and all have different side effects, so which one gets prescribed depends entirely on the individual.